Fluoride, Teeth and Health: a report of the Royal College of Physicians (1976)

In 1976, the Royal College of Physicians (RCP) published a landmark report reviewing the available evidence from around the world on the health effects of water fluoridation. (1)

As well as confirming the dental benefits of this public health initiative, the experts who conducted the review – including RCP president Sir Cyril Clarke, Sir Richard Doll and Sir Melville Arnott – found that:

  • There is no evidence that the prevalence of any musculo-skeletal conditions is increased in areas with fluoride at a concentration of 1 mg per litre in water.

  • There is no evidence that the incidence or mortality of any renal disorder is increased by fluoride in water at a concentration of 1 mg/litre.

  • There is no evidence that fluoride increases the incidence or mortality of cancer in any organ.

  • There is no evidence that the incidence of congenital malformations is increased by fluoride.

  • There is no evidence that fluoride is responsible for any disorder of the thyroid.

  • There is no evidence that allergies can be caused by 1mg/litre of fluoride in water.

Naturally fluoridated water drunk for generations by millions of people with no evidence of harmful effects on health

In their conclusions, the RCP team observed that water containing 1 mg/litre of naturally occurring fluoride had been drunk for generations by millions of people, and that the introduction of water fluoridation schemes since the mid-1940s had added millions more to the total.

This, they said, had led to an enormous body of information on fluoride and health which, in their view, amply justified the following conclusions:

  • Fluoride in water added or naturally present at a level of approximately 1 mg/litre over the years of tooth formation substantially reduces dental caries throughout life.

  • There is no evidence that the consumption of water containing approximately
    1 mg/litre of fluoride in a temperate climate is associated with any harmful effect irrespective of the hardness of the water.

  • In comparison with fluoridation, systemic fluoride supplements such as tablets, drops and fluoridated salt have not been shown to be as effective on a community basis.

  • There is no evidence that fluoridation has any harmful environmental effect.

1. Fluoride,.Teeth and Health (1976). A Report of the Royal College of Physicians

REPLICATING THE BENEFITS OF NATURALLY OCCURRING FLUORIDE IN WATER AT 1 mg/litre

“The purpose of fluoridation is not to administer a specific dose to each person in the population but to replicate the beneficial effects observed in communities that receive water with naturally present fluoride at a concentration of 1 mg/litre.”

RECOMMENDATION ARISING OUT OF THE RCP REPORT

“The College recommends fluoridation
of public water supplies in the United Kingdom where the fluoride level is appreciably below 1 mg per litre.”