Mottled teeth in Oakley, Idaho, - Change of Water Supply

A new water supply for Oakley, Idaho

One of the most impressive events during McKay´s search for the cause of "mottled teeth" occurred in Oakley, Idaho. The dentist, who then lived and worked in New York City, was impressed for this was the first time in the history of dentistry that a water supply was changed solely for a dental aspect. Yet it´s some of the inhabitants and a caring Director of Public Health who deserve the highest respect for the responsible action taken to solve their problem.

The problem arose about 1908, when a pipe line was constructed from a thermal spring near Oakley and the water distributed in the usual way for domestic purposes (1). When the second set of teeth erupted in the children grown up there since then, they were "of a chalky appearance, apparently devoid of enamel, and later on showing brown spots upon the upper teeth which ultimately turn black and in a great many of the cases decay. The teeth are not well formed and aside of the hideousness of them, are of very little use to the children" (2).

The situation became so distressing that a group of public-spirited members of the Women´s Civic League asked the local dentist, a Dr. H. B. Smith, to undertake a survey of the public schools. The result of this examination was alarming and the attention of Dr. F. W. Almond, Director of Public Health of the State of Idaho, was called to the situation. In a letter directed to the Surgeon General, Almond wrote in 1923:

"I recently made an inspection of the schools in this village and found perhaps 400 of the 500 children attending to be affected with this bad condition of the teeth. The dentist reports that a burr applied to the teeth will go right through into the pulp with very little resistance.

I also observed that a great many of the children between the ages of 12 and 15 were bothered with enlarged thyroids, some of them being barely noticeable while others had assumed quite large proportions" (2).

Only those people using the city water were afflicted, while the families living on smaller private wells did not show this condition. Dr. George Walter McCoy (3), director of the Hygienic Laboratory, suggested in an internal memorandum to the Surgeon General, that this might be the same dental defect as first observed in Colorado Springs and described by Drs. McKay and Black in 1916. Thus, a summary of the work of these dentists, compiled in a USPHS publication by Dr. F. C. Smith (4) was included in the PHS reply to Almond, along with copies of some articles published by McKay; nothing was known yet about the causative factor. While some facts indicated that the cause might be in the composition of the water used, there was no consistent variation in one of the components usually checked by analysis to account for the condition (3). Doubt was raised that simple aeration, as proposed (5) by the Secretary, Oakley Warm Springs Water Company, would help to overcome the trouble (6). Experiments carried out in the Idaho Department of Public Health with guinea pigs, to which the suspected water was given to possibly reproduce the staining effects seen in humans, were to no avail (1).

In August 1924, McKay was on vacation in Colorado Springs when the health officer of that city, Omar R. Gillette, called his attention to a communication received by him from Oakley, concerning the occurrence of the familiar lesion. In the meantime, the Women´s Civic League had placed before the citizens a campaign to bond the community to the amount of $35,000 to discard the present water supply and to have a new supply from a different source substituted. Because of considerable opposition even among prominent and influential citizens, McKay was invited to address a mass meeting on the evening preceeding the election. He was able to convince a majority "that they had not the ethical right as parents and citizens to unload this blight upon the present generation of children of the community nor upon generations yet unborn, and at the election the bond issue was indorsed and ordered by a gratifying majority" (1). As to a proper substitute, the most valuable and conclusive evidence that could be obtained would be to locate individuals who had spent the years of enamel development in contact with a contemplated source of new supply.

As was shown years later, Oakley made a good choice. On a re-examination, in February 1933, McKay found "that. after the change in the water, there had been no new cases of mottled enamel, and this fact naturally made a profound impression on the citizens of the community. A rather spectacular demonstration of this character probably did more to reveal the importance of dentistry to the community than would have been possible through years of dental service of the ordinary type, and it was a fortunate circumstance that Dr. McKay had the vision early in his experience with this affection, and was able to save the children of the community from future deformity of this character, a deformity sufficiently conspicuous and disfiguring to make it almost a public calamity" (7).

References:

(1) McKay F. S.: "Mottled enamel: a fundamental problem in dentistry", Dental Cosmos 67 (1925) 847; (2) F. W. Almond, M.D., Director Public Health Service of the State of Idaho, to Surgeon General, Nov. 5, 1923, in the H. T. Dean papers, History of Medicine Division, Natl. Library of Medicine, Bethesda, (hereafter referred to as H. T. Dean papers); (3) G. W. McCoy to Surgeon General, Nov. 28, 1923, in the H. T. Dean papers; (4) Smith F. C.: "Mottled enamel and brown stain", Publ. Health Rep. 31 (1916) 2915; (5) C. A. Zaner to Bureau of Chemistry, May 7, 1924, in the H. T. Dean papers; (6) McCoy to Zaner, Aug. 1, 1924, in the H. T. Dean papers; (7) Editorial: "The value of dental research to the community", J.Am. Dent. Ass. 20 (1933) 1281;

HOME