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January 13, 1940


JAMA. 1940;114(2):179. doi:10.1001/jama.1940.02810020083025

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To the Editor:—  Lest a favorable verdict be found for the caries-preventing influence of fluoride in drinking water before fore sufficient evidence on the point has been accumulated, I would like to sound a note of caution. Dean and his co-workers did sound a faint warning in the report on their Illinois study (Pub. Health Rep.54:862 [May 26] 1939), and in The Journal editorial, September 16, page 1132, the reader was again cautioned that some water constituent other than fluoride might possibly be the caries-inhibiting agent. So far as human caries statistics are concerned, no greater importance can be attached to the fluorine content of drinking water than to its total hardness. In 1937 I pointed out an inverse relationship between the incidence of caries and the hardness of drinking water in some seventy-five American cities (J. Dent. Research16:417 [Oct.] 1937) and the observations of Dean

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