Plan of the studyFluoride is present, naturally, in almost all water supplies, usually in trace amounts, but in many parts of the United States it occurs in concentrations of between 1.0 and 8.0 p.p.m. It was in that country that most of the earlier research into its effect on dental conditions was done and that the beneficial effect of relatively low levels of fluoride in the drinking water was first demonstrated. As a logical extension of that research the idea was conceived of adding fluoride to some water supplies to see if the same beneficial effect could be obtained; accordingly in 1945 controlled fluoridation studies were set u p in two areas in the United States and in one in Canada.Fluoride was added to the water supplies in these areas to give a concentration of from 1.0 to 1-2 p.p.m., the level which epidemiological studies had shown to give maximum protection to the teeth without causing enamel mottling. T h e studies were planned to last for at least 10 years so that the effect of fluoridation during the whole period of development and calcification could be assessed on both the deciduous and permanent dentitions. Interest in fluoridation was aroused in this country by the results achieved in these studies after even 5 years. A mission was sent by the British Government to study fluoridation in operation and to assess its effectiveness, safety and practicability. T h e mission reported favourably (Ministry of Health, Department of Health for Scotland, Ministry of Housing and Local Government, 1953) but recommended that, before the general adoption of fluoridation, its effect should be demonstrated in a few selected areas in the United Kingdom. Accordingly studies were begun in 1955-6 in three areas in the United Kingdom.
Selection of areasThe areas selected were: Watford in England, Kilmarnock in Scotland, and part of the county of Anglesey in North Wales. Three comparable areas were selected also, to serve as controls: Sutton, the town of Ayr and the remainder of the county of Anglesey respectively.T h e main criteria for the selection of areas were that ( I ) the population should be large enough to provide adequate samples of children; (2) the study area and its associated control area should be situated near to each other and be of the same character; (3) the pairs of study and control areas should be in different parts of the country so that the effect of fluoridation could be assessed in different environmental and dietary conditions; (4) the water supplies of each study area and of its control area should if possible be from the same geological sources and undergo the same https://www.cambridge.org/core/terms. https://doi
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