Jill Wrapson

Artificial Fluoridation of Public Water Supplies in New Zealand: 'Magic Bullet,' Rat Poison, or Communist Plot?^*

Dental caries has been and continues to be a major and costly public health problem throughout much of the world. Artificial fluoridation of the public water supply has been regarded globally by many public health officials as a major revolutionary advance in the fight against tooth decay. However, to the doubters, the practice of fluoridation is perhaps the most contentious of public health measures. This paper examines the concerns of the various pro- and antifluoridation lobby groups involved in the fluoridation debate in New Zealand in the early 1950s.

Fluoridation of the public water supply has been hailed the 'longest running technical controversy in the public eye.' ¹ Regarded globally by many health professionals, governments and citizens alike as the 'magic bullet' in the fight against tooth decay, fluoridated water has been described as a 'remedy supplied by nature in some parts of our nation and applied by human ingenuity in others.' ² To sceptics, however, artificial fluoridation has meant loss of liberty, enforced mass medication, a hidden danger worse than the disease it is supposed to help, or the means by which to impose communism upon a docile nation. As with other countries that have adopted this measure, fluoridation of the water supply has led to extensive debates in New Zealand.

Fluoridation involves raising the natural fluoride level of a public water supply by artificial means to a scientifically determined optimal concentration, for the purpose of assisting in the protection of teeth against dental caries. The advocates of fluoridation consider it the most effective way of improving the dental health of whole communities irrespective of socio–economic status, poor dental health having long been a major and costly public health problem throughout much of the world.

Public health, so highly regarded in the early- to mid-twentieth century as a tool in improving the quality of life of a population, ³ was an important facet of early New Zealand social policy. ⁴ One matter of concern was that of dental health. In New Zealand, whilst Maori appear to have been virtually immune to dental decay before the arrival of the European, ⁵ that 'superior dental status' changed with the advent of European-influenced living. ⁶ Sir Truby King, founder of the Royal New Zealand Society for the Health of Women and Children, popularly known as the Plunket Society, noted in the 1930s that '[d]ecay of the teeth is not a mere chance unfortunate disability of the day—it is the most urgent and gravest of all diseases of our time—a more serious national scourge than Cancer or Consumption.' ⁷

Dental caries has a number of ramifications for human health generally, including making it difficult to chew, swallow, and digest food properly. In addition it leads to bacterial infections, the inability to speak properly, changed facial appearance, and, as a consequence, mental health issues. ⁸ The New Zealand School Dental Service, established following World War I, ⁹ was one of the Department of Health's early primary weapons in the fight against tooth decay. Unable to provide the coverage needed to ensure healthy teeth in all the nation's schoolchildren, ¹⁰ educational initiatives were put into place as well. Posters were produced advising the population how to care for their teeth (Figures 1, 2, and 3). Nevertheless, despite concern having been voiced for over fifty years, and notwithstanding the efforts of the Department of Health, dental health in the early 1950s was still extremely poor. The overall situation was such that Dr H.B. Turbott, Deputy Director, later Director, of the Department of Health described the state of teeth of the general population in New Zealand as 'appalling.' ¹¹ Help was, however, soon to be forthcoming. At the time of Turbott's comment, New Zealand was reaching the end of a long road toward the establishment of water fluoridation—a road begun before the turn of the twentieth century.

Figures 1-3: Department of Health Leaflet circa 1940-1950, Robinson Collection NZMS 822, Box 147, Item 335.1, Auckland Central Library Special Collections, Auckland. Reproduced with permission from Special Collections, Auckland City Libraries, Auckland, N.Z.

The rise of water fluoridation in New Zealand

Although often regarded as a twentieth century solution, the benefits of fluoride in relation to dental health had been proposed in the nineteenth century. Sir James Crichton-Browne, a physician with a strong interest in child health issues, writing in the Lancet in 1892, commented that due to a changing diet in which fluoride was not so readily available,

it is not difficult to understand how we may have thereby incurred comparatively feeble and unprotected teeth. I think it well worthy of consideration whether the reintroduction ... of fluorine in some suitable natural form ... might not do something to fortify the teeth of the next generation. ¹²

As early as 1902 a Danish fluoridation pamphlet recommended calcium fluoride be taken daily for healthy teeth. ¹³ The major breakthrough with regard to the benefits of fluoride took place, however, in the United States. Studies of a dental condition known as 'Colorado Brown Stain' in people whose teeth were otherwise particularly resistant to decay, led researchers to the conclusion that levels of fluoride in the water supply of around only one part per million were in fact highly beneficial to the dental health of populations. ¹⁴ In various parts of the world, the potable water supply naturally contains fluoride in just such concentrations. For generations, people living in those areas have lived normal, healthy lives, with the added benefit that the incidence of dental decay has been shown to be markedly less than in communities with naturally low levels of fluoride in the water. ¹⁵

In New Zealand the fluoride content of potable water supplies is well below the level required to benefit human teeth. ¹⁶ Nutritional scientist Dr Muriel Bell's ¹⁷ work since the 1920s led her to believe that a deficiency of fluoride and another nutrient, iodine, led to the 'widespread disorder of human health.' ¹⁸ Whilst a marked and highly successful reduction in the incidence of goitre in New Zealand was achieved ultimately by a combination of adding iodine to domestic salt and the introduction of an education programme, the reduction of dental caries was to be far more controversial.

Although the United States led investigations into the benefits of fluoride, New Zealand was undertaking its own research and, by 1947, New Zealand researchers had come to regard the most important source of fluoride as being in the water supply. ¹⁹ New Zealand researchers also recognised that 'to wait passively for the results of overseas workers is a weak and sterile attitude because even if it is successful overseas, it will still have to be tried for New Zealand, where conditions are not necessarily the same.' ²⁰ New Zealand scientists, along with their overseas counterparts, investigated a wide range of issues relating to the possible use of fluoride in the fight to enhance the protection of teeth against dental caries. Scientific concerns under investigation included the best source of fluoride, fluoride content in existence in everyday foods, possible detrimental effects on the body's tissues and organs, excretion, and toxicity. ²¹

The Nutrition Research Department in New Zealand did make available fluoride solutions and, later, fluoride tablets, to those members of the public who wished to protect their children's teeth from decay. ²² It was, however, to be the early 1950s before any substantial numbers of people received fluoride treatment—by which time fluoridation of the public water supply had begun in Hastings, ²³ heralding the start of the fluoridation controversy in New Zealand.

Convinced by Muriel Bell's assessment of the scientific data, to New Zealand scientists, dentists, and the Department of Health, fluoridation appeared—in the light of current knowledge—to offer 'the only counter to the inability of our people generally to practise that dental cleanliness and follow that dietary pattern which make for dental health.' ²⁴ The Hastings 'experiment,' as it was called when it began in 1953, was intended to be a ten-year project, with Napier acting as the control city. ²⁵ Initially the scheme appeared to excite little public opposition and seemed to receive the approbation of the press, despite New Zealand being only the second country in the world to introduce artificial fluoridation into the public water supply.

However, as the experiment progressed, resistance grew, ²⁶ and fluoridation began to be viewed with great misgivings by an increasingly vocal sector of the population. Questions were asked in Parliament as to whether legislation for compulsory fluoridation was being considered. ²⁷ Although the answer was in the negative, mounting hostility to fluoridation and the possibility of a referendum in Hastings due to a change of Council, together with a desire by the profluoridationists to avoid such a referendum in favour of a public inquiry, ²⁸ led to the appointment of a Commission of Inquiry, with hearings held in Hastings and other main centres from 1956 to 1957. The remit of the Commission was to consider the benefits and possible health dangers of water fluoridation, whether there were other methods of providing fluoride, and whether local councils should make the decision to fluoridate or not on behalf of residents. ²⁹ The submissions to that Commission of Inquiry illustrate the broad cross-section of New Zealand society involved in the debate, and their qualms reveal much about the more extensive concerns of the day. They also exemplify the polarised positions that had developed in the three years since the introduction of fluoridation. ³⁰

The fluoridation debate

The emergence of two clear sides to the debate surrounding water fluoridation in New Zealand occurred against a backdrop of influential developments in politics and science on both local and international fronts. The 1950s in New Zealand saw a continuation of those 'cradle to the grave' social policies, ³¹ such as old-age pensions, state housing, school milk, and the school dental service which had been implemented in the first half of the twentieth century and represented many of Labour's welfare state policies. ³² Nevertheless, despite the government taking some degree of responsibility for the welfare of the population in many spheres, the refusal to legislate for fluoridation reveals that the prevailing attitude in this young nation was one of democracy, not coercion. ³³

On a larger scale, despite New Zealand's geographical isolation, the nation was unable to distance itself from world events. The 1950s saw the rise of the Eastern Bloc, the invasion of Hungary, the effects of the Cold War and also McCarthyism. New Zealand was not immune to the fears associated with this political environment, as evidenced—and possibly fostered—by extensive media coverage. Equally, scientific developments such as radiation, which could be used to either benefit or destroy humankind, also received widespread news treatment in New Zealand, especially because of this country's proximity to nuclear testing in the Pacific.

Given this broad climate of change and contrast within which fluoridation was introduced to New Zealand, it is not surprising that the ensuing debate involved quite a complex array of both players and arguments. Although the pro- and antifluoridationists who entered the debate were, relatively speaking, small in number, their voices were significant. Those in favour of fluoridation included the powerful, paternalistic, and male-dominated dental and medical professions. ³⁴ Profluoridation women were represented by, amongst others, the Home Science Alumnae and the Plunket Society. The Junior Chamber of Commerce, popularly known as the Jaycees, offered a platform to young men—often professionals or businessmen, and many married with young families—who worked, according to one Medical Officer of Health, 'by every means at their disposal [to] combat false, misleading and sometimes scaremongering publicity disseminated by opponents of fluoridation.' ³⁵ At the Commission's Auckland hearing, the Jaycees aligned the benefits of fluoridation with a number of health measures that had already been implemented to benefit the population at large. ³⁶

Antifluoridationists included amongst their numbers a few dissenting members of the dental and medical professions. ³⁷ Societies dedicated solely to the antifluoridation cause had begun to spring up in various parts of the country. The antifluoridation lobby also found a voice through a wide range of New Zealand organisations in existence at that time. Whilst New Zealand has been portrayed as the 'quarter-acre pavlova paradise,' complete with a conformist, homogenised society, ³⁸ in reality the nation consisted of a diverse population, with an equally diverse range of organisations giving expression to their interests and concerns. Despite their individual aims and objectives, coming together against the fluoridation of public water supplies were organisations such as the NZ Vegetarian Society, the Theosophical Order of Service, the British Israel World Federation, the British Union of Abolition of Vivisection, the NZ Association of Naturopaths, the NZ Homeopathic Society, the Natural Health Crusade, and the Crusade for Social Justice. Women, in this pre–feminist era, were not bereft of a stage from which to canvass against fluoridation, the Auckland Women's Union and the Housewives' Association providing just such fora.

Reasons for opposing fluoridation varied. In Hastings, some objected on the grounds of being the subject of experimentation. In the minds of others, fluoridation was linked with scientific discoveries such as chlorine gas, used as an early means of chemical warfare in World War I. ³⁹ Yet others linked fluoridation with insect or rat poison, ⁴⁰ a common constituent of which was sodium fluoride—the compound used to artificially fluoridate public water supplies. Also there were objections to fluoridation made on religious grounds: 'Water should be pure and free from adulteration as God made it.' ⁴¹ A further argument put forward blamed diet for poor dental health: 'the water has nothing to do with dental troubles which are mainly due to inferior bread.' ⁴² This attitude was supported by the Theosophical Society, which voiced the opinion that '[f]luoridation condones the bad eating habits of the people.... It seeks to make it possible for people to continue breaking the laws of health.' ⁴³ Clearly, the populace was not wholly convinced of the scientific benefits of fluoridation, despite the assurances of health professionals.

For many, the issue was not about the effectiveness or otherwise of fluoridation at all, but about freedom. The Hastings Anti-Fluoridation Committee stated:

For as long as our history remembers, British people have held the right to accept or reject all forms of medical treatment as free individuals, and they have handed on that right to succeeding generations. They may have made mistakes, but they have stayed free. The question now is, are we New Zealanders going to put an end to all that? ⁴⁴

Similarly, a correspondent wrote:

I am not discussing the question whether the use of fluorides is harmful or good. What terrifies me is the relentless march of bureaucracy in imposing its will on the people. Bureaucracy has won the pasteurised milk battle in a number of cities.... I am alarmed at the insidious way that our liberties are being filched from us. Must we be a Slave state as well as a Welfare state? ⁴⁵

For yet others, the fluoridation of water supplies was linked to the Communist threat—a potent tool used by antifluoridationists in America. ⁴⁶ 'Reds,' it was even feared by the government of the time, might be lurking in New Zealand and the country's Communist Party, small as it was, was scrutinised excessively as to its membership and for the possibility of revolutionary activities generally. ⁴⁷ One leaflet issued in New Zealand was headed 'Ex-Communist's Testimony.' Reprinted from an American publication, it included a sworn statement by a former member of the Communist Party who apparently attended Communist underground training schools outside the city of New York:

We discussed quite thoroughly the fluoridation of water supplies and how we were using it in Russia as a tranquilizer in the prison camps. The leaders of our school felt that if it could be induced into the American water supply, it would bring about a spirit of lethargy in the nation; where it would keep the general public docile during a steady encroachment of Communism. We also discussed the fact that keeping a store of deadly fluoride near the water reservoir would be advantageous during the time of the revolution, as it would give us opportunity to dump this poison into the water supply and either kill off the populace or threaten them with liquidation, so that they would surrender to obtain fresh water. ⁴⁸

One of the few physicians in New Zealand to speak out against fluoridation was Dr Eva Hill, who was so convinced of the detrimental effects of fluoridation on health that she published her own pamphlet (Figure 4), also linking fluoridated water with both poison and communism. ⁴⁹

Figure 4: Front cover, 'Facts about Fluoridation of Water Supplies', Eva Hill, E. Hill, Auckland, 1955. Reproduced with permission from Special Collections, Auckland City Libraries, Auckland, N.Z.

The attitudes and language of the opposing factions reflected much about each group and how each thought of their opponents. The majority of the dental and medical professions appeared convinced by the scientific data and were concerned at the 'unscientific or anti-scientific attitude' certain members of the public took towards the opinions of scientists. ⁵⁰ According to one Medical Officer of Health, Derek Taylor (later to become head of the World Health Organisation's Health Education Unit based in Geneva), in the early days of fluoridation it was:

understandable ... why supporters of fluoridation in Hastings did not wage a large scale educational campaign in the town. They relied upon the good sense of their fellow citizens to accept what to them seemed a straightforward advance in preventive medicine and preventive dentistry. ⁵¹

Derek Taylor was unequivocal in expressing his lack of respect for the opponents of fluoridation. He described them as coming from

the same sources which opposed such public health measures as vaccination, pasteurisation and chlorination in the past, being various religious groups, diet 'cranks' and the like. ... [T]heir propaganda has been sufficiently frightening to enlist a number of 'ordinary' citizens to their ranks. ... [H]ad the local authorities [in Hastings and Havelock North] not been strong minded and had a commendable sense of public duty fluoridation in Hastings and therefore in New Zealand could have been delayed for a generation or more. ⁵²

Equally candidly, a Department of Health pamphlet stated that '[o]pposition to such a measure means nothing else than condoning a state of ill-health—a totally indefensible attitude on moral grounds alone.' ⁵³

On the whole, to the antis, the pros were 'authoritarian,' 'undemocratic,' or 'totalitarian' in outlook. ⁵⁴ Antifluoridationists were rather more pro-active in attempting to win the public over to their side, constantly using significantly more powerful or, as profluoridationists termed them, 'scaremongering' turns of phrase. ⁵⁵

Nevertheless, despite well-orchestrated presentations by the antifluoridationists, the 1957 Commission of Inquiry found in favour of fluoridation, stating that 'widespread use should be made of the fluoridation process for the purpose of achieving an urgently needed improvement in the present serious state of dental health in New Zealand.' ⁵⁶

Conclusion

That the antifluoridationists lost this initial battle is perhaps unsurprising. To the Commissioners, those supporters who gave evidence were generally regarded as being eminent within the dental, medical, and scientific fields; their evidence was judged as being based on scientific facts, and their conclusions based on reasoning and logic. ⁵⁷ In contrast, many opponents were clearly considered lay witnesses and, whilst carefully emphasising that due weight had been given to their arguments, ⁵⁸ the evidence of some antifluoridationists was obviously considered unreliable by the commissioners during the Inquiry. ⁵⁹ Nevertheless, this loss did not dissuade the anti-fluoridationists. Despite acceptance by the government of the commission's recommendations, it was left to individual local authorities to instigate water fluoridation, albeit with the encouragement of the Department of Health. By the late 1950s the fluoridation battle lines in New Zealand had been firmly drawn, the polarised stands of the proponents and opponents due to remain entrenched in the decades ahead as local communities throughout the country debated, and continue to vigorously debate to the present day, the merits or otherwise of whether or not to fluoridate local water supplies.

University of Auckland

Acknowledgements

I would like to thank Associate Professor Linda Bryder for her initial encouragement in the writing of this paper and Dr Derek Dow for his helpful comments. As well, I should like to express my appreciation to the two anonymous reviewers for their constructive criticism and to the editors of Health & History.

Notes

^* A previous version of this article received the prize for the best student paper presented at the Australian (now 'and New Zealand') Society of the History of Medicine at the meeting in Auckland in February 2005. A prize will be awarded at future conferences of the Society as the Ben Haneman Memorial Student Prize.

^1. Allan Mazur, "Looking Back at Fluoridation," Risk: Health, Safety & Environment 12 (2001): 59–65.

^2. D. Schultz, "Fluoride," FDA Consumer 26, no. 1 (1992): 34–8.

^3. Edwin "Ted" Pratt, Jr., Raymond D. Rawson, and Mark Rubin, "Fluoridation at Fifty: What Have We Learned?" The Journal of Law, Medicine & Ethics 30, no. 3 (2002): 117–21.

^4. The Public Health Act came into being in New Zealand in 1900.

^5. Marion F. Harrison, "Fluorine Content of New Zealand Teeth," The New Zealand Dental Journal 45, no. 219 (1949): 2–27.

^6. Derek Dow, "Driving Their Own Health Canoe: Maori and Health Research," in Past Judgement: Social Policy in New Zealand, edited by Bronwyn Dalley and Margaret Tennant (Dunedin: University of Otago Press, 2004), 94.

^7. Sir F. Truby King, The Story of the Teeth and How to Save Them (Auckland, Christchurch, Dunedin, Wellington, Melbourne, Sydney, and London: Whitcombe & Tombs, 1935), 7.

^8. World Health Organisation, Fifty Years of WHO in the Western Pacific Region: Report of the Regional Director to the Regional Committee for the Western Pacific (Manila: WHO Regional Office for the Western Pacific, 1998). There would have been few families in New Zealand where a family member did not suffer the ignominy and misery arising from the wearing of, often ill-fitting, dentures. The Department of Health issued a series of posters during the 1940s promoting healthy teeth and warning of the loss of looks and the broad range of health issues arising from dental problems, as well as admonishing the public with regard to the high proportion of dentures worn in New Zealand. See Department of Health leaflets "Look after your TEETH!," and "Preserve your Teeth and STAY HEALTHY!," Health Department Leaflets circa 1940s–1950s, Robinson Collection NZMS 822, Box 147, Item 335.1, Auckland Central Library Special Collections (hereafter ACLSC), Auckland.

^9. G.H. Leslie, "Growth of the School Dental Service in New Zealand," Health 10, no. 3 (1958): 15.

^10. Appendices to the Journals of the House of Representatives (hereafter AJHR) (1956): B-5, 55.

^11. "H.B. Turbott (Department of Health) to the town clerk, Auckland City Council, 29 April 1958," Fluoridation Correspondence 4/50 – 1959, Robinson Collection NZMS 822, Box 129, Item 281.3, ACLSC, Auckland.

^12. Sir James Crichton-Browne, "An Address on Tooth Culture: Delivered at the Annual Meeting of the Eastern Counties Branch of the British Dental Association at Cambridge on June 22nd, 1892," Lancet 140, no. 3592 (1892): 6–10. There is an intriguing link between New Zealand and the highly respected and frequently-published physician Sir James Crichton-Browne. Fellow Scotsman and immigrant to New Zealand, Dr James Mason, became New Zealand's first Chief Health Officer, corresponding with Crichton-Browne over the years. Both Mason and Truby King appear to have been influenced by Crichton-Browne in the area of child health. See D. Dow, "Biography at Odds With Advocate's Life," Doctor 27, August (2003): 40.

^13. J.J. Pindborg, "En Dansk Fluorideringspjece fra 1902," Tandlaegebladet (Denmark) 69, no. 7 (1965): 557–61.

^14. 'Colorado Brown Stain' was also known as 'dental mottling' and gradually after 1932 was re-named 'dental fluorosis.' 'Mottling,' or 'fluorosis,' was first recorded in 1901–1902 in America, and in areas where heavy dental mottling existed it was a cause for concern due to the unsightly nature of the condition. It was not until 1931–32. that this mottling was linked to fluoride occurring naturally at high levels in local water supplies. It was to be another five years before Dr H. Trendley Dean developed the hypothesis that mottled enamel was more resistant to decay than sound enamel. Further developments led to the conclusion that there existed an optimum amount of fluoride in the water, naturally or by artificial means, that would effectively reduce tooth decay. Following field trials, the United States Public Health Service endorsed artificial water fluoridation in 1950. See Donald R. McNeil, The Fight for Fluoridation (New York: Oxford University Press, 1957), 4, 27, 38–39, 40, 183.

^15. It should be noted, however, that along with dental fluorosis, a condition known as skeletal fluorosis is known to arise in various parts of the world where high concentrations of fluoride occur naturally in the water. See H.E. Shortt, G.R. McRobert, and T.W. Barnard, "Endemic Fluorosis in the Madras Presidency," Indian Journal of Medical Research 25, no. 2 (1937): 553–68. Whilst the role of malnutrition was significant in that particular study, it was not a factor in an American study which investigated the effects of fluoride in human bones and which found that ingesting naturally fluoridated water of up to eight parts per million produced no harmful bone changes. See N.C. Leone, et al., "A Roentgenologic Study of the Human Population Exposed to High-Fluoride Domestic Water: A Ten-Year Study," American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine 74, November (1955): 874–85.

^16. New Zealand Dental Association, Fluoridation: Question and Answer (Dunedin: John McIndoe, 1956), 4.

^17. J.R. Robinson, "Obituary: Muriel Emma Bell," New Zealand Medical Journal 79, no. 518 (1974): 1082–3. Dr Muriel Bell's esteemed career included her work as nutritionist to the Department of Health, foundation member of the Medical Research Council of New Zealand, chairman of the Nutrition Research Committee, and member of the Dental Research Committee.

^18. Muriel E. Bell, Nutrition in New Zealand: Forty Years' History, 1920–60 (Dunedin: John McIndoe Ltd, 1962), 4.

^19. Marion F. Harrison and Muriel E. Bell, "Nutritional Factors Affecting the Teeth," New Zealand Dental Journal 43, no. 211 (1947): 5–34.

^20. Harrison and Bell, 32.

^21. Ibid., 17–32.

^22. Bell, 9.

^23. Ibid., 9.

^24. AJHR (1960): H-31, 8.

^25. AJHR (1953): H-31, 54. This experiment, or study, was instigated by the Hawke's Bay Branch of the New Zealand Dental Association, which approached the local borough council for support. That Council in turn approached the minister of Health who agreed to finance a pilot scheme for New Zealand, with Napier acting as the control town. See Derek Taylor, "Fluoridation comes to Hastings," New Zealand Medical Journal 54, no. 299 (1955): 23–4. The project had the co-operation of the Medical Research Council and the Department of Scientific and Industrial Research, and was designed to 'ascertain whether under New Zealand conditions there is the same significant reduction in the incidence of dental caries as is reported from some other countries.' See AJHR (1953): H-31 54.

^26. Taylor, "Fluoridation comes to Hastings," 24.

^27. New Zealand Parliamentary Debates (hereafter NZPD) 22 (1956): 1508–9.

^28. "Fuller to New Zealand Dental Association, 23 July 1956," Colonel J. Ferris Fuller, MS-Papers-6670-65, Alexander Turnbull Library, Wellington.

^29. W.F. Stilwell, Report of the Commission of Inquiry on the Fluoridation of Public Water Supplies (Wellington: R.E. Owen, 1957), 7.

^30. Stilwell, 200–4.

^31. Linda Bryder, "'Plunket's Secret Army': The Royal New Zealand Plunket Society and the State," in Past Judgement and Social Policy in New Zealand History, edited by Bronwyn Dalley and Margaret Tenannt (Dunedin: University of Otago Press, 2004), 109.

^32. Margaret Tennant, "History and Social Policy: Perspectives from the Past," in Past Judgement and Social Policy in New Zealand History, edited by Bronwyn Dalley and Margaret Tenannt (Dunedin: University of Otago Press, 2004), 9.

^33. Derek Dow, Safeguarding the Public Health: A History of the New Zealand Department of Health (Wellington: Victoria University Press, 1995), 189. Initially at least, education and persuasion—rather than compulsion—tended to be the preferred modus operandi of the Department of Health with regard to major health issues. As discussed in Dow (1995), this is reflected in a number of health issues including hydatid disease, the introduction of iodised salt for goitre, and immunisation.

^34. Between 1950 and 1959 only nine women graduated with a Bachelor of Dental Surgery in New Zealand. See A.R.C. Pack, "Women in New Zealand Dentistry," New Zealand Dental Journal 77, January (1981): 19–25. The power of the dental profession to influence the government can be seen from the correspondence of Colonel J. Ferris Fuller, a member of the New Zealand Dental Association, Director of the Dental Services of the Armed Forces of New Zealand, and member of the Fluoridation Committee of the Department of Health. In his correspondence Fuller even went so far as to propose to the Minister of Health names for the members of the Commission of Inquiry. See "Fuller to New Zealand Dental Association 9 March 1956 and 23 July 1956," Colonel J. Ferris Fuller, MS-Papers-6670-65, Alexander Turnbull Library, Wellington.

^35. Taylor, "Fluoridation comes to Hastings," 26.

^36. "Melville Leslie Tronson, president, Auckland Junior Chamber of Commerce, speaking on 6 December 1956 at the Commission of Inquiry, Auckland," BAAK, A43/5a, Archives New Zealand, Auckland.

^37. Stilwell, 24, 72.

^38. Austin Mitchell, The Half-Gallon Quarter-Acre Pavlova Paradise (Christchurch: Whitcombe & Tombs, 1972), 20.

^39. Hastings Anti-Fluoridation Society, Results of Fluoridation Told by the People of Hastings (Hastings: The Pelorus Press Limited, 1958), np.

^40. John Barrett, Cancer and Cure: A Doctor's Story (London: Bachman & Turner, 1976), 11.

^41. Taylor, "Fluoridation comes to Hastings," 24.

^42. Taylor, "Fluoridation comes to Hastings," 24.

^43. "M. Stroobant, director, The Theosophical Order of Service in New Zealand, to the mayor and city councillors, City of Auckland, 8 March 1955," Fluoridation Correspondence (Unfiled) 1950–80, Robinson Collection NZMS 822, Box 129, Item 281.3, ACLSC, Auckland.

^44. Hastings Anti-Fluoridation Committee, "The Fluoridation Report Answered," nd, Fluoridation Correspondence (Unfiled) nd, Robinson Collection NZMS 822, Box 129, Item 281.4, ACLSC, Auckland.

^45. D.S. Milne, "Correspondence: Fluoridation of Water," letter to the Editor, New Zealand Medical Journal 54, June (1955): 393.

^46. Within America, the threat of communism was illustrated in articles such as "Catholic Weekly Criticises Fluoridation Foes," Journal of the American Dental Association 49, no. 2 (1954): 249 ; and Donald R. McNeil, The Fight for Fluoridation (New York: Oxford University Press, 1957), chapters VI–X.

^47. Matthew Wright, Reed Illustrated History of New Zealand (Auckland: Reed Publishing (NZ) Ltd, 2004), 387.

^48. Fluoridation: Ex-Communist's Testimony (Lower Hutt: Everard Press, 1957), Robinson Collection NZMS 822, Box 132, Item 286.1, ACLSC, Auckland.

^49. Eva Hill, Facts about Fluoridation of Water Supplies (Aukland: E. Hill, 1955). In correspondence with Mr. D.M. Robinson, mayor of Auckland, Dr. Hill also expresses her concern at the "possible subversive intent" relative to fluoridation of the public water supply. See "Hill to Robinson, 18 February 1955," Fluoridation Correspondence (unfiled) nd, Robinson Collection NZMS 822, Box 129, Item 281.3, ACLSC, Auckland.

^50. C.N. Derek Taylor, "Health Education Aspects of Fluoridation in New Zealand: Some Problems Involved," New Zealand Medical Journal 56, August (1957): 321–25, 321.

^51. Taylor, "Health Education," 322.

^52. Taylor, "Fluoridation comes to Hastings," 23.

^53. Department of Health, "Fluoridation and Dental Health, Pamphlet No. 90, Wellington, 1957," Robinson Collection NZMS 822, Box 131, Item 284.1, ACLSC, Auckland.

^54. D.M. Robinson, "Recording of Public Meeting in Lower Hutt, 30 April, 1958," Robinson Collection NZMS 822, Box 59, Item 140.21, ACLSC, Auckland.

^55. "F.S. McLean, director, Division of Public Hygiene, Department of Health, speaking at the Commission of Inquiry, Hastings, November 1956," BAAK, A43/4a, 1N1, Archives New Zealand, Auckland.

^56. Stilwell, 152.

^57. Ibid., 15.

^58. Ibid., 15.

^59. Ibid., for example, 31, 39, 57, 99, 105, 117.

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