Fluoride in the Water and the Paranoid Style in New York City Politics
By Matthew Vaz
“Fluoridation of municipal water supplies has been catnip for cranks of all kinds,” offered historian Richard Hofstadter in his legendary 1964 essay “The Paranoid Style in American Politics.” He conceded that perhaps one day evidence would emerge of the harmful effects of fluoridation, yet he insisted it was unlikely that the anti-fluoride crowd would ever be confirmed in their claim that the project “was an attempt to advance socialism under the guise of public health or to rot out the brains of the community” in furtherance of “socialistic or communist schemes.” [1] Fluoride has once again emerged as a matter of public controversy since a federal judge, in October of 2024, ordered the EPA to conduct a risk assessment on the effects of fluoride in the water. [2] The issue has been further enlivened by indications that the incoming presidential administration may support ending fluoridation of water. Little remembered is the heated and drawn-out controversy that brought fluoride to the water supply of New York City. Richard Hofstadter, who lived and worked in New York all through the contentious debate, undoubtedly must have had some of his fellow New Yorkers in mind.
Mayor Robert F. Wagner Jr. Image Courtesy of Library of Congress.
From 1953 until 1965, the entire mayoralty of Robert F. Wagner Jr., the city administration was held frozen in place by medical consensus tugging in one direction and a passionate anti-fluoridation movement pulling in the other direction. The political battle over fluoridation is an instructive episode for understanding the politics of the period, at both the local and the national level. The Wagner administration’s effort to advance a social democratic program of governance on behalf of the general welfare was set against staunch ideological opposition to social planning couched in the language of liberty. The debate, meanwhile, proceeded with a heavy dose of Cold War paranoia. Within all this, Mayor Wagner in his plodding style, maneuvered, delayed, listened to all comers, listened some more, bided his time, and then got where he was going, as the broader priorities of liberalism were filtered through the tedious mechanics of city politics.
Advocates of fluoridation in New York were optimistic in the early days of the Wagner administration. The state had conducted a ten-year study of the cities of Newburgh and Kingston New York, each with about 30,000 residents, both on the banks of the Hudson River just North of New York City. Newburgh opted for fluoride in 1945 and Kingston did not. The state examined rates of cancer, heart disease, kidney disease, and child birth complications over the decade and found no meaningful differences. Yet, in examining dental outcomes for children, the study found that the youth of Newburgh had 60 percent fewer decayed permanent teeth than the youth of Kingston.
Leona Baumgartner Served as Commissioner of New York City’s Department of Public Health (1954-1962). She was a key advocate for fluoridation. Photo courtesy of World Health Organization.
By 1955 an estimated 1,400 communities, totaling 34 million Americans, had already adopted the practice. The mayor called on the Chairman of the City Board of Health, Leona Baumgartner, to carefully examine the issue and report back with a formal recommendation. [3] The editorial board of the New York Herald Tribune was encouraged. In an editorial titled “Ten Cents a Year for Good Teeth,” the paper noted “One more favorable report ought to clinch the matter and spur the city into action.” [4] Yet not all of their readers agreed. One letter to the paper condemned “depriving the individual of liberty without due process of law.” [5]
In early 1956 the city health board reported back favorably on fluoridation and Wagner publicly expressed his support for the first time. Nonetheless, he maintained his characteristic caution, telling the press that he intends to “keep an open mind… in case new facts arise.” [6] The editorial board of the New York Times celebrated that the mayor had come around, yet noted “the city is years late.” [7] Still, the issue would ultimately have to be decided by the Board of Estimate, a kind of supra-legislature — established by the City Charter in 1901 and eventually invalidated by the US Supreme Court in 1989 — made up of the Mayor, the City Comptroller, the City Council President, and each of the five borough presidents. Before the board voted on issues, it was required to conduct public hearings, which often devolved into tumultuous affairs. The hearing on water fluoridation would prove to be among the most raucous and lengthy in the city’s history.
The Committee to Protect Our Children’s Teeth organized a letter writing campaign to push Mayor Wagner and other members of the Board of Estimate to support fluoridation. Images courtesy of Newman Library Archives and Special Collections, Baruch College, City University of New York.
When the hearing date finally arrived in March of 1957, throngs of people descended on city hall. With nearly 700 people in attendance, the mayor spent much of the fourteen-hour hearing banging his gavel trying to keep order. Dr. Benjamin Spock, the famous pediatrician, spoke first, expressing strong support. The opposition aimed most of its attacks at City Health Commissioner Leona Baumgartner, the first women to have held that post. In total thirty-four speakers supported the project, while fifty-four opposed it. [8] Beyond the medical and scientific arguments, opponents of the plan called it “tyrannical,” arguing that its arrival meant that the “American way of life was all over but the shouting,” describing fluoridation as “compulsory mass medication.” [9]
Yet, the most compelling objections came from Arthur C. Ford, the city Commissioner of Water, Gas and Electricity Supply. Ford, the first Black commissioner in the history of the city, explained that the city’s water system of more than 5,000 miles of pipes and tunnels was so complex that he “could not guarantee an even spread of the allegedly safe amount of fluoride throughout. Some faucets would give more and some less.” [10] The borough presidents of the Bronx, Queens and Brooklyn all aligned with the opposition. [11] In the end, the board was left stumped. Borough President of Staten Island Albert V. Maniscalco described himself as “completely confused,” while Manhattan Borough President Hulan Jack called for “caution.” Further, as the New York Herald Tribune explained, “The mere fact that this is a city election year was enough to postpone any action.” [12]
Wagner worked around the problem of Arthur C. Ford by simultaneously promoting and sidelining him with a lifetime appointment to the Water Supply Board, an entity tasked with long term planning. Meanwhile, Wagner tapped Armand D’Angelo to replace Ford as Commissioner of Water Supply, Gas and Electricity, a department tasked with the day-to-day operations of water delivery. [13] Wagner instructed D’Anglelo and the water department to study the technical feasibility of the project, and in 1959, after two years of study, D’Angelo reported back favorably. [14] Wagner encouraged his fellow members of the Board of Estimate to join in support. Yet the borough presidents, along with City Comptroller Lawrence Gerosa, lined up against the project. [15] The borough presidents were particularly attuned to motivated constituencies at the neighborhood level, and less concerned with the editorial boards of the New York Times and the New York Herald Tribune. Comptroller Lawrence Gerosa meanwhile was angling to challenge Wagner for the mayoralty by appealing to conservatives and disaffected Democrats in the outer boroughs, a group that was hot with anti-fluoride sentiment.
The votes were simply not there in 1959, and Wagner let the issue lie for several years. Nonetheless, his health commissioner Leona Baumgartner remained a constant vocal advocate. Further, in December of 1961, the Surgeon General of the United States, Dr. Luther Terry, visited the mayor at city hall and urged him to act without delay. [16] In the Summer of 1962, the New York Times complained that the mayor had remained “deaf” to appeals that he re-enter the fray, chiding “All it takes is courage.” [17] Wagner set the date for new hearings for November, shortly after election day in 1963. [18] A city councilmen from Staten Island introduced a resolution calling for a city-wide referendum on the matter before the city moves forward. [19] Yet the mayor’s political position had strengthened considerably since the raucous hearings in the Spring of 1957. The mayor was reelected in a landslide in ’57, and then elected for a third term in 1961. Further, the mayor had neutralized the county machines, while elevating supportive allies to the Queens and Manhattan borough presidencies, and replacing rival Lawrence Gerosa with ally Abe Beame as comptroller. This time, Wagner could see, the votes on the Board of Estimate were there. [20]
While the mayor was in a stronger political position, a new layer of ideological stridency had settled atop the opposition. Since the Spring of 1962, John F. Kennedy had been waging an all-out campaign to establish a national program of medical care for the aged. The president had launched his national effort with a huge rally at Madison Square Garden at which he appeared alongside Mayor Wagner, and inveighed a crowd of 20,000 to support his plan. He pushed back against those who demanded that “the government mind its own business.” Kennedy insisted, “This bill serves the public interest. It involves the government because it involves the public welfare.” [21] As this national fight intensified, the heated charges that such a program amounted to socialized medicine attached neatly to the local fight over water fluoridation.
When the Board of Estimate finally took up the fluoride program in November of 1963, once again, hundreds descended on city hall. The hearings began at 10:13 in the morning and ran for twenty hours straight with no breaks until 6:13 AM the next day. [22] The Surgeon General of the United States testified in person, and was greeted with boos. The City Health Commissioner Dr. George James, declared that “New York City has the world’s biggest toothache,” pointing to the high rates of tooth decay among children to be found in Harlem, East Harlem, and the South Bronx. He explained that it cost the city $2.75 million a year to treat the 60,000 children who use health department clinics. While much of the opposition testimony came from authentic medical experts with assertions ranging from doubt to condemnation, the booing and the hissing from the crowd came from the city’s right-wing political fringe. Vito Battista led his tiny but vocal United Taxpayer Party out in force for the hearing. [23] He had formed the party in general opposition to public welfare, and insisted that the city should sell all of its public housing to private developers. For Battista and his ilk, no dental experts among them, fluoridation had come to represent an extension of the social democratic public programs of the Wagner mayoralty locally and the Kennedy Administration nationally. As it became obvious that Wagner had the votes lined up, the opposition intensified their calls for a public referendum. Yet the mayor was clear, “If we have a referendum on everything then we don’t need a government.” [24] The Board of Estimate unanimously approved the plan on December 12, 1963. [25]
Protestors at the Kensico Reservoir in 1965. Courtesy of Getty Images.
The opposition quickly mounted a lawsuit seeking an injunction, asserting that the program exceeded the police power of the state. The New York State Supreme Court ruled in Paduano v. City of New York in February of 1965 with Judge Joseph Brust writing, “the health of our children is a legitimate area of public and governmental concern, whether under the police power of the State, or in the exercise of the State’s power to protect the general welfare.”’ [26] The injunction was denied and the complaint was dismissed. Soon after, the Supreme Court of the United States, in an unsigned order, denied review of the case. [27] Thus ended the matter with regards to politics and law.
Fluoride was finally released into the city water supply on October 1, 1965 when workers turned a valve at the Kensico Reservoir in Valhalla. Picketers were on hand to protest, although their fight was lost. One of the picket signs read, “Here Comes Your Poison.” [28] As with so much in the Wagner era, heated public rhetoric was offset by delay and deft political maneuvering. The mayor proved willing to sit in his seat and listen for longer than all others were willing to talk. For fourteen hours in 1957, and for twenty hours in 1963, but really for twelve years over three terms, the mayor deployed his style of hearing all comers, delaying, maneuvering, dragging his feet, and ultimately arriving at the place he intended to go along.
Matthew Vaz is an Assistant Professor of History at the City College of New York, CUNY.
[1] Tom Perkins, “End of Fluoridation of US Water Could be in Sight,” The Guardian, October 4, 2024.
[2] Richard Hofstadter, The Paranoid Style in American Politics: And Other Essays (Cambridge: Harvard University Press, 1996).
[3] David Wise, “Mayor Asks New Study of Fluoride to be Sure,” New York Herald Tribune, April 14, 1955, p. 21.
[4] “Ten Cents a Year for Good Teeth,” New York Herald Tribune, April 17, 1955, p. A4.
[5] Joseph C. Hutchinson, “Liberty and Fluorides,” New York Herald Tribune, April 24, 1955, p. A4.
[6] Richard C. Wald, “Wagner Comes Out for Fluorides, Hearing Due,” New York Herald Tribune, February 19, 1956, p. 23.
[7] “The Mayor on Fluoridation,” New York Times, July 28, 1956, p. 16.
[8] Clarence Dean, “Hundreds Crowd All-Day Hearing on Fluoridation,” New York Times, March 7, 1957, p. 1.
[9] John G. Rogers, “700 Throng City Hall in Fluoride Debate,” New York Herald Tribune, March 7, 1957, p. 1.
[10] John G. Rogers, “700 Throng City Hall in Fluoride Debate,” New York Herald Tribune, March 7, 1957, p. 1.
[11] Clarence Dean, “Hundreds Crowd All-Day Hearing on Fluoridation,” New York Times, March 7, 1957, p. 1.
[12] John G. Rogers, Fluorides Controversy Stumps Estimate Board,” New York Herald Tribune, March 8, 1957, p. 1.
[13] “Ford Takes Post on Water Board,” New York Times, September 24, 1957, p. 72. William E. Farrel, “City Water Board Cool to a Merger,” New York Times, August 24, 1965, p. 18.
[14] Paul Crowell, “City Fluoridation is Feasible but Costly, Mayor is Told,” New York Times, November 23, 1959, p. 1.
[15] Lahymond Robinson, “City Fluoridation of Water Supply Appears Doomed,” New York Times, November 28, 1959, p. 1.
[16] Charles G. Bennet, “Fluoridation in ’63 Indicated by the Mayor,” New York Times, April 3, 1963, p. 1.
[17] “The Mayor and Fluoridation,” New York Times, July 9, 1962, p. 30.
[18] ‘Clayton Knowles, ”Action deferred on Fluoridation,” New York Times, July 4, 1963, p. 19.
[19] “City Vote Urged on Fluoridation,” New York Times, November 10, 1963, p. 1.
[20] Walter Sullivan, “Fluoride Battle to Resume Today,” New York Times, November 18, 1963, p. 1.
[21] “Text of President Kennedy’s Address to Senior Citizens’ Rally at Madison Square Garden,” New York Times, May 21, 1962, p. 20.
[22] Peter Kihss, “Wagner Presses for Fluoridation Within a Month,” New York Times, November 20, 1963, p. 1.
[23] Peter Kihss, “Experts Divided on Fluoridation at City Hearing,” New York Times, November 19, 1963, p. 1.
[24] Peter Kihss, “Wagner Presses for Fluoridation Within a Month,” New York Times, November 20, 1963, p. 1.
[25] Peter Kihss, “Fluoridation Victory is Forecast as Dudley Indicates ‘Yes’ Vote,” New York Times, November 21, 1963, p. 63; Charles G. Bennet, “Final Vote Won by Fluoridation,” New York Times, December 13, 1963 p. 1.
[26] Paduano v. City of New York, 257 N.Y.S 2d 531.
[27] “High Court Denies Appeal to Bar Fluoridation Here,” New York Times, January 17, 1967, p. 23.
[28] “City Starts Fluoridation,” New York Times, October 1, 1965, p. SU5 2.