Preventive Sheet #6 By Abdulkareem Basaam

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Preventive Sheet #6 By Abdulkareem Basaam

Post by Sura on 22/3/2012, 5:55 pm

http://www.mediafire.com/?ckc861f4sdd5sai
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Re: Preventive Sheet #6 By Abdulkareem Basaam

Post by Shadi Jarrar on 9/4/2012, 11:04 pm

Systemic fluoride –water fluoridation

Systemic fluoride : fluoride systemically affects body and we can find in *
1)water
2)salt
3)milk
4 ) tablets and drops

Preventive measures are divided into :
1)community based measures : like water fluoridation
2) individual measures : office and home like teeth brushing


Water fluoridation has advantages :
1) low coast way of reducing caries 2)saves man power
But it requires centralized water supply and continuous monitoring
We need continuous monitoring due to its dangerous systemic effects
_ all water contains fluoride in varying concentration
_seawater contains significant quantities of fluoride 0.8 to 1.4 mg/l
_lakes and rivers _less than 0.5mg/l
_water trapped in sediments 3_6 mg/l


Fluoride belt : communities with endemic fluorosis due to excess fluoride in drinking water
In Jordan the south is the most affected region with fluorosis


_lake nakurukenya has the highest natural fluoride and it is 2800mg/l

H.TRENDLEY DEAN 1939 :
_50%less caries in F area than those without fluoride in water
_near maximal reduction in caries occurred with a concentration of 1 ppm
_only sporadic cases of mild fluorosis occurred
_ F in conc not exceeding 1 ppm is of no public health danger
PPM : weight of chemical that must be added to one unit volume of water to give one part per million (ppm).
_milligram per liter is the same as ppm
1PPM : most appropriate conc at which maximum caries reduction is achieved while limiting dental fluorosis to acceptable level of prevalence and severity

Temperate climate : they notice that mottling increase with F and mean annual temperature because people drink a lot of water in that areas so countries in tropical areas are advised to reduce the fluoride content in water .
F CONCENTRATION : in the past the desired conc is .7 _1.2 ppm but now its .5 _1 ppm
Ex:hong kong fluoridated at .7 reduced to .6 ppm


SELF CONTROL STUDY : look at the same area before and after water fluoridation
CONTROL AREA STUDY : look at CONTROL areas and TEST areas to compare water fluoridation .

IS artificial fluoridation effective ?
They made study (self control) and they found that after addition of fluoride there is reduction in DMFT 50%.
And they made control area study :
Grand rapids_ experimental town (added F )
Muskegon _control (no F )
After six years caries experience of GR children was almost half of Muskegon children .

_artificial fluoridation is the same as natural fluoridation and reduction of caries is determined by the concentration of fluoride only .

After a number of studies they found :
1)40_49% reduction in caries for deciduous dentition
2)50_90 % reduction in caries for permanent dentition
Effect of cessation of fluoridation :
They made study in Scotland
Before cessation DMFT =2.63
After cessation DMFT =3.92
49%increase in caries experience in 5 years period

_nearly all human studies involving water fluoridation or fluoride supplements programs failed to isolate the systemic influence of fluoride on teeth from the topical effect of exposing the teeth during ingestion .
Evidence of topical effects of fluoride :
1)decline in root caries in adults who move to fluoridated areas
2)caries increases in adults who leave fluoridated areas
3)primary teeth are protected by fluoridated water even though prenatal incorporation into unerupted primary teeth is insignificant
So the pre eruptive mechanism of fluoride are questionable and probably minimal
And water fluoridation is effective in children and adult (topical effect)


BOTTLED WATER : variable and different sources
The manufactures should list mineral content of their products

Desalination :reduced fluoride in water ,almost all fluoride is removed.
Fluoridation in the world :
Uk :10%
USA:60%
BRAZIL:42%
IRELAND:67%
Scandinavian countries _deactivating fluoridated areas

There is a controversy about water fluoridation
YORK review of water fluoridation :
_systemic review of the evidence on water fluoridation
_included dental academics and professionals who are anti_fluoridationists

York review conclusions :
Support water fluoridation
Lack of high quality research (3-4 decades ago)
Need for studies
Water companies and local authorities to set new schemes for implementation .

Lecture # 6
Done by :Abdelkareem bassam





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Shadi Jarrar
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