Fluoride supplements When fluoridation of municipal water is not possible because there is no central water supply or because there are a large number of wells and a small population, school-based fluoride supplementation programs are an alternative for communities where fluoride in drinking water is not optimal.122 Prescription fluoride supplements (0.25 mg/day, 0.5 mg/day or 1 mg/day, Depending on the age of the child and the concentration of fluoride in the water supply – if less than 0.3 mg/L or between 0.3 and 0.6 mg/L and all sources of fluoride) are currently recommended daily for children aged 6 months to 16 years with fluoride levels in the water supply below 0.6 mg/L (ppm).78 Currently. In addition to the age and fluoride concentration of drinking water, all sources of fluoride should be assessed using a complete fluoride history. when doctors or dentists prescribe fluoride supplements. Patient exposure to multiple water sources can make proper prescribing complex.123 The fact that lower social classes consistently have the highest levels of dental caries in the population has remained an unresolved problem (12). The availability of water fluoridation for a large part of the world`s population is prevented by various political, geographical, financial and technical reasons such as the lack of central water supply systems and inadequate water infrastructure. Based on the successful use of iodized salt to prevent goiter, fluoridated salt was introduced in Switzerland in 1955 to reduce the risk of tooth decay (17). This practice has been facilitated by: (1) successful community trials, (2) recommendations from WHO and the International Dental Federation World Dental Federation, (3) the authorisation of sodium and potassium fluoride as food additives by the European Union, and (4) adaptation to local political, technological and cultural environments (19). In 1980~82, the addition of fluoride to table salt was approved for human consumption (12). Fluoridated salt reaches the consumer through multiple channels, including household salt, school meals, commercial kitchens and bread, and exerts systemic and topical effects (14). The bioavailability of fluoride in milk and the biological plausibility of milk fluoridation have been demonstrated by a significant amount of unpublished clinical research. Four systematic reviews have been published on the clinical effectiveness of milk fluoridation in preventing tooth decay. The first three reviews found that all studies reported a reduction in tooth decay in people who consumed/received fluoridated milk (19-21). However, the fourth, more comprehensive review, which included 18 studies from 12 countries, found that only nine studies showed prevention of tooth decay in baby teeth and 12 in permanent teeth (22).

A very recent study conducted in Bulgaria also showed that fluoridated milk given daily to children in schools resulted in a significant reduction in tooth decay development compared to children receiving milk without the addition of fluoride (23). In general, milk fluoridation is effective in preventing tooth decay. To protect and reduce tooth decay in baby teeth, it has been recommended to consume fluoridated milk from children early, preferably before the age of 4, and at the beginning of their first permanent molars (24). Currently, more than one and a half million children worldwide consume fluoridated milk (24), and the experience gained in this international programme has provided considerable knowledge about the practical aspects of fluoridation. A study of the different levels of fluoride in water was conducted by Dr. H. Trendley Dean, a dentist with the U.S. Public Health Service. [17] [18] In 1936 and 1937, Dr.

Dean and other dentists compared statistics from Amarillo, which had a fluoride content of 2.8 to 3.9 mg/L, and Wichita Falls with a low fluoride content. The data is said to show less cavities in Amarillo children, but the studies have never been published. [19] Dr. Dean`s research on the relationship between fluoride and dental caries, published in 1942, included 7,000 children from 21 cities in Colorado, Illinois, Indiana, and Ohio. The study concluded that the optimal amount of fluoride, which minimized the risk of serious fluorosis but had positive benefits for tooth decay, was 1 mg per day per adult. Although fluoride is more abundant in the environment today, it is estimated to be at the concentration of 1 mg/L. Set lower limits on the size of communities to be respected. Fluoridation is mandatory for communities with a population of 20,000 or more and a naturally occurring fluoride content of less than 0.8 mg/L. Fluoridation levels should be maintained between 0.8 and 1.2 mg/l. • Mandatory fluoridation – 2013 update POPULATION RECEIVING FLUORIDATED WATER: 1992: 85.9% 2000: 88.8% 2006: 88.9% 2012: 90.3% 2014: 89.5% 2016: 89.5% 2018: 89.5% Fluoridation became an official policy of the U.S.

Public Health Service in 1951, and by 1960, water fluoridation was widespread in the United States, reaching approximately 50 million people. [2] In 2006, 69.2% of the U.S. population received fluoridated water from public water systems, representing 61.5% of the total U.S. population. [3] At the end of 2012, 67.1% of the U.S. population obtained water from municipal water systems (CWS) that provided fluoride-containing water at or above recommended levels. This included the 3.5% of the population taking PCS with natural fluoride at or above recommended levels. 74.6% of patients with PCS received fluoride-containing water at or above recommended levels.

[4] By passing a law in 1952, money was provided for the addition of fluoride to the water of these aqueducts on the island of Puerto Rico, which could therefore be suitable for preventing tooth decay. This made fluoridation mandatory in Puerto Rico, but was not enforced, and as of 1997, there was no water fluoridation in Puerto Rico. In September 1998, the Governor of Puerto Rico signed a water fluoridation obligation. It would be implemented in stages, and by the year 2000, 75 per cent of Puerto Rico`s population would have to drink fluoridated water. UPDATE 2008: Although FAN is not aware of a fluoridation program in Puerto Rico, in 2006 the Association of State and Territorial Dental Directors selected the communities of Barranquitas, Cayey and Fajardo-Ceiba as recipients of the 2006 Community Water Fluoridation Award. NOTE: “Water fluoridation was introduced to Puerto Rico in 1953 and 1954. However, in the second half of the 1980s, water fluoridation was halted due to budget constraints. In 1973, as cases continued to be heard in state courts, a consensus emerged that fluoridation was acceptable, at least from a legal point of view. [47] In Beck v. City Council of Beverly Hills of 1973, the California Court of Appeals, Second District, stated: “The courts of the United States have consistently held that water fluoridation is a reasonable and appropriate exercise of police power in the interest of public health. The question is no longer open.

[47] The most common use of fluoridated salt is found in Jamaica, Costa Rica, the canton of Vaud and Switzerland.