How can we measure dental caries
dmft/DMFT
d3mft/D3MFT
it can be done on an individual basis or divided by the population to give a mean figure
can take a percentage of those who have a d3mft to see the prevalence of caries
can see what percentage have no obvious caries experience
What is the highest quality of evidence
meta analyses, systematic reviews of RCTs or RCTs with low risk of bias
What is fluoride
anion of fluorine
non metal
What happens to the teeth in the presence of fluoride
substitution reaction
ph falls in presence of sugar and when remineralization occurs fluoride is incorporated through simple substitution reaction and fluoride is packed more tightly into the crystal structure
post eruptive effect is most accurate
Describe enamel formation
preameloblasts imitated by dental papilla
elongate to become secretory ameloblasts
ameloblasts stimulate dentinogenesis
secretory stage, ameloblasts move from dentine. Tomes processes angled which gives differences in crystallite orientation and structure
differential movement leads to enamel rods
maturation stage - ameloblasts mineralize the enamel
What is water fluoridation
adjustment of fluoride ion to the UK optimum of 1ppm (1mg/L)
it varies from 0.5 ppm-1.2ppm related to the ambient air temperature
natural level in Glasgow is 0.1mg
How is the fluoride content adjusted
by using hydrofluorosilicic acid or hexafluosilicic acid H2SiF6
sodium fluorosilicate or sodium silicofluoride (Na2SiF6)
powder is added to water and saturated and then that water is added to the raw water supply
What did studies show the effect of water fluoridation to be
some reduction in dmft
14.6% more children will be decay free
mean reduction in dmft/DMFT 2.25 per child
no adverse effects were found
What is the prevalence of fluorosis at 1ppm
48%
12.5% fluorosis is of aesthetic concern
What is enamel mottling
its staining
has over 90 causes
What is the effect of water fluoridation on health inequalities
it is likely to reduce the differences in severity of tooth decay between social classes among 5 YO
Is there a different effect of natural vs artificial fluoride
evidence says no difference
What did the cochrane review say on water fluoridation
35% reduction in mean dmft
26% reduction in DMFT
15% more children caries free (deciduous teeth)
14% more children caries free (permanent teeth)
Why is the argument that there’s no moral issues regarding water fluoridation
its beneficial
has no harmful consequences
does not infringe on any basic human rights
replicates a situation found naturally in some places
could be unethical not to fluoridate where practicable to do so
How many people in UK drink fluoridated water
6m
