Dental Hygiene and Care

Some people think that fluoride should be added to the drinking water in all places where the amount of naturally occurring fluoride is less than one part per million. They believe that this will reduce the amount of dental caries.

Other people disagree. They say that adding fluoride to water is too expensive. They also say that the health of those who drink fluoridated water may suffer. They say that fluoride is dangerous.

Fluoride is added to the water in some parts of Britain, but not in others. Many dentists recommend that children should take fluoride tablets if they live in areas where there is no fluoride in the water supply.

No one knows exactly how fluoride acts to reduce dental caries. It seems likely that it does so by making the enamel less soluble. Fluoride is deposited in the enamel and dentine of the teeth mostly before they erupt. However fluoride is also absorbed onto the surface of newly erupted teeth, but only during the first few weeks after they have erupted. Therefore it is the teeth of children which benefit most from the addition of fluoride to the diet. One common source of fluoride in the diet is tea. When it is made with fluoride free water, tea averages one part per million of fluoride.

There are two ways to stop tooth decay. The first is to eat less sugar and sweets, to cut down on snacks between meals and to clean your teeth regularly. The second is to add fluoride to drinking water or take fluoride tablets.

Which method of preventing tooth decay seems best to you? Remember, adding fluoride to water costs money, and some people think it is not good for health.

It is important to try to control dental disease, because it costs the country a lot of money. In 1977, the cost of treatment for dental disease was estimated at £140 000 000 per year, in England alone. Dental disease is responsible for the loss of approximately 2 million working days each year.

Dental caries is widespread throughout the world. However it is rare in some groups of people. In some parts of the world caries used to be rare or unknown, but it is now common. Consider the following facts:

1. When Captain Cook visited Tahiti, a remote Pacific Island, 200 years ago he was greatly impressed by the beautiful white teeth of the local people.
2. In 1965, one visitor to Tahiti described the teeth of the Tahitians as ‘catastrophic’. There was very widespread dental caries. Many of the teenagers had no teeth at all.
3. Until about 70 years ago, dental caries was unknown among the Eskimos. It is now increasing among them.
4. Today dental caries is increasing among the people in many of the world’s poorer countries. In earlier times, caries was rare or unknown in these places. However, differences within some countries are still seen. For example, dental caries is often more widespread among the richer people (especially those living in towns), than among the poorer people living in rural areas.
5. The traditional diet of Eskimos was bear and seal meat.
6. Traditional diets in Tahiti, among the Eskimos, and in most poorer developing countries do not include sugar or sweets.
7. Sugar and sweets are now readily available in developing countries, especially in the towns, but they are expensive.

And now imagine that you are a dental health expert who has been called in by the government of a developing country to report on the people’s teeth. You discover that dental caries is widespread in the towns, but almost absent in the rural areas, especially among the poorer people. You are asked to write a report for the Minister of Health. The Minister is particularly puzzled by the fact that the wealthiest people in his country appear to have more decayed teeth than the poorer people.