Community Water Fluoridation Flashcards
Topical F
applied to tooth
Systemic F
taken into the body
Factors causing caries
host, agent (bacteria), time, environment (diet)
fluoridation
the adjustment of the F content of a community’s water supply for an optimal [c] for prevention of dental caries-one of the Ten Greatest Public Health Achievements during the 20th century
Colorado Brown Stain
ID’d in Colorado by Dr. F McKay that F was causing mottle enamel
Coined the term dental fluorosis and an index to classify its severity
Dr. H T. Dean-U.S. Public Health Service Worker
First community water fluoridation program was where
Grand Rapids MI
in 1962 it was determined that water F concentration should be based on ________ (think consumption)
region temperature-hotter=drink more water
U.S. Dept. HHS recommends a level of _____ mg/L or ppm for all community water? Before this what range was accepted
0.7; before it was 0.7-1.2ppm but above 1 starts causing dental fluorosis
in 2014 the HSH decided that all regions should have ____ppm F in water, because _____ did not change intake of F
0.7ppm
Temperature (did not matter)
Past thought mechanism of action of F
believed to be incorporated into the developing tooth enamel, a benefit to children’s health only
Dental caries more or less prevalent today?
Less among all ages (lower DMF scores)
fluorosis rates trend
increasing
Current mechanism of action of F (what we think now)
F works best to control caries when constantly present in low ambient levels in the oral cavity (minor pre-eruptive action), benefits people of all ages
Post-eruptive mech of action of F
inhibition of demin of sound enamel, enhancement of remin during repeated de/remin cycles, inhibit bacterial activity (less action production)
Pre-eruptive mechanism of action of F
NOT proven….. incorporated into the enamel, reduce solubility, more caries-resistant
How is F most effective
low concentrations over a long period of time
Surfaces on the tooth which get better protection from F
smooth surfaces (better than pits and fissures)-***KNOW THIS
____% reduction in caries when consuming F
30%
Diffused benefit of F
beverages and food products produced in F communities are exported to surrounding communities
Halo Effect
Diffuses benefit of F—beverages and food products produced in F communities are exported to surrounding communities
Dilution of F
Availability of F through multiple sources such as tooth pastes, mouth rinses, and professional application
benefits of F (who? cost? what it does?)
benefits all SES, race etc, cheap, overcomes other barriers and mass prevention
Economics of water F? How cost effective is it
shown to be the most effective prevention measure
Two main reasons why CWF is less effective today
Diffusion and Dilution
Cost effectiveness
economic analysis that compares the relative costs and outcomes of different courses of action
Cost-benefit ratio
an analysis that assigns a monetary value to the measure of effect
Factors influencing per capita cost of water F
size (population)-bigger=lower cost number of F injection points type of equipment to be used Amount and type of F chemical used, its price, storage Expertise of water plant How much F the water source already has
over 50,000 population it cost roughly ___ to F water
~14 cents-that is one study in MN
Healthy people 2020 goal is what
to get 79.6% water F
Community mandatory F Laws
mandates about water supplies serving a certain number of people must be F
US Public Health Services recommend but cannot enforce
levels of F for caries prevention
___ sets safe drinking water standards and sets the upper/max limit of F
EPA
EPA does NOT question what
Low levels of F, they ONLY do high levels
Health risk of drinking F water at the levels allowed in drinking water? (i.e. if you drink 2 gallons, will you overdose?)
Nah, there is none
Severe forms of skeletal fluorosis after _______
lifetime of high exposure
Anti F Arguments (politics)
Adverse health effects, not effective, mass medication, autonomy (people should be able to decide), communist plot
EPA says people who consume _____mg/L have an increased risk of bone fractures
4mg/L
Children aged 8 and younger who consume water with ____ mg/L to ___ mg/L are at increased risk for enamel fluorosis
2mg to 3.9mg/L
Propaganda from the F action network
bad studies (from countries with high F) False links between F and other diseases
Wisconsin study in Antigo
made an inaccurate connection between heart disease and recent F and stopped F. after 200% caries rate increase in 5 yrs they started again. Idiots
School water Fluoridation (what levels?)
used where community drinking water could not be fluorinated… Fluoridated at 4.5 TIMES the optimal concentration ***KNOW THIS
most bottled water contains ___ ppm F
0.3ppm-not required to be labeled
Water filters-Remove F?
Some do- some don’t
-reverse osmosis and distillation units (99%)
