PubMed · 10697346
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M C Downer. 1999. Trying to keep it simple.. https://pubmed.ncbi.nlm.nih.gov/10697346/
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Every community, region or country with a high or rising prevalence of dental caries should implement a caries-preventive program that automatically brings the benefits of systemic and topically applied fluoride to the entire population. The fluoridation of community water supplies or salt fulfills the requirements of providing safe, effective protection from dental caries at reasonable cost. The use of dietary fluoride supplements or fluoridated milk does not meet the requirements of a comprehensive national or community program because compliance is poor or only selected age groups are targeted. Water fluoridation is ideal for countries, regions or communities with many central water supplies or where salt production or distribution is not centralized or easy to control. Water fluoridation also has advantages where many areas exist with natural water fluoride concentrations at optimal or greater than optimal concentrations. Salt fluoridation is ideal for countries or regions with few, potable central water supplies in which salt production and distribution are centralized and easily controlled. Concentrations of fluoride for water fluoridation range from 0.5 to 1.2 parts per million (ppm) parts of water depending on climate and dietary practices. The concentration for fluoridation of salt is approximately 200 to 250 mg fluoride per kg of salt, also depending on dietary practices. Properly fluoridated salt should produce levels of urinary fluoride excretion similar to those found in communities with fluoridated water. Benefits of the two methods are similar. Salt fluoridation may be done more cheaply.
Suginoki Dental Clinic, which is managed by Suginami Dental Association, financially supported by Suginami City, and technically assisted by the University Hospital, Tokyo Medical and Dental University, was established for dental treatment of handicapped persons living in Suginami City, Tokyo who are difficult to be treated by private practitioners. It has one full-time dentist, 12 part-time dentists, two dental hygienists, one nurse, and one clerk; one of the part-time dentists practices twice a week there. Since December 1994, 406 patients visited the clinic and the total cases was 9,273 in December 1999; 99 cases were mentally retarded, 36 autism, and 30 epileptic patients in the younger group; and 65 cases were cerebrovascular disease and 27 cardiac malfunction patients in the older group. Almost all the patients needed special care such as monitoring, intravenous sedation, nitrous oxide sedation, and general anesthesia. Four cases underwent general anesthesia, and no complication was seen among the cases. It was concluded that the clinic has been successful due to a good relationship among the Dental Association, Suginami City, and the dental hospital.