Dental caries is most prevalent oral disease associated with a range of adverse outcomes including sever pain, and decreased ability to eat some foods, such as hard and sweet food (Pahel, Rozier and Slade, 2007), also individual treatment for dental caries is effective, such treatment can be late because of expensive or other couses until people are experiencing significant levels of pain and functional weakness. McKay(1952 cited in Cho, et al., 2014) reported that there is strong relation between fluoride exposure and high resistance to dental decay. Therefore, water fluoridation should be used in all countries to help prevent dental decay, 'a practice that involves the deliberate addition of fluoride to the public water supply' Armfield (2010, p. 656). For instance, the United State has added fluoride to drink water. Much of the United King, Australia and Canada have used water fluoridation to inhibit dental caries (decay), but some countries have refused this application because they argue that water fluoridation has little effect on dental decay and harmful. This essay will discuss preventive effect of water fluoridation on tooth, the form of tooth and economic benefits of water fluoridation. Also, the argument about side effect of water fluoridation and replacing by topical application such as toothpaste and fluoride mouth wash.
The water fluoridation can be efficient way to reduce dental caries. Mount (2005) points out that Fluoride enhances dental health by being incorporated into the crystalline framework of the tooth to form fluorapatite, which is more stable than hydroxyapatite, and that way inhibits the process of demineralization of the teeth. It also improves remineralization of the teeth surface, inhibits bacterial metabolism, and inhibits dental plaque formation, which is 'a biofilm that provides a microhabitat for organisms with opportunity for adherence either to the tooth surface or to other microorganisms' Munro and Grap (2004 cited in Jones, 2011, p.300). In addition, According to study by Armfiel (2010) who contrasted two area first one it has high concentration of fluoride in drink water with other people who have negligible fluoride. He observed that people who lived in zone with small fluoride concentrations less than 0.3 ppm has more caries, missing, and filled teeth than did people who lived in area with optimal fluoride concentrations more than 0.7 ppm.
However, money people argue that topical fluoride can replace water fluoridation such as mouth wash toothpaste and it can be safer for consumers and ignore harmful effect. According to Groves (2001) who found several of less than 1 fewer teeth decayed in children in Newburgh in 1989, favoring fluoridation. And by 1995 children teeth in Kingston had slightly less dental caries and half as much harm from fluoride. This negative result was May due to a change in the fluoridation agent. Additionally, According to World Health Organization (WHO) number, Ireland is the most fluoridated country in the world, at 66%, does not have tooth decay. The five nations with less tooth decay (Finland, Denmark, UK, Sweden, and the Netherlands) had small water fluoridation was10% Groves (2001). Also, Chile was fluoridating water in 1985, but limited it when the average of 6.0 dental decay per child, which filled to 5.3 by 1991, increased to 6.7 in 1995. Furthermore, in a report authored by Perry D. Cohn, Ph.D., M.P.H., for the New Jersey Department of Environmental Protection and the New Jersey Department of Health, the rates of bone cancer in fluoridated and no fluoridated areas were compared. Both by counties or by municipalities, men 50 years old and less had 3 to 7 times as many bone cancers in the fluoridated zone. Men between 10 to 19 years old fared the worst
Despite, topical fluoride has positive effect on tooth but it still effect only on outside of teeth compared with water fluoride which work as topical and systemically. According the study was made by Health and Welfare (2011 cited in Cho, et al., 2014) to appreciate the efficiency of society water fluoridation at improving dental health, In this program, an output was modeled to estimate the sample size sufficient to disclose a various in the mean number of dental decay, missing, or filled permanent teeth (DMFT) between the water fluoridation area and the non-water fluoridation area. This cross-sectional study assessed the effects of cessation of water fluoridation. The study was unique in that 11-year-old children in the water fluoridation area had ingested fluoridated water for approximately 4 years after birth, after which fluoridated water was no longer available. As a result, the systemic effect of the water fluoridation could be. The result was the percentage of 6-year-olds who had decayed or filled primary teeth was just less than 70% in the water fluoridation area and about 62% in the non-water fluoridation area. The percentage of 8 years old who had decayed, missing, or filled permanent teeth was 21.7% in the water fluoridation zone and less than 20% in the non- WF area, and the DMF rate for 11-year-olds was 40.4% in the water fluoridation and 52.0% in non-water fluoridation area. Although decay, missing or filling primary teeth (dft) for 6-year-olds in the water fluoridation was higher than in the non-WF area, it was not a statistically significant difference. DMFT for 8-year-olds in the WF-ceased area was not significantly lower than in the non-water fluoridation area, either. However, there were significant differences between areas in the mean number of decayed, missing, or filled permanent teeth surfaces (DMFS), DMFT, and mean number of filled permanent teeth (FT) for 11-year-olds. The regression model showed that the DMFT ratio of the mean DMFT score for 11-year-olds in the water fluoridation area against non- the water fluoridation area, this showed that the adjusted mean DMFT in the water fluoridation area was 16% greater for 6-year-olds and 42% lower for 11- years old than in the non-WF area. This mean than orally ingested fluoride can act topically on teeth by increasing the concentration of fluoride in saliva and plasma similar to mouth wash or toothpaste, but Pre-eruptive teeth that are covered by gingiva or bone and not exposed to the oral environment are not influenced by the topical action of ingested fluoride. In this study, 11-years old children in the water fluoridation area had ingested fluoridated water from birth to about 4 years old, at which point water fluoridation ceased. As their permanent teeth had been in pre-eruptive state during this time, their teeth were not exposed to a fluoridated oral environment. Therefore, their teeth were not influenced by the topical action of orally ingested fluoride. Additionally, the 8-year-old children had ingested fluoridated water for 1 year after birth on average, because they were born after 3 years. Overall, water fluoridation has significant effect on teeth in pre eruption stage or development stage of teeth which is more useful than topical effect.
Furthermore, water fluoridation can has economic benefits. Campain (2010) absorbed that community water fluoridation demonstrated cost savings. Under base-case assumptions, savings ranged from$26.80 in the 1970s to $6.44 in the 1990s. In worst-case suppositions, savings were still verifiable ' $12.30 in the 1970s, and plateauing in 1980s and1990s to approximately $3. Under best-case suppositions, cost-effective ranged as high as $55.52 in the1970s, $19.09 in the 1980s and $12.98 in the 1990s.A similar pattern is observed for both the 21'45 and46'65 age-cohorts. For the 21'45 cohort, base-case assumptions provisions ranged from $33.60 in 1970, $22.21 in 1980 and $12.41 in 1990. The 46'65 age-cohort also demonstrated money-saving at each time point, albeit declining over time ($6.09 in 1970, $2.75 in 1980 and $2.08 in 1990).
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Cho, H. J., Jin, B. H., Park, D. Y., Jung, S. H., Lee, H. S., Paik, D.L. and Bae, K.H., 2014. Systemic effect of water fluoridation on dental caries prevalence. Community Dentistry and Oral Epidemiology, 42(4), pp.341-348
Armfield, J. M., 2010. Community effectiveness of public water fluoridation in reducing children's dental disease. Public Health Reports, 125(5), pp.655-664
Mount, G.J. and Hume W.R., 2005. Preservation and Restoration of Tooth Structure. 2nd ed. Brighton (Australia): Knowledge Books and Software.
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