water fluoridation in singapore
TRANSCRIPT
FLUORIDATION IN SINGAPORE
Is it 100% safe? Is it really necessary now?
A PRESENTATION BY: DENTY MEILIZA GOZALIKHAIRUNNISAA OTHMANNOR WAHIDAH ARBA’INNURUL ‘ADILAH JUMATI
CONTENT PAGE
• Objectives
• Introduction to Water Fluoridation
• Pros and Cons
• Relevance to OHTs
• Summary
• References
OBJECTIVES
• To discuss the risks and benefits of fluoride
• Understand further in depth about the significance of water fluoridation in Singapore
• Gain insight into the problems occurring in the debate of water fluoridation
• Correlate current local water fluoridation issues with our delivery of hygiene care
INTRODUCTION
WATER FLUORIDAT ION IN S INGAPORE
• Singapore is the first country in Asia to fluoridate its water in 1958
• Fluoride range in Singapore• 1958- 0.7ppm• 1992- 0.6ppm • 2008- 0.5ppm
Singapore Dental Journal, June 2011
Singapore Dental Journal, June 2011
PROS AND CONS OF WATER FLUORIDATION
IN SINGAPORE
P R O S
• Prevent dental caries
• Accessibility• Ease of
controlling fluoride dosage
• Cost and time effective
C O N S
• Unethical issue• Dental fluorosis• Harm to body• Individual
fluoride dosage
WATER FLUORIDAT ION IN S INGAPORE
ADVANTAGES
• Optimally fluoridated water
• Low dosage over long period of time
– CNA news
Ann Acad Med Singapore. 1984 Apr;13(2):247-51.Fluoridation of public water supplies in Singapore.Teo CS.
1. Prevent car ies
1. Prevent car ies
Fluoride in water safe,The Straits Times, Nicholas
Yong
Singapore Dental Journal, June 2011
2. Access ib i l i ty
• Wide public reach• Non-users of fluoridated dental products• Children with parents with busy lifestyle
Straits Times, Singapore
Dr Hemalatha Nathan 31 Aug 2012
Straits Times, Singapore, Health Minister Khaw Boon Wan
27 April 2010
3. Ease of contro l l ing F- dosage
• Central water supply• PUB
Straits Times, Singapore, Health Minister Khaw Boon Wan
27 April 2010
Singapore Dental Journal, June 2011
4. Cost and t ime eff ect ive
• Cost saving• Do not require dental treatment• Less revenue to be set aside for dental needs (more
economical)
• Time saving
• Labour• Labor-saving preventive measure (‘home care’)• Huge manpower not required to serve massive demand
Singapore Dental Journal, June 2011
caries incidence
dental treatment required
= time wastage
DISADVANTAGES
1. Unethica l Issue• “Forced to drink” as 100% fluoridated
• No option for refusal of F- in H20
• Fluoride is a form of ‘drug’ • not essential for all
• ONLY Mass medication with uncontrolled dose
• Unaware of the possible side effects
The Case Against Fluoride: How Hazardous Waste Ended Up in Our Drinking
By Paul H. Connett, James S. Beck, H. S. Micklem
Four Arguments Against the Fluoridation of Water Supplies Mark Diesendorf BSc, PhD
2. Dental fl uoros is
• Long term effect caused by excessive ingestion of fluoride
• Affects during the development stages of teeth
Aust Dent J. 1990 Dec;35(6):530-5.Enamel defects in a fluoridated south-east Asian community.Chellappah NK, Vignehsa H, Lo GL.
Singapore Dental Journal, June 2011
2. Dental fl uoros is
• However, it is perceived as a negligible matter• Not a commonly raised public concern
Dr Joyce BoudevilleDental Surgeon from Raffles Dental
Fluoride in water safe, The Straits Times
Straits Times, Singapore, Health Minister Khaw Boon Wan
27 April 2010
Community Dent Oral Epidemiol. 1996 Feb;24(1):25-7.Prevalence of dental fluorosis in children in Singapore.
Lo GL, Bagramian RA.
3. Harm to body
• Fluoride in water makes it available to all of the tissues in the body when ingested (systemic effect)• Bones (crippling skeletal fluorosis)• Nervous system – brain• Thyroid gland Four Arguments Against the Fluoridation of Water
Supplies Mark Diesendorf BSc, PhD
3. Harm to body
Fluoride in water safe, The Straits TimesBy: Nicholas Yong, December 2010
3. Harm to body
Straits Times, Singapore
Dr Hemalatha Nathan 31 Aug 2012
The Centers for Disease Control and Prevention
(CDC, 1999, 2001)
4. Ind iv idual F- Dosage
• Impossible to control or measure total fluoride dosage consumed by every individual
• More vulnerable individuals:• Infants• Children• Pregnant women• The elderly• Individuals with impaired renal function• Fluoride allergies
“
”http://clinicalnature.com/2011/03/why-i-changed-my-mind-about-water-fluoridation/
RELEVANCE TO OHTS
Relevance to us
1. incidence of dental fluorosis• Reduce usage of other fluoridated products• To be aware of swallowing fluoridated products• Monitoring of children’s brushing
2. Raise awareness of alternatives of caries prevention
3. High caries risk patients• Drink more water• Suggest fluoridated products
4. Parents who refuse any kind of fluoride treatment• Explain proposed treatment• Explain benefits and consequences• Provide alternatives• Respect their wishes
SUMMARY
In Summary
• There are pros and cons of water fluoridation.• Pros: Prevent caries, accessible to all, easy to
control dosage of F-, time• Cons: Unethical, dental fluorosis, risk of systemic
problems, possible fluoride poisoning
• Dental fluorosis is a concern, but it is only affecting children during the teeth development phases (aged 8 years or younger)
• Water fluoridation outputs more risky disadvantages to the general public. However, no clear evidence has been found in Singapore.
IS PREVENTION REALLY BETTER THAN CURE OR IS
DEPENDING ON FLUORIDATED PRODUCTS ALREADY SUFFICIENT?
References
• http://www.healthxchange.com.sg/News/Pages/Against-Fluorides-in-Water.aspx
• http://www.healthxchange.com.sg/News/pages/fluoride-in-water-safe.aspx
• http://www.straitstimes.com/premium/forum-letters/story/dental-surgeons-back-water-fluoridation-policy-20120831
• http://www.channelnewsasia.com/stories/singaporelocalnews/view/1052918/1/.html
• http://www.sciencedirect.com/science/article/pii/S0377529112700111
• http://www.ncbi.nlm.nih.gov/pubmed/8897751
• http://www.qawf.org/UploadFiles/file/4_ARGUMENTS.pdf
• http://www.sda.org.sg/sda_content/SDJ/June2011_Vol32_1.pdf
• http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm
Thank you for your attent ion