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

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

Fluoride in water safe,The Straits Times, Nicholas

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

27 April 2010

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

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.

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

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

“ ”

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

Water fluoridation in singapore

Healthcare