The revival of water fluoridation in the state of New South Wales, Australia, in the 21st century.

The State of New South Wales (NSW) in Australia has over half a century of experience with water fluoridation. Yass was the first town to be fluoridated in 1956 and Sydney in 1968, and by the late 1970s, approximately 90% of NSW was fluoridated. However, since then, there have been no new fluoridation schemes. In NSW under the Fluoridation of Public Water Supplies Act 1957, the decision to fluoridate rests with local government authorities (councils). Since 2004, the NSW Health Department has been proactive in promoting and extending water fluoridation to unfluoridated rural communities in an attempt to reduce oral health inequalities. This has resulted in 20 councils implementing fluoridation, increasing population coverage of water fluoridation from 90% in 2004 to 96% in 2012. When the remaining 16 councils that have been gazetted to fluoridate implement fluoridation, approximately 98% of NSW residents will have access to fluoridated water. This article provides an overview of the framework used to extend water fluoridation to many rural communities in New South Wales in the 21st century.

Milestones in oral health services in the Republic of Ireland.

With the many changes occurring in Ireland it would seem an opportune time to review the body of research conducted and policy enacted in the Republic of Ireland on oral health services and oral health. The dental health of the nation prior to water fluoridation, the legislation and policy decisions impacting on oral health up to budgetary changes, and the production of evidence-based guidelines will be discussed. The first national survey of dental health was conducted in Ireland in 1952 - 'Dental Caries in Ireland'. In the intervening 60 years, further surveys of the oral health of people in Ireland have been carried out. Legislation, surveys and policy documents that have shaped dentistry and the oral health of the population are set out in Tables 1 and 2. A more comprehensive description of the policies can be found in the thesis submitted in fulfilment of Masters in Dental Public Health (MDPH) by the lead author.

[Evolution in access to fluoridated water in São Paulo State, Brazil, from the 1950s to the early 21st century]. / Evolução do acesso à água fluoretada no Estado de São Paulo, Brasil: dos anos 1950 à primeira década do século XXI.

Access to fluoridated water is a known protective factor against dental caries. In 1974, fluoridation of the public water supply became mandatory by law in Brazil, resulting in improved coverage, especially in more developed regions of the country. Coverage increased across the country as a priority under the national oral health policy. This article systematizes information on the implementation and expansion of fluoridation in Sao Paulo State from 1956 to 2009, using secondary data from technical reports, official documents, and the Information System for Surveillance of Water Quality for Human Consumption (SISAGUA). In 2009, fluoridation covered 546 of 645 counties in São Paulo State (84.7%), reaching 85.1% of the total population and 93.5% of the population with access to the public water supply. The results indicate that fluoridation has been consolidated as part of State health policy. However, the challenge remains to implement and maintain fluoridation in 99 counties, benefiting 6.2 million inhabitants that are still excluded from this service.

Evolução do acesso à água fluoretada no Estado de São Paulo, Brasil: dos anos 1950 à primeira década do século XXI / Evolution in access to fluoridated water in São Paulo State, Brazil, from the 1950s to the early 21st century

Ter acesso à água fluoretada é um reconhecido fator de proteção contra a cárie dentária. No Brasil, a fluoretação da água de abastecimento público tornou-se obrigatória por lei em 1974, seguindo-se a esta regulamentação acentuada expansão da cobertura, sobretudo nas regiões de maior desenvolvimento socioeconômico. A ampliação dessa cobertura em todo o país é uma das prioridades da política nacional de saúde bucal. Neste artigo, sistematizam-se informações sobre a implantação e expansão da fluoretação no Estado de São Paulo, no período de 1956 a 2009, utilizando-se dados secundários obtidos em relatórios técnicos, documentos oficiais e no sistema SISAGUA. Em 2009, a cobertura se estendia por 546 (84,7%) dos 645 municípios paulistas, chegando a 85,1% da população total e a 93,5% da população com acesso à rede de distribuição de água. Tais resultados indicam que a medida está consolidada como parte da política estadual de saúde. No entanto, persiste o desafio de implantar e manter a fluoretação em 99 municípios, beneficiando cerca de 6,2 milhões de habitantes excluídos do benefício.

Access to fluoridated water is a known protective factor against dental caries. In 1974, fluoridation of the public water supply became mandatory by law in Brazil, resulting in improved coverage, especially in more developed regions of the country. Coverage increased across the country as a priority under the national oral health policy. This article systematizes information on the implementation and expansion of fluoridation in Sao Paulo State from 1956 to 2009, using secondary data from technical reports, official documents, and the Information System for Surveillance of Water Quality for Human Consumption (SISAGUA). In 2009, fluoridation covered 546 of 645 counties in São Paulo State (84.7%), reaching 85.1% of the total population and 93.5% of the population with access to the public water supply. The results indicate that fluoridation has been consolidated as part of State health policy. However, the challenge remains to implement and maintain fluoridation in 99 counties, benefiting 6.2 million inhabitants that are still excluded from this service.

Cities without cavities: democracy, risk, and public health.

This essay examines the history of fluoride debates in four Canadian cities. It argues that fluoride's opponents were primarily motivated by what they saw as the health and environmental risks of adding fluoride to the water supply. They also believed that fluoridating the public water supply was a fundamental violation of civil liberties. The fluoride debates have much to teach us about how people evaluate potential health risks and how they respond to state interventions in the field of public health.

Celebrating 50 years of fluoridation: a public health success story.

Community water fluoridation has served Americans extremely well as the cornerstone of dental caries prevention activities for over 49 years. While January 25, 1995, marks the fiftieth anniversary of fluoridation's inauguration at Grand Rapids, Michigan, the dental and general health benefits associated with the ingestion of water-borne fluorides have been well known by researchers for an even longer period. Continued research has repeatedly confirmed the safety, effectiveness and efficiency of community water fluoridation in preventing dental caries for the world's population.

Fluoride and oral health: a story of achievements and challenges.

It's been nearly 45 years since Grand Rapids, MI, approved this country's first citywide fluoridation program. In that time the steady growth of evidence drawn from surveys and other research has yielded inarguable conclusions on fluoride's benefits to oral health. Today, it is one of the country's most heralded public health measures. By 1988, 41 of the 50 largest cities in the United States were served by fluoridated water systems. Yet in some communities the measure still draws fire. Antifluoridationists have charged, among other arguments, that fluoridation proponents are part of a Communist plot, aimed at poisoning the American people and taking over the government. Looking back over the past four decades, fluoride has had a role in a variety of arenas in American life: political, social, medical, and economic. This month's Emphasis takes a look at fluoride's heritage, and considers some of the most recent findings on its safety, benefits, and cost-effectiveness.

Thirty years of fluoridation: a review.

Fluoride contributes to stability of both teeth and bones and to reduction of caries, especially if ingested before eruption of teeth. Reduction of caries continues at about 60% in persons drinking fluoridated water only as long as fluoride washes over teeth. One-half the population of the US does not have access to water with an optimal fluoride concentration of about 1 mg/L. Misinformation about fluoridation contributes to reluctance of communities to supplement the natural but inadequate fluoride of those water supplies. Fluoridation of water has no positive or negative effect on incidence or mortality rates due to cancer, heart disease, intracranial lesions, nephritis, cirrhosis, mongoloid births, or from all causes together. The collective decision to increase the natural fluoride content of water supplies is not an infringement of civil rights, nor does it establish a precedent in the binding sense of the law. Supplemental fluoride in water makes it available to all members of the community in a safe, practical, economical and reliable manner. Fluoridation saves money in dental costs and time lost from work. Fluoridation is an appropriate action of government in promoting the health and welfare of society.