PREVENTION OF DECAY

 MOVING TOWARD PREVENTION OF DECAY

The first glimmer of hope for avoidance came with the discovery some 30 years ago of the value of fluoridated drinking water. Ingested regularly during childhood while the teeth were being formed, fluoride could combine with the developing enamel to make it more acid-resistant. It could halve the incidence of decay in children. Currently, some 3,000 communities serving about one third of the total population have fluoridated water. 

Many dentists in no fluoridated areas now prescribe fluoride tablets, or vitamins with fluoride added, for children. Another advance came about 20 years ago with the discovery that painting a sodium fluoride solution directly on the enamel could cut decay 25 to 40 percent. This, however, was true only for children up to about age 15. And the applications, which took quite some time, did not add extra protection for children in fluoridated water communities. 

After some searching, scientists next turned up stannous fluoride, a combination of tin and fluorine. One application a year of stannous fluoride proved far more effective than sodium fluoride applications. It added to the protective effect of ingested fluoride. And it worked for adults as well as children.

There followed incorporation of fluoride in toothpastes-to provide, in effect, a daily topical fluoride application that could supplement periodic applications by the dentist. In 1960, for the first time, the American Dental Association established a therapeutic category for dentifrices. 

Where before toothpastes had been considered aids to cleaning and no more, now, with fluoride added, they could also reduce decay by one third or more. At that point, the picture was this: Ingested fluoride could help endow youngsters with teeth better able to resist decay. Topical applications by a dentist and use offluoridated toothpaste could increase protection. Combined, the measures could reduce decay by as much as 90 percent in children. 

Another important development was to come when work of the Armed Forces demonstrated dramatically that adults, too, could benefit. These very same methods provide for even further improvement in reducing decay.