3-16. COMMUNITY WATER FLUORIDATION
The most effective of all dental public health measures is fluoridation of
community water supplies. A 65 percent reduction in dental decay can be produced by
water fluoridation. The optimum level of fluoride in water is one part fluoride in one
million parts of water (one part per million (ppm)). This concentration may vary from 0.7
to 1.2 ppm depending on the mean daily temperature of the area being considered.
Simply, more water is consumed in warmer climates. Therefore, less fluoride in the
water is needed than in cooler climates. The protection produced by a continuous
consumption of water lasts a lifetime. Studies show that 50 percent of teenagers in
communities having fluoridated water are free of dental decay as compared to only 5
percent in nonfluoridated communities. The incidence of root caries in older patients is
also only half of that in nonfluoridated water supplies. Consumption of drinking water
containing two ppm or more of fluoride by children can cause enamel defects and staining
of teeth called fluorosis. It is an intrinsic stain and can be an unsightly esthetic problem
to the patient. (Water sources other than a community supply should be checked for
fluoride content before a fluoride supplement is prescribed.) Fluoridated water has
been endorsed by the Department of the Army for adoption on Army installations where
there is a substantial child population in residence, where natural fluoride levels are
ineffectively low, and where the levels can be adequately controlled. Most Army
installations in the US and many in overseas areas use fluoridated water
3-17. SUPPLEMENTAL SYSTEMIC FLUORIDATION
a. General. Caries reduction rates can be obtained by administering fluoride
drops or tablets to children. Dosage, as prescribed by a dentist or physician, is based
on the age of the child and the level of fluoride in their drinking water.
b. Three Years or Older. A typical prescription for a child 3 years or older is as
Sodium fluoride tablets 2.2 mg.
Dispense 120 tablets.
Sig. One tablet each day, to be chewed
and swished before swallowing.
CAUTION: Store out of reach of children
c. Two to Three Years of Age. For the child between two and three years of
age, the directions for the label can be changed to specify either one half of a 2.2 mg
tablet each day or a tablet containing 1.1 mg of sodium fluoride every day.