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FLUORIDATION
IN SINGAPORE
Is it 100% safe? Is it really necessary now?
A PRESENTATION BY:
DENTY MEILIZA GOZALI
KHAIRUNNISA...
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 f...
INTRODUCTION
WATER FLUORIDATION IN
SING APORE
• Singapore is the first country in Asia to fluoridate its
water in 1958
• Fluoride range...
PROS AND CONS OF WATER
FLUORIDATION IN
SINGAPORE
P R O S C O N S
WAT E R F L U O R I DAT I O N
I N S I N G A P O R E
ADVANTAGES
• Optimally fluoridated water
• Low dosage over long period of time
– CNA news
Ann Acad Med Singapore. 1984 Apr;13(2):247-...
1. Prevent caries
Fluoride in water safe,
The Straits Times, Nicholas Yong
Singapore Dental Journal, June 2011
2. Accessibility
• Wide public reach
• Non-users of fluoridated dental products
• Children with parents with busy lifestyl...
3. Ease of controlling
F- dosage
• Central water supply
• PUB
Straits Times, Singapore,
Health Minister Khaw Boon Wan
27 A...
4. Cost and time
effective
• Cost saving
• Do not require dental treatment
• Less revenue to be set aside for dental needs...
DISADVANTAGES
1. Unethical Issue
• “Forced to drink” as 100% fluoridated
• No option for refusal of F- in H20
• Fluoride is a form of ‘d...
2. Dental fluorosis
• Long term effect caused by excessive ingestion of fluoride
• Affects during the development stages o...
2. Dental fluorosis
• However, it is perceived as a negligible matter
• Not a commonly raised public concern
Dr Joyce Boud...
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)
•...
3. Harm to body
Fluoride in water safe, The Straits Times
By: Nicholas Yong, December 2010
3. Harm to body
Straits Times, Singapore
Dr Hemalatha Nathan
31 Aug 2012
The Centers for Disease Control and Prevention
(C...
4. Individual F - Dosage
• Impossible to control or measure total fluoride
dosage consumed by every individual
• More vuln...
RELEVANCE TO OHTS
Relevance to us
1.  incidence of dental fluorosis
• Reduce usage of other fluoridated products
• To be aware of swallowin...
SUMMARY
In Summary
• There are pros and cons of water fluoridation.
• Pros: Prevent caries, accessible to all, easy to control
dos...
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...
Thank you for
your attention
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Water fluoridation in singapore

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Water fluoridation in singapore

  1. 1. FLUORIDATION IN SINGAPORE Is it 100% safe? Is it really necessary now? A PRESENTATION BY: DENTY MEILIZA GOZALI KHAIRUNNISAA OTHMAN NOR WAHIDAH ARBA’IN NURUL ‘ADILAH JUMATI
  2. 2. CONTENT PAGE • Objectives • Introduction to Water Fluoridation • Pros and Cons • Relevance to OHTs • Summary • References
  3. 3. 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
  4. 4. INTRODUCTION
  5. 5. WATER FLUORIDATION IN SING APORE • 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
  6. 6. PROS AND CONS OF WATER FLUORIDATION IN SINGAPORE
  7. 7. P R O S C O N S WAT E R F L U O R I DAT I O N I N S I N G A P O R E
  8. 8. ADVANTAGES
  9. 9. • 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 caries
  10. 10. 1. Prevent caries Fluoride in water safe, The Straits Times, Nicholas Yong Singapore Dental Journal, June 2011
  11. 11. 2. Accessibility • 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
  12. 12. 3. Ease of controlling F- dosage • Central water supply • PUB Straits Times, Singapore, Health Minister Khaw Boon Wan 27 April 2010 Singapore Dental Journal, June 2011
  13. 13. 4. Cost and time effective • 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
  14. 14. DISADVANTAGES
  15. 15. 1. Unethical 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
  16. 16. 2. Dental fluorosis • 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
  17. 17. 2. Dental fluorosis • However, it is perceived as a negligible matter • Not a commonly raised public concern Dr Joyce Boudeville Dental 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.
  18. 18. 3. Harm to body
  19. 19. 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
  20. 20. 3. Harm to body Fluoride in water safe, The Straits Times By: Nicholas Yong, December 2010
  21. 21. 3. Harm to body Straits Times, Singapore Dr Hemalatha Nathan 31 Aug 2012 The Centers for Disease Control and Prevention (CDC, 1999, 2001)
  22. 22. 4. Individual 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/
  23. 23. RELEVANCE TO OHTS
  24. 24. 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
  25. 25. SUMMARY
  26. 26. 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.
  27. 27. IS PREVENTION REALLY BETTER THAN CURE OR IS DEPENDING ON FLUORIDATED PRODUCTS ALREADY SUFFICIENT?
  28. 28. 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/10529 18/1/.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
  29. 29. Thank you for your attention

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