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62
There would appear to be two main avenues open to us if we
are to stem the tide of present and future advancing dental decay—
to increase the number of qualified dental surgeons and/or to
reduce the number of conditions requiring dental treatment. Both
solutions are long-term.
At present dentistry, as a career, is failing to attract a sufficient
intake to cover retirements or to fill existing vacancies in health
authorities' services. This is a national problem which, even under
favourable conditions, may take a decade or so to rectify and, in
any event, is beyond the control of local authorities.
Without an almost complete reorganisation of our dietary regimen,
a reduction in dental conditions requiring treatment is unlikely.
Present eating practices, especially among children, are most
reprehensible, and parents in general seem unable or unwilling to
direct the early feeding habits of their offspring towards balanced
diets. It is a direct consequence of the modern child's predilection
for foods and drinks high in carbohydrate content that the dental
condition of the nation's children is so deplorable. Education
regarding diet and dental hygiene is obviously a first step in which
local authorities can participate but, unfortunately, without active
parental participation this usually comes too late to influence the
condition of milk teeth. What is urgently needed is a method which
would be effective from birth or before. Fluoridation of water
supplies fulfils these requirements and it is here that local authorities
can influence public opinion and exert the greatest pressure.
Authoritative bodies have established that fluoridation results in
substantial improvement in dental health especially with regard
to children for, of teeth likely to suffer from dental caries, 75%
are attacked before the age of 15 years.
In these days of stringent economy, cost effectiveness is becoming
of paramount importance. Although application of this
term to the health, welfare and social services is difficult, nevertheless,
in this particular instance, it has some relevance. For onefiftieth
of the total cost of providing the country with dental treatment,
a trace (1 p.p.m.) of fluoride could be added to drinking
water at source which would reduce dental decay by 50%. To
expect an immediate saving would be unrealistic but eventual and
substantial financial benefits would be assured. Topical application
of fluoride as a universal treatment has been rejected as being less
effective, time-consuming and wasteful of manpower. It will be
remembered that fluoridation, as an economy measure, was recommended
by the Guillebaud Committee in 1958.
Testing the validity of fluoridation, strictly as an economy
measure, investigations have shown that in areas where fluoride
occurs naturally in drinking water in recommended concentration,