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Enamel and dentin consists of mineral crystals (mainly calcium & phosphate) contained in an organic protein/lipid matrix (McKay, 1916). Dental mineral is absorbed easily by acid generated by cariogenic bacteria when fermentable carbohydrates undergo metabolism. Fluoride contained in solution at minor levels, which transforms into a concentrated one in dental plaque, can significantly inhibit dissolution of tooth mineral by acid. Fluoride promotes re-mineralization by adsorbing to the surface of the tooth and attracting calcium ions contained in saliva. Fluoride also plays a part to bring the calcium and phosphate ions together and is included in the chemical reaction that takes place, producing a crystal surface that is much less soluble in acid than the original tooth mineral(Britten, 1941).Fluoride originating from topical sources like fluoridated drinking water is eaten up by cariogenic bacteria when they produce acid. Once fluoride gets inside the cells, it interacts with enzyme activity of the bacteria and the regulation of intracellular pH (Burt, 1978). This decreases bacterial acid production, which directly lessens the solubility rate of tooth mineral.
Population Served by Water Fluoridation
By 1992 year end, 10,567 public water systems serving 135 million persons in 8573 U.S. communities had instituted water fluoridation. Almost 70% of every U.S. cities with populations of more than one lakh used fluoridated water (Britten, 1941). In addition, 3784 public water systems serving ten million people in 1924 communities had natural fluoride levels higher than or almost close to 0.7 ppm. Altogether, 144 million people in the US (i.e. fifty six percentage of the population) were using fluoridated water in 1992, including sixty two percent of those served by public water systems (Britten, 1941). However, almost 42,000 public water systems and 153 U.S. cities with populations greater than or equal to 50,000 have not implemented water fluoridation (Britten & Perrott, 1941).
Safety of Water Fluoridation Early experiments into the physiologic impact of fluoride in drinking water preceded the first community field trials. From 1950, opponents of water fluoridation have warned that it increases the cancer risks, and several other health conditions The safety and impact of water fluoridation have been re-evaluated quite often, and no reliable proof supports a relation between water fluoridation and any of these diseases(Britten & Perrott, 1941).
Challenges in This Century
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