Determination of appropriate exposure to fluoride in non-EME countries in the future

Abstract

(the references originally cited were updated) n appropriate exposure to fluoride must be able to interfere with the development of dental caries (benefit) without great concern for dental fluorosis (risks). This condition in relation to individual seems feasible leading to a rational use of fluoride. Nevertheless, dealing with population and particularly non-EME countries (nonEstablished Market Economies or developing), the most suitable method of fluoride use will depend on each nation. On the other hand, each country should have a public health program to control dental caries as part of its health system. The choice between fluoridated dentifrice or fluoridated drinking water and the option for salt will depend on its applicability in each country. At the same time, it is important that either the appropriate exposure to a community method of fluoride use as well as the association with other methods and preventive measures in relation to risks-benefits are evaluated for each country. The determination of an appropriate exposure to fluoride in non-EME countries in the future will depend on critical analysis of how it has been used at present. Available data have shown that some non-EME countries have even been able to revert the dramatic situation of dental caries in their population, but in others caries experience continues a public health problem. Nevertheless, in other countries the increase in caries prevalence, which was expected, has not occurred but endemic fluorosis has been a concern. The challenges for non-EME countries are huge and identical solutions cannot be used for distinct problems.

Fluorose dentária em escolares de 12 e 15 anos de idade. Salvador, Bahia, Brasil, nos anos 2001 e 2004

“…É sugestivo que exista essa possibilidade pela difusão maciça do uso dos fluoretos na atualidade 9 , especialmente os dentifrícios fluoretados 10 .…”

Ingestão de flúor por crianças pela água e dentifrício

“…No presente, com o declínio da cárie, discute-se uma exposição ao flúor que garanta a manutenção do benefício (redução de cárie) sem grandes preocupações com o risco de fluorose dental. Nos países de economia de mercado estabilizada, essa exposição é conhecida, mas há muita dúvida nos demais (Cury,4 …”

Qualidade da água para consumo humano e concentração de fluoreto

“…21 In 1988, fl uoride was added to a brand of toothpaste widely used in Brazil, and by 1989, more than 90% of the products available to consumers were fl uoridated. 8 The use of fl uoride in the water and in toothpaste has been responsible for a signifi cant decline in the levels of dental caries among children and adolescents in Brazil and has been heralded as an important change that may confer a different oral health pattern from that of the present for the coming generations.…”