| USE OF FLUORIDE IN PREVENTION OF DENTAL CARIES Use of fluoride in prevention of dental cavities 
              started in the beginning of the last century but it was only in 
              the middle of the last century that sufficient scientific evidence 
              existed to justify its use. It is perhaps one of the most successful 
              effort by man (and also women ) to fight a disease with some thing 
              that is so naturally occurring .
  Fluoride can be used in any of the following 
              ways :(a) Fluoridation of drinking water.
 (b) Topical fluoride application.
 (c) Use of fluoride in toothpaste, mouthwashes,chewing 
              gums, tablets e.t.c.
 FLUORIDATION OF WATERIt is now amply supported by studies, that if communal drinking 
              water contains fluoride between 0.5 to 0.9 ppm (approximately 1 
              ppm is the recommended amount) then it leads to considerable tooth 
              decay inhibition without producing any significant mottling of enamel.
 To achive the complete fluoride effect for reduction 
              of dental cavities , communal water should be fluoridated and should 
              be available for the first 12 to 13 years of life, as the fluoride 
              should be available during the formation of tooth (during calcification), 
              erruption ,and even during post erruption phase . there can be a 
              reduction of more then 50% if fluoride is available in drinking 
              water or added to a concentration of 1 ppm . Its benificial effect 
              can be guaged from the fact that it is reported to lead to a ten 
              fold reduction in cavities of proximal surface of permanent incisors. TOXIC EFFECT OF WATER FLUORIDATION:There have been opponents of fluoridation and there argument is 
              , that harmful effect on older persons outweight the benefit of 
              reducing cavities, also since the toxic effect of large dose of 
              fluoride is well known they oppose addition of fluoride to the drinking 
              water even in minimum quantity.
 Other fear that water fluoridation will lead to mottled (disfigured 
              ) enamel, is also unfounded, on the contrary it has been found that 
              children who have benifited from fluoridation of water have a very 
              estheticaly pleasing bluish white teeth.
 For more information on Fluoride click 
              here TOPICAL APPLICATION OF 
              FLUORIDE :Even though fluoridation of communal water is known to be benificial 
              , it can not reach the entire population as there are a number of 
              people who live in are which does not have a communal water supply 
              so the next best alternative is:
  (1) fluoridation of school water supply.(2) fluoride tablets.
 (3) topical fluoride application.
 (4) self administration ,like with toothpaste.studies done in this 
              field show
 positive results and indicate that there can be a reduction of 40% 
              to 90 % in the incidence
 of cavities .
 HOW FLUORIDE WORKS:There are several ways in which fluoride is thought to act on tooth.
 (1) It is believed that fluoride gets incorporated in the tooth 
              structure at the time
 of calcification.
 (2) It is a well established fact that fluoride reacts with hydroxyapatite 
              to form
 fluorapatite , it reduces the acid solubility of the tooth structure
 (3) The topical fluoride application is believed to reduce the permiability 
              of
 enamel.
 (4) The tooth structure that has fluoride incorporated in them have 
              the ability to
 prevent acid production by microorganism.
 (5) It also helps in hardening of tooth structure that has been 
              softened by the
 action of acid.
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