Effects of Oral Health in Relation to Fluoridation and Socioeconomic Status in Developed and Developing Countries
[Thesis]
Elrayah, Omer
Davies, Theresa A.
Boston University
2019
73
M.S.
Boston University
2019
The rate of tooth decay has declined since the start of fluoridation in the United States. Fluoridation was initiated when evidence of fluoride's ability to make teeth stronger and more resistant to acid was reported. Despite the benefits of fluoride, many researchers using inbred mice have shown that excessive amounts of this trace element leads to fluorosis and eventually skeletal fluorosis, which can lead to osteoporosis. Interestingly, the downward trend in the rate of decline in tooth decay is also observed in various countries that do not participate in fluoridation programs, including both developed and developing countries. This decline is likely due to the high fluoride concentration within their natural waters in combination with improved oral hygiene care. Since excessive amounts of fluoride have been known to cause discoloring of teeth, decalcification of enamel, lower intelligence quotient, arthritis, osteoporosis, etc., it is also surprising that the United States consumes more fluoride than the rest of the world combined. Although fluoridation of water remains the most cost effective treatment for tooth decay in the United States its use has decreased, suggesting it may no longer be needed. To test the need of fluoridation a comparison of developed countries, which participate in fluoridation, including the United States and the United Kingdom was made with developing counties that do not participate in fluoridation programs, such as Sudan, China, and India. Observations made from several studies and discussed here demonstrate that tooth decay is positively influenced by fluoridation but can also contribute negatively to fluorosis. Even though medical treatment is more advanced in developed countries than in developing countries, tooth decay still is a major health concern in both. Factors such as socioeconomic status and lifestyle behaviors are influential and need to be considered when determining the best approach to decrease tooth decay in communities.