Table salt fluoridation can reduce the prevalence of dental caries

Table salt fluoridation can reduce the prevalence of dental caries up to 84 percent, according to a new book published by the Pan American Health Organization (PAHO), "Promoting Oral Health: The Use of Salt Fluoridation to Prevent Dental Caries".

Salt fluoridation programs over the last decade have placed the countries of the Americas at the leading edge in reducing dental caries, and these programs are now being replicated in other regions, the book notes. Fluoridation benefits also translate into savings in dental treatments of up to $250 per person for every $1 spent on fluoridation initiatives.

"Dental caries is the most common childhood disease and can be avoided thanks to salt fluoridation," said PAHO's Dr. Saskia Estupiñan-Day, regional advisor on oral health and author of the publication. "We are the world leaders on salt fluoridation programs. The Latin American and Caribbean experience is being replicated worldwide. Many countries are seeking our assistance and technical cooperation to implement this greatly beneficial and cost-effective public health strategy."

Studies on dental caries in 12-year old children have shown that the average regional rate of caries in the Americas dropped from 5.05 in 1987 to just 2.41 in 2004, thanks to salt fluoridation programs. The most notable reduction took place in Jamaica, a country that has achieved an 84 percent reduction in childhood dental caries in 1995 thanks to a nationwide salt fluoridation program started in 1987.

Jamaica's program was highlighted by the Center for Global Development's Millions Saved: Proven Successes in Global Health as one of the 17 most relevant public health initiatives taken worldwide in recent years. Colombia, Costa Rica, Mexico, Uruguay and other countries have also achieved remarkable reductions of dental caries in their respective populations.

Water fluoridation has been a staple of oral hygiene for decades in North America and the world. However, distribution of fluorine throughout water supply systems in Latin America and the Caribbean is not always the best way to reach people, particularly in remote areas.

The new PAHO book shows how table salt fluoridation has proven to be one of the most cost-effective public health interventions in history. It also details the history of programs that have been implemented and the know-how for the salt industries, governments and health professionals still in the developmental phase of salt fluoridation program implementations.

"We have just entered a decisive process of consolidation and protection of our achievement in Latin America as it relates to salt fluoridation," Estupiñan-Day said.

The new book is a step by step guide on how to plan, promote, launch, operate, monitor and evaluate salt fluoridation programs. It also provides blueprints for legislation, epidemiological surveillance, and biological monitoring that are necessary for carrying out successful programs.

The book was funded by the Kellogg Foundation, which has supported salt fluoridation efforts throughout Latin America and the Caribbean as the means to prevent the most common childhood disease.

"It is thanks to the Kellogg Foundation that salt fluoridation programs in Latin America and the Caribbean had such a beneficial impact", said Estupiñan-Day. "This is a perfect example of how the financial assistance of a foundation in common efforts to promote and implement global health strategies can turn out to be successful when the private and public sectors work together in such a satisfactory manner."

The book will be launched at a meeting of the World Dental Congress in Montréal, Canada, August 25. A panel of experts will attend along with Dr. Saskia Estupiñan-Day. It will be conformed by PAHO's assistant director, Dr. Carissa Etienne; the executive director of the World Dental Federation (FDI), Dr. J.T. Barnard; and senior vice president for Programs of the W. K. Kellogg Foundation, Dr. Anne C. Petersen.

"Promoting Oral Health: The Use of Salt Fluoridation to Prevent Dental caries" will be available August 25 in English at http://publications.paho.org.