A Review of the Uses of Fluoride and Outcomes of Dental Caries Control in Singapore

Abstract

In 1958, Singapore was the first country in Asia to implement a community water fluoridation program covering 100% of its population. There were no reports of anti-fluoridation activities or calls for referenda then; and at present, there is only mild opposition to water fluoridation. The water was initially fluoridated at 0.7 ppm but was gradually adjusted downwards to 0.6 ppm in January 1992, with a further reduction to 0.5 ppm in January 2008 where it has since remained unchanged. Fluoride varnishes and gels are also available for use by the professional for judicious application in individuals who are at high-risk of dental caries. In addition, fluoridated dentifrices and mouth rinses are also readily available over the counter for home use.

In addition to the use of fluorides, the following factors also contribute to the high level of oral health in Singapore: (i) a highly educated populace; (ii) public health education to increase awareness and literacy is routinely carried out by the Health Promotion Board; (iii) the School Dental Service provides ‘free’ dental care to school children up to 18 years of age; and (iv) primary dental care is also readily accessible by the general public by an extensive network of private and public sector dental clinics.