Periodontal Disease
Gum disease and dental caries are the two most prevalent dental diseases in our country. Periodontal disease affects nearly 90–95% of the population, while dental caries affects about 60–80% of our children. These are caused by poor oral hygiene.

Today, apart from maintaining oral hygiene and having a non–cariogenic diet (caries inducing), other preventive measures are available for treatment which include:

Use of Fluorides
Systemic fluorides are available in the form of fluoridated water, and in natural foods like tea, apples and wheat. Topical application of fluorides is available as: Fluoride mouthwashes eg. Colgate Fluorigard.

Fluoride gels
Which are applied to the child’s teeth (milk/permanent) at the ages of 3, 6, 10 and 12 years. This is a procedure that is carried out in the dental office and takes about 15 minutes per arch. It can cost the patients INR 1000 to INR 1500.

Fluoride toothpastes
Most commercially available toothpastes now contain fluorides.

Fluorides

• Fluoride is safe and necessary, but only at appropriate levels.
• Fluoride works two ways: systemically, meaning it strengthens teeth internally, under the gums in the jawbone. Externally, fluoride strengthens tooth enamel on the surface of the teeth. Children between 6 months and age 16 should take in fluoride every day.
• Water fluoridation is the safest and most cost–effective way to prevent tooth decay.
• Two of the most common sources of fluoride are tap water and fluoridated toothpaste. Fluoride occurs naturally in some water, but in most major municipalities it is added to the water to help prevent tooth decay.
• Pediatric dentists recommend that children who regularly drink bottled water, well water, or unfluoridated tap water get fluoride in some other way. Fluoride vitamins, drops, and tablets are good examples of fluoride supplements.
• Most bottled water brands process water by distilled or reverse–osmosis systems that remove fluoride along with contaminants. Some types of bottled water add fluoride to the final product and are safe for children of all ages.

Fluorides

• If you want to keep fluoride in your tap water, try using a charcoal or carbon–activated filtration pitcher that offers better–tasting water without removing fluoride.
• As important as fluoride is, it only works when used at the appropriate levels. Too much fluoride can cause a harmless discoloration of the teeth known as Enamel fluorosis.
• Most cases of enamel fluorosis result from children taking fluoride supplements when their drinking water is optimally fluoridated. If there is enough fluoride in the child’s primary source of drinking water, pediatric dentists will seldom prescribe supplements.
• It is impossible to know how much fluoride is in a child’s primary source of drinking water without having it tested. Ask your pediatric dentist to test the fluoride level of your bottled water, tap water, or well water before supplements are prescribed.
• Pediatric dentists recommend scheduling a child’s first dental visit when the first tooth appears or no later than the first birthday to determine risk factors and evaluate fluoride needs before the child’s permanent teeth come in.
• Regardless of whether or not their water is fluoridated, children need to brush with a pea–sized amount of fluoridated toothpaste two times a day: after breakfast and before bed. Parents need to supervise children’s tooth–brushing until age 8, when most children have the manual dexterity to accomplish this task independently.
• Parents, be more cautious using toothpaste with children under age 2. They are not able to spit the toothpaste out after brushing and tend to swallow it. Too much fluoride taken internally between age 2–4 can lead to enamel fluorosis, or discoloration of the teeth.
• Data consistently have indicated that water fluoridation is the most cost–effective, practical, and safe means for reducing the occurrence of tooth decay in a community. Water fluoridation continues to be the cornerstone of community oral disease prevention.

The benefits of fluoridation are available, on average today to approximately 55 per cent of the population served by public water supplies have access to adequate levels of fluoride in their drinking water. It has been demonstrated that the action of fluoride in preventing tooth decay provides a benefit to children and adults throughout their lives. The health benefits of fluoridation include a reduction in the frequency and severity of dental decay, a decrease in the need for tooth extractions and fillings, a reduction in pain and suffering associated with tooth decay, and the obvious elevation of self–esteem that goes with improved functioning and appearance.

Fluoride prevents tooth decay two ways: Through direct contact with teeth and when people drink it in the water supply during the tooth forming years and later. The most inexpensive way to deliver the benefits of fluoride to all residents of a community is through water fluoridation. All water contains some fluoride naturally. When a community fluoridates its water, it adjusts the level of fluoride in the water to prevent dental decay.