Fluoridation of public water supplies in Singapore

Fluoridation of public water supplies as a means of reducing the prevalence of dental caries was introduced in Singapore in 1956. This paper will describe the fluoridation programme, and discuss its role in the prevention of dental decay. Water fluoridation has been advocated by the World Health Organisation in 1958 when the first report by an expert committee concluded that drinking water containing about 1 ppm. fluoride had a marked caries preventive action, and that controlled fluoridation of drinking water was a practicable and effective public health measure. Today, more than 60 countries serving over 330 million people have drinking water which is fluoridated. In Singapore, public water supplies contain 0.7 ppm. fluoride. The efficacy of this programme is reported in follow-up studies. After ten years, mean dmf/DMF reduction of 34.4% was recorded for seven-year old Chinese school children, and 33.6% for the same age group Malay school children. These results are consistent with world-wide studies which show beneficial reduction in carries level in children by 30-80%. Fluoridation of public water supplies is indicated if there is an efficient system of distribution and when there is a moderate-to-high prevalence of dental caries.