•     Too little fluoride in drinking water. This subject, unlike that of fluoridated toothpaste, is highly controversial. Fluoride in drinking water gets incorporated into the developing tooth of a child, making it more resistant to decay. Fluoridation of water supplies cuts dental decay by about half but it has vocal opponents who claim that it is dangerous and pointless to give a whole population a medication when so few need it. In fluoridated areas tooth decay is becoming a thing of the past yet alarming, if unconfirmed, reports are appearing about the increase of certain cancers and other diseases in these same areas.

Almost every responsible health body right up to the World Health Organisation recommends the fluoridation of water, but still only a small proportion of people in the western world are actually receiving fluoridated water. Dentists ostensibly support the fluoridation of water but few are truly committed to the cause and this coupled with the power and influence of the anti-fluoride lobby has made the fluoridation of drinking water a slow business. Dentists have been slow too when it comes to making progress with the food industry and the government on the subject of sugar control.

•     Poor health education. There are numerous myths about tooth decay and its causes, especially when it comes to sugar. Far too many people still think of sugar as healthy and essential for energy-it is neither, of course.

Most dentists acknowledge that sweets are harmful but say little about the harm done by sugar in other forms or the dangers of refined foods generally. Dentists have not banded together to stop sweet advertising or tried to ban it from TV during children’s programmes, for example. They also seem not to be particularly conscientious about preventive measures. In 1978, for example, a study found that only just over a quarter of adults claimed to have had tooth-brushing demonstrated to them by a dentist.


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