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Health education, fluoride tablets or rinses when fluoridation is not available, and access to dentists for assessment, cleaning, and treatment are also an essential part of public health.
More recently, topical application of fluoride and the use of plastic dental sealants, developed in the 1970s, to reduce exposure of pits and fissures in teeth to caries-causing organisms has been shown to be highly effective.
There are a variety of mechanisms by which fluoride exerts anticaries properties.
Fluoride present in the aqueous phase of enamel interacts with calcium in the calcium–phosphate matrix of enamel and both inhibits demineralization and promotes remineralization of enamel.
This has interfered with the institution of this preventive health measure in many locations, but over time fluoridation is being more widely implemented; it has been adopted by most of the major cities in the USA.It requires a multidisciplinary team of engineers, chemists, physicians, nutritionists, and dentists.The efficiency of fluoridation is proven to be safe and cost-effective.The CDC has been the lead agency in promoting fluoridation since 1975.In 2011, CDC recommended reducing the recommended fluoride level from a range of 0.7–1.0 parts per million (ppm) to 0.7 ppm in order to reduce the possibility of excess fluoride from multiple sources, including natural levels in water and toothpaste, with consequent dental fluorosis or tooth staining.