BOH Agenda 032520 - Laserfiche WebLink

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1 . 3 . 4 Critical appraisal of pre- and post-eruptive caries-preventive effects of fluoride in drinking water The initial belief that fluoridation prevented caries solely via pre -eruptive mechanisms was a deduction based on the historical epidemiologic studies that discovered fluoride ' s contributions to both dental fluorosis and dental caries . The subsequent " paradigm shift " in thinking that favored a predominantly post-eruptive mechanism occurred near the end of the 20th century . It was based on an upsurge in biological studies and re - analysis of the historical epidemiologic data . This century, new studies of adults and other studies designed specifically to test relative contributions of each mechanism offer support for the pre - eruptive mechanism . Also, findings from studies of fluoride supplements and milk fluoridation provide in - principle support that pre - eruptive mechanisms are important for population - level prevention of dental caries . Overall , the studies of caries preventive mechanisms support a combination of pre - eruptive and post-eruptive effects of fluoride in drinking water . Over time, scientific opinion has altered as to whether the " predominant " contribution is via one or the other mechanism , with studies this century suggesting that it is probably a draw . Logically, the share attributable to pre - eruptive effects is greatest in childhood ( where little time has elapsed in order for a post-eruptive effect to accrue ) and it is necessarily predominant in adulthood . It seems unlikely that any single biological experiment or observational epidemiological study will resolve the question definitively . Instead , the most defensible conclusion is that both mechanisms are important in understanding caries preventive benefits of fluoridation . It follows that the greatest caries- preventive benefit is achieved when both mechanisms operate, which occurs for individuals who have lifetime exposure to fluoridation . 4