OBJECTION: The topical application of fluoride to the teeth is equally as efficient in reducing the incidence of dental caries as the consumption of fluorides in the drinking water, and presents fewer problems.
APPRAISAL: The topical application of fluoride has been shown by Knutson and Scholz to produce an average reduction pf 40 percent in the incidence of dental caries. The studies of controlled fluoridation of supplies of communal water have demonstrated a 58 percent reduction in the incidence of dental caries in permanent teeth in Newburgh, New York, an 80 percent reduction in caries experience in the six-year-group in Evanston, Illinois, and 53.9 percent in the age groups 5 to 15 in Brantford, Ontario.
Topical applications have been evaluated by the St. Louis Medical Society which reported the following conclusions: "Topical applications of fluorides (directly to the teeth) has proven to be of definite value as a measure of prophylaxis against tooth decay. It has been demonstrated, however, to be less effective in its reduction than that produced by the systemic intake of fluoridated water from birth. The limited number of dental personnel available in both public-health and private practice, and the expense of such a method, make it a poor choice of methods of treatment in comparison with fluoridation of a community's supply of water. It is wholly impractical as a public health measure, therefore, in any but the small or rural areas."
Aside from the facts just established, fluoride must be applied topically in several series of treatments. Conscientious cooperation, personal inconvenience, and loss of time as well as a budget are required. Kesel has concluded, in view of these factors, that the topical application of fluoride cannot be very effective in controlling dental caries for large groups of people.