Acceptance, caries reduction and reported adverse effects of fluoride prophylaxis in Norway

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Abstract
Water fluoridation was not introduced in Norway, although 99% of the population receive water with suboptimal fluoride levels. Alternative methods of fluoride prophylaxis gained wide acceptance in this country. While less than 1% of the children received fluoride tablets in 1971, sales data in 1976 indicated a daily supply of fluoride tablets to 50% of the 0-5 yr olds and to 20% of the 6-11 yr olds. Most schoolchildren joined mass prophylactic programs with regular applications of fluoride solutions. Fluoride-containing dentifrices are available and are increasingly used. The increased use of fluoride was paralleled by a marked reduction in caries and restorative need. During the past 5 yr, a reduction of about 45% in the number of fillings inserted in 6-17 yr old children was noted. In some areas, a 70% reduction was recorded. The ratio between expenses for prophylaxis and savings in cost of treatment is favorable. The Norwegian Adverse Drug Reaction Committee received 34 case reports of adverse effects ascribed to fluoride prophylaxis from 1970-1977. None of the 25 follow-up studies performed suggested fluoride was responsible for the reported symptoms. In Norway, the benefits of fluoride prophylaxis are becoming increasingly evident.

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