Czech and Slovak Republics: From water fluoridation to salt fluoridation

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Czech and Slovak Republics: From water fluoridation to salt fluoridation

Marthaler, Pollak

Up to 1989, the Czech Republic (then still together with the Slovak
Republic) had a water fluoridation policy. An apparatus for
fluoridation in middle sized cities was developed. Water fluoridation
in Czechoslovakia started in the small town Tabor in 1958 and was
subsequently introduced in many middle-sized cities. In Brno, the
second largest city, fluoridation began in 1960 and in the capital
Prague in 1962. About 10 smaller cities followed in 1963-65. In the
following years, approximately one-third of the population benefited
from water fluoridation. For rural areas, the daily intake of fluoride
tablets was recommended an in part carried out.

With the end of the communist regime in 1989, public health dentistry,

particularly the school dental services, were not continued. Water
fluoridation was abandoned but was maintained in a few towns until
1993. Subsequent surveys indicated an increasing caries prevalence
after these changes (reference, Broukal?).

Soon after the fall of the iron curtain, 2 czecho/swiss dentists

residing in Switzerland since 1968 made tenacious efforts to introduce
preventive programs the effectiveness of which they had experienced in
Switzerland during 2 decades. Attempts were made to introduce
supervised toothbrushing exercises in schools with concentrated
fluoride preparation, similar to those in Switzerland. These began in
1995 and were supported by GABA (a Swiss toothpaste and toothbrush
producer) and the 2 dentists travelled several times per year to their
former home country to monitor school-based prevention. The contacts
thus established with the health ministries of both republics offered
the opportunity to suggest salt fluoridation. Salt fluoridation was
also discussed at 2-day-seminars on preventive dentistry with Prof
Künzel (Erfurt), Dr. Pollak and Prof. Marthaler as main speakers, which
were organized in conjunction with the Czech Dental Association and the
dental schools of the local Universities (Prague, 1996; Olomouc, 1997;
Brno, 1999). Production of fluoridated salt started in Olomouc in the
Czech Republic in 1994. In Fluoridated salt imported from Germany has
also been on sale since 1994. Its market share among the domestic salt
was approximately 35 % in the last few years. Leaflets, CD’s and other
means for promotion of fluoridated salt were created. Dentists have not
been very active in recommending the use of fluoridated domestic salt.

With the help of the two dentists who emigrated to Zurich in 1968 and

held more than one hundred of speeches and lectures on preventive
dentistry (almost every dentist in the two Republics has been attending
such lectures, and the two dentists have been granted lecturerships at
university dental schools) supervised toothbrushing programs are now in
operation in schools. Usage of toothbrushes and fluoridated toothpastes
have increased. In addition, 2 schools for dental hygienists were
initiated in the early nineties (1994, Usti and Praha).

In the Slovak Republic, the situation has been similar. Since 1994,

supervised toothbrushing exercises in kindergardens and schools were
introduced simiar to the Swiss system. Two schools for dental
hygienists were created (the first one in 1994 in Presov) and showed
great interest in prevention. Production of fluoridated salt was
started in the salt factory in Presov, Eastern Slovakia in 1994 and one
year later in Bratislava. (1995).

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