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Tuesday, 1 November 1983
Page: 2162

Question No. 385

Dr Everingham asked the Minister for Health, upon notice, on 24 August 1983:

(1) What instructions in the use of fluoride solutions are given (a) to dental therapy trainees and (b) by dental therapists to selected parents.

(2) What supervision of mouth rinsing practices of children is recommended in these instructions.

(3) Are the use of (a) fluoridated dentifrice, (b) topical fluoride gel or (c) fluoride rinsing (i) used, (ii) recommended or (iii) warned against in (A) districts with water fluoridation and (B) patients with dental fluorosis in such districts.

Dr Blewett —The answer to the honourable member's question is as follows:

1 (a) While the Commonwealth has no responsibility for matters concerning the use of fluoride solutions by States for the control of dental caries, the following information is provided.

Instructions which are given to dental therapist trainees include the criteria for use of this preventive treatment, type and strength of the solutions used, technique of application and advice that solutions should not be swallowed. A solution which is frequently used for topical application contains 1.23 per cent of fluoride, and is used at intervals of six to twelve months.

The use of fluoride solutions in school dental services is generally limited to children in non-fluoride areas, or to patients with high level of dental caries.

Mouth rinsing programs using fluoride solutions are practised to a limited extent in New South Wales, South Australia and Western Australia. Instructions for such programs include the selection of children, the quantity and type of the fluoride solution to be used, the period and frequency of rinsing, and it is emphasised that the solution is not to be swallowed. Sodium fluoride solutions of 0.2 per cent are normally used and the rinsing may be repeated up to six times in the year. The volume of fluoride solution used on each occasion is limited to 10 mls.

1 (b) In cases where children have a high level of dental caries, dental therapists may suggest that a child receive topical fluoride treatment, or in those States which use fluoride mouth rinse programs, dental therapists may suggest that a child be included in a mouth rinse program at school. Dental therapists do not recommend the home use of fluoride mouth rinses except in Western Australia where selected parents are informed that fluoride rinses can be purchased at pharmacies and should be used strictly in accordance with the instructions given on the label.

(2) Mouth rinsing with fluoride solutions at school is carried out under the supervision of either staff of the school dental service, a teacher or a teacher 's aide. The general control of such programs is a matter for dentists of the school dental services.

3 (a) The use of a fluoride dentifrice is recommended in fluoridated and non- fluoridated areas.

(b) Topical fluoride gels are used and recommended by the school dental services in Victoria, the Northern Territory and the Australian Capital Territory. Fluoride gels are not warned against. However, most States prefer to use a fluoride solution. As indicated above (3 (a)) topical fluoride treatment is used primarily in areas where the water is deficient in fluoride, or for children with a high level of dental caries.

(c) While rinsing with fluoride solutions is recognised as an effective method for the control of dental caries its use has not been recommended in the majority of State and Territorial school dental services. Fluoride rinsing is recommended as an accepted procedure in the school situation in New South Wales, South Australia and Western Australia but currently is not widely applied. Recommendation concerning the use of fluoride rinses at home has been covered in paragraph 1 (b) above.

The procedure of rinsing with fluoride solutions is not warned against as long as it is subject to adequate supervision and control.

The following comments concerning dental fluorosis apply to each of the paragraphs (3) (a), (b) and (c) above. Dental fluorosis is a manifestation of a high systemic fluoride intake during the period of tooth formation and does not change the approach to the use of fluoride dentifrices, topical fluoride gels or solutions, or fluoride rinsing, but suggests consideration of the present systemic intake of fluoride. Fluorosis of aesthetic significance is uncommon in Australia. Children with dental fluorosis generally have a low level of dental caries so that topical fluoride application or mouth rinsing with fluoride solutions is not appropriate.