Salt fluoridation in Central and Eastern Europe.

For decades Central European countries have been interested in preventive dentistry. Water fluoridation played a major role in the former German Democratic and Czechoslovak Republics and a minor one in Poland. These schemes were abandoned after 1989. Extensive research on all aspects of salt fluoridation was conducted in Hungary from 1966 to 1984 but attempts to introduce it in the country have had little success. Salt fluoridation was implemented in the Czech and the Slovak Republics in the mid-nineties. The market share of the fluoridated domestic salt appears to have reached 35% in the Czech Republic; it became eventually part of a preventive strategy comprising school-based dental health education including topical fluoride. Another four countries have been considering salt fluoridation but schemes did not materialize. Antifluoridation activities occasionally impeded caries prevention, and for years some respected dentists declared their position against fluorides. Caries prevalence in 12-year-old children is by 1 to 3 DMFT higher than in Western Europe. For many years to come, modern fluoride-containing toothpastes and dentifrices may not be affordable for the lower socio-economic strata of the populations in Central and Eastern Europe. It is concluded that salt fluoridation, which is by far the cheapest means of lowering caries prevalence, could markedly improve the oral health situation even if the economical situation is slow to improve.