Dental health and fluoride supplements on Tristan da Cunha

Abstract

Background The island of Tristan Da Cunha is one of the few examples in the world of a remote enclosed community. The inhabitants of the island were transported to England in 1961 as a result of a volcanic eruption and during their time in England they received a detailed dental health examination. They were later examined back on the island in 1966 by Dr John Fisher and in 1982 a school fluoride supplementation programme was introduced. Aim The present paper reports the results of the first dental health survey to be carried out on the island since the introduction of a regular school fluoride supplementation programme in 1982. Subjects and methods A cohort of 6–19-year-old subjects on the island were examined in 1996 using a similar protocol to that which was used by Fisher in the 1966 examination. Results Comparing the 6–12-year-olds who were caries free in 1966 with those caries free in 1996 using the Chi-squared statistic reveals a statistically significant greater number caries free in the more recent cohort (χ2 = 6.0, p = 0.014). For the older age group (13–19 years), a similar comparison reveals a highly statistically significant difference (χ2 = 12.26, p = 0.005). Conclusions A significant increase in the number of caries free 6–19 year old children in Tristan Da Cunha between 1966 and 1996 was noted: 1) This is a significant finding in the light of the school fluoride supplementation programme that was introduced on the island in 1982; and 2) Appropriate fluoride supplementation regimes may have conferred a protective effect in a group of children with a cariogenic diet. The paper discusses the significance of this study in the support of fluoridation as a method of reducing the prevalence of dental caries and also discusses possibilities for future research on the island of Tristan Da Cunha.