Fluoride supplements and changes in tooth decay on the Island of Tristan da Cunha: 1966–1996

Key Points The island of Tristan da Cunha is one of the few remaining enclosed communities in the world. This paper reports the results of the first dental health survey to be carried out on the island since a fluoride supplementation programme was introduced in 1982. The dental health of 6–19-year-old children in Tristan da Cunha showed a significant improvement between 1966 and 1996. The number of caries-free individuals is suggestive of the efficacy of a school fluoride supplementation programme. The availability of longitudinal records makes this a good population for carrying out future studies of dental health and disease. 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 (χ 2 = 6.0, p = 0.014). For the older age group (13–19 years), a similar comparison reveals a highly statistically significant difference (χ 2 = 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.