目的：

7th Congress of AAPD: Symposium II
30. Nov. 2006, Main Hall,
Okayama University 50th Anniversary Hall
Part II: Spreading school-based fluoride mouth rinsing program (S-FMR)
National survey on the school-based
fluoride mouth rinsing program in Japan
- Regional spread conditions in various kinds of schools -
Kazunari Kimoto* 1, 2
1 Division of Oral Health, Department of Health Science,
Kanagawa Dental College, Japan
2 Non-profit Japanese Conference on the Promotion of the
Use of Fluoride in Caries Prevention, Japan (NPO-JPUF)
Background
Background
Total population: 127,756,000
Sapporo
4-5 years old: 2,234,000
6-11 years old: 7,194,000
Children: 13,114,000
Niigata
Sendai
12-14 years old: 3,626,000
Okayama
Number of Dentists: 95,157
Tokyo
Yokosuka
(04 From Minister of Health, Labor and Welfare)
To one million population by 746 Dentists
Number of Dental Hygienists: 79,695 (04 From Minister of Health, Labor and Welfare)
To one million population by 624 Dental Hygienists
Okinawa
Background
Background
The mean DMFT at 12-year-old in 05
Sapporo
1.82
DT : 0.60, MT : 0.03, FT
FT::1.19
1.19
from Minister of Education, Culture,
Sports and Technology Japan
Niigata
Okayama
Sendai
Tokyo
Yokosuka
In Japan, medical expenses insurance is on a piece-rate basis,
national dental expenses/national income is 0.7%; ¥ 2,538 billion,
04. The dental expenses insurance was included slightly
preventive care. Unfortunately, certain dentists and dental
hygienists give priority professional care in clinic and self care in
home over public care.
Okinawa
Other fluoride uses at present in Japan:
1) Community water fluoridation;
none except some natural areas (06)
2) Professional topical fluoride application in 1-14 years old;
59% (05 From Minister of Health, Labor and Welfare)
3) Fluoridated dentifrice in market share;
88% (05 From Lion Foundation of Dental Health)
4) Number of children in FMR at home in 4-14 years old
(estimated data); 347,000
(02 From Ando, et al)
5) FMR agents as over the counter drug (OTC);
none for sale at present (30. Nov. 06)
The goals to 2010 in Japan by NPO-JPUF:
1) Community water fluoridation;
realizing in some areas
2) S-FMR; Number of children will be increased to
1,000,000
3) Fluoridated dentifrice in market share;
more than 90%
(88% in 05) ⇨ realized ?!
4) Professional topical fluoride application;
more than 60%
(59% in 05) ⇨ realized ?!
Purpose
1)
Follow up the spreading conditions of the schoolbased fluoride mouth rinsing program (S-FMR)
since 1970.
2)
Estimate the total number of schools and children
participating in the S-FMR for proposition regard-
ing final assessment of Healthy Japan 21 in 2010.
3)
Set up the next goal, and promote the fluoride
uses throughout Japan.
Materials and Methods
Data were collected by questionnaire regarding the
schools and children participating in the S-FMR, financial support for the S-FMR, frequency of rinsing,
mouth rinsing agent and fluoride concentration in the
rinsing solution.
Questionnaires were sent to the key persons and
dentists of NPO-JPUF by mail or e-mail nearly every
two years.
Additionally, the estimating number in 2010 were
determined using simple regression analysis and/or
polynominal regression analysis on the basis of the
data from 1994 to 2002, by Stat View 5.0.
Table 1
The contents of the questionnaire
for the S-FMR in Japan
1) Number of schools participating by grade level
2) Number of children participating by grade level
3) Sources of financial support
4) Frequency of rinsing per week
5) Type of rinsing solutions
(Mouth rinsing agent for use)
6) Fluoride concentration of rinsing solution
Table 2 Number of prefectures adopted the S-MFR
during the past 35 years
Year
1970
Number of
prefectures
1
Year
1982
1972
3
1974
Number of
prefectures
Number of
prefectures
18
Year
1994
1983
20
1996
38
6
1985
23
1998
39
1976
10
1987
26
2000
38
1978
15
1990
29
2002
40
1980
16
1992
32
2004
45
35
2005 47
(Schools)
(Children)
◆
10,000
Number of schools
Number of children
600,000
Children
8,000
400,000
Schools
6,000
4,000
200,000
2,000
0
0
 83
 85
 87  90
 92
 94
 96  98
 00
 02
 04
 06
Fig. 1 The changes on the number of schools and
children in the S-FMR by nearly every two year
(Schools)
(Children)
800
80,000
(Children)
(Schools)
600
(Children)
(Schools)
400
60,000
The 1st: Niigata Pref.
The 2nd: Aichi Pref.
50%
200
40,000
The 3rd: Shizuoka Pref.
80%
The 4th: Saga Pref.
20,000
0
0
1
5* 8*
15**18**
47
Rank of Prefecture (according to number)
Fig. 2 Number of schools and children in the S-FMR
in 2006 (Regional difference in 47 prefectures)♯
♯ These data must be adjusted by difference of prefectural population, attending to 2 profiles were
not adjusted in this figure.
Total number of rank from the 1st to the 5th (or the 8th) amounts to 50% of the precedence.
*
**Total number of rank from the
1st to the 15th (or the 18th) amounts to 80% of the precedence.
2nd phase (2002 - 2006)
The turning point: 2000 - 2002
1st phase (1983 - 2000)
00
1999: The Synthetic opinion of fluoride application
by Japanese Association for Dental Science
2000: The Recommend of fluoride application in Healthy Japan 21
by Minister of Health and Welfare Japan
The Technological support for community water fluoridation
by Minister of Health and Welfare Japan
The Strategy of regional project in prefectural Healthy Japan 21
2002: The Scientifically support for fluoride application
by Japanese Society for Dental Health
2003: The Guideline for fluoride mouth rinse
by Minister of Health, Labor and Welfare Japan (reorganization: 01)
Publication of The fluoride mouth rinse practical manual for
caries prevention by research meeting of fluoride application
Table 3 Number of schools and children participating,
the rate of financial support in the S-FMR by grade level
Grade level
Number of
schools
Number of
children
Financial support
Governments etc.* / The others**
Nursery school
& Kindergarten
3,313 (9.1%)*** 143,413 (6.4%)**** 84.1 % / 15.9 %
Primary school
1,528 (6.6%)
300,912 (4.2%)
89.2 % / 10.8 %
262 (2.4%)
45,508 (1.3%)
90.7 % / 9.3 %
28 (2.8%)
1,501 (2.7%)
34.8 % / 65.2 %
5,131 (7.2%)
491,334 (3.8%)
85.5 % / 14.5 %
Secondary school
Special school, etc. ♯
Total
*
The prefectural or municipal governments and/or educational committee
** The others (School, Parent, Dental Association, Jointed combination, etc.)
*** Number of schools in the S-FMR / Total schools by grade level in Japan
**** Number of children in the S-FMR / Total children by grade level in Japan
♯
The school for physically handicapped or mentally related children and the others
Table 4 Outline of the rinsing-methods in the
questionnaire for the S-FMR by grade level (%)
Grade level
Frequency per week* Fluoride concentration* S-FMR agent for use
Nursery school
& Kindergarten
5 times
/ once
225ppmF / 450ppmF / 900ppmF Reagents / Medicaments
58.0 / 26.4
48.4 / 27.7 / 17.3
38.9 / 61.0
Primary school
6.1 / 91.1
5.1 / 24.1 / 69.5
67.6 / 32.4
Secondary school
8.5 / 87.3
4.7 / 17.5 / 76.8
76.2 / 23.8
/ 37.5
15.8 / 36.8 / 42.1
48.0 / 52.0
40.9 / 47.8
33.2 / 26.2 / 35.9
48.9 / 51.1
Special school, etc.♯ 41.7
Total
* These are not the approximate value, because the rinsing-methods in the S-FMR
are different by regional distinction.
♯
The school for physically handicapped or mentally related children and the others
In Japan, anti-fluoridationists commonly want to
apply a statement in the WHO technical report.
Go ahead !!
Announcing by NPO-JPUF,
“ Beginning of fluoride mouth rinse is
recommended for Japanese (or Asian)
children in 4-5 years old.”
Tending to mislead by
WHO statement
“ FMR was not recommended for children
below 6 years old, as it might contribute to
the risk of dental fluorosis ??????????????? ”
(Fluoride and Oral Health, WHO, 1994)
In Japan, fluoride use is limited
to topical application, none
Community Water Fluoridation
S-FMR
( only 3.8% of children )
+
Fluoridated dentifrice
( 88% of market share )
USA, Canada, South America,
Australia, Europe and Asia (Malaysia,
Singapore, Hong Kong, Korea,
Thailand, China, Laos and the others)
where fluoride is enough supply
Community Water fluoridation
(or Salt fluoridation, Milk fluoridation
Fluoride supplements)
+
Fluoridated dentifrice
Professional topical fluoride application
Fluoride application
in home use;
self-applied fluoride
Conclusion
These results suggest that cooperation among dental
organizations, dental schools and municipal corporations
can play an important role in order to correct at regional
differences in the S-FMR in Japan.
We propose that a goal, the item with regarding to caries
prevention, for the S-FMR should be adopted in Healthy
Japan 21 at the final assessment in 2010.
Some public health measures based on the health
promotion should be provided in order to make a big jump
for the S-FMR in the future.
Fluoride;
だれにでもできる
小さな努力で
確かな効果
Community Water Fluoridation
and Fluoride Mouth Rinse
Lets gain everyones successful,
to surely efficacy,
by minimum effort.
I appreciate your attention and interest. Thank you very much.

Download Report