CASE 18: Preventing Dental Caries in Jamaica

Map showing Jamaica

How do we know

In order to evaluate the effects of salt fluoridation, an oral health survey was launched in 1995 to compare the caries scores with those observed in 1984. Thirty nine schools out of 800 were randomly selected and a total of 1113 children who were 6 to 15 years old were examined. Two dentists and 7 auxiliaries were calibrated as examiners and 9 dental assistants as recorders, in a 2-day training workshop. Data was collected according to the WHO Oral Health Surveys Manual.


Health Condition: Dental caries, or tooth decay, is one of the most common chronic health problems of children. Untreated caries is painful and may affect diet, school attendance, and sleep. Tooth decay can have significant negative health and social consequences in later life. In the early 1980s, dental caries in Jamaica was widespread. On average, children had 6.7 decayed, missing, or filled teeth, and fewer than 3 in every 100 children were free of caries.

Intervention or Program: In 1987, at the encouragement of a dentist from the country's Ministry of Health, Jamaica's only salt producer began producing and selling fluoridated salt. The Ministry of Health and the Jamaican Parliament completed the necessary legal and regulatory framework, and the government provided biological and chemical monitoring of the salt.

Impact: By 1995, the health of children's teeth in Jamaica had improved dramatically. In both 6-year-olds and 12-year-olds, the index of the severity of caries had fallen by more than 80 percent.

Cost and Cost-Effectiveness: Salt fluoridation costs only 6 cents per person annually. Cost savings from the program are extraordinary: For each $1 spent on salt fluoridation, $250 will be saved in reducing the need for future dental treatment.