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Objectives: The study aimed to use Geographic Information Systems (GIS) to investigate the spatial distribution of the concentration of fluoride (F) in groundwater resources of Sri Lanka, and the geographic accessibility to an alternative water source having a low or safe F limit to mitigate dental fluorosis. Methods: The study used randomly collected (6107) groundwater samples from Sri Lanka and categorized them as "dentally optimal" and "unsafe" based on their F content. The minimum distance from an identified high F source (above dentally optimal level) to a safe groundwater source was determined using geospatial analysis. Results: Dentally optimal F sources (<1 and <1.5 mg/L) were identified among the high F groundwater sources (>2 mg/L), some even within a walking distance of 500 m. Results indicated that 26% of dentally unsafe groundwater sources (2.0 mg/L+ wells) had a low F source (<1.0 mg/L) available within a distance of 500 m. It was also evident that 39% of high F wells (2.0 mg/L+ wells) had a low F well (<1.5 mg/L) within a distance of 500 m, if the WHO guideline value for optimal F levels (1.5 mg/L) was assigned as the safe F limit. Conclusion: The spatial approach demonstrated a reasonable access to alternative water sources with low or safe F limit in endemic fluorosis areas. Optimizing the use of accessible low F sources is highly recommended as the first‐line option to mitigate dental fluorosis in Sri Lanka since the defluoridation methods introduced in past did not provide sustainable oral health solutions for the inhabitants in high‐risk areas. [ABSTRACT FROM AUTHOR]

Background: The School Dental Service contributes to the reduction of social inequalities in oral health among school children. Aim: To investigate the distribution of School Dental Clinics staffed by School Dental Therapists in Sri Lanka in relation to the distribution of the child population and socioeconomic status. Design: School Dental Clinics were mapped using geographic information system (GIS) software and overlayed with population data of 3–13‐year‐old children (including poverty status). Results: Overall, there was an uneven geographic distribution of the total 422 School Dental Clinics. Sri Lankan children have restricted access to school dental care in a few poverty stricken districts in the Northern, Eastern, North Central, and Uva provinces. When the geographic distribution of children by poverty status was analysed, it was found that in Sri Lanka, only 53% of the most socially disadvantaged children lived within 5 km from a School Dental Clinic, compared to 75% of the least disadvantaged. Conclusion: A coordinated national School Dental Service strategy is needed in response to identified areas of poor or inadequate accessibility to dental services for large parts of the child population, especially those from low socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

Our study aimed to demonstrate the use of Geographic Information Systems (GIS) to assess the distribution of public dental clinics in Sri Lanka by developing a baseline population based geographic model. Population data was obtained from the Population & Housing Census (2001) and socioeconomic data from the Household Income & Expenditure Survey (HIES) 2002. Public dental clinic locations were obtained from the office of the Chief Dental Officer. About 3 million people (11.7%) out of a total of 2.2 million lived in Divisional Secretariat (DS) divisions devoid of public dental clinics were further disadvantaged by poverty prevalence rates exceeding 30% in their respective divisions. Moreover, 14% of the total population lived in a DS division without a public dental clinic. Of people below the poverty line, about 2.76 million lived in DS divisions where there was no public dental clinic. Therefore, it is concluded that distribution of public dental clinics in Sri Lanka has obvious limitations in serving the rural poor. The spatial approach provides a useful decision-support tool in health informatics with an enormous potential to harness in equity based public health care planning. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the distribution of groundwater fluoride levels in Sri Lanka in relation to its population distribution to determine the population at risk for dental caries or dental fluorosis., Methods: The study used the most upgraded spatial distribution map of groundwater fluoride levels in Sri Lanka, and it was overlaid with a census of population data of the country., Results: The results indicated that 12% of children aged <12 years were at risk for dental fluorosis, while 81.4% of those who lived in low-fluoride zones were vulnerable for development of dental decay. Overall, 82.4% of the country's population lived in low-fluoride zones and 11.2% were at risk of potential health hazards posed by ingestion of excessive fluoride., Conclusion: The spatial approach provides a useful decision-support tool for developing an oral health strategy of safe fluoride use based on predicted oral health risks in communities., (© 2019 FDI World Dental Federation.)