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Alves RX. Evolution's coverage of the fluoridation of public water supply in the State of Sao Paulo, Brazil, from 1956 to 2009 [Dissertation]. Sao Paulo: Faculdade de Saude Publica da USP; 2010. Introduction – Dental caries still represents, in terms of oral health, the main concern in public health in Brazil. Fluoridation has played an important role in reducing caries rates, and was considered one of the top ten great public health achievements of the twentieth century. Regulated by the Brazilian Ministry of Health in 1974, the measure had strong expansion in the 80‟s, especially in socio-economical developed regions, as the State of Sao Paulo. The expansion of coverage to municipalities with fluoridated water treatment systems is a priority of national policy on oral health. Objectives Identify, reunite and systematize available information on the coverage of fluoridation and describe its evolution in the state of Sao Paulo regarding period 1956 to 2009. Material and Method A descriptive study using secondary data, taking as the unit of analysis districts of the State of Sao Paulo, describing a historical coverage since the imposition of the measure. The presentation of data is done using tables, graphs and thematic maps derived from geographic information systems. Results Fluoridation coverage in the State of Sao Paulo has grown from one to 536 municipalities in the period 1956 to 2009. The State introduced in 2009, 85,1% of the total population covered by the measure and 93,5% of population with access to the distribution of water, served by fluoridated water. The majority (99%) of the population lives in towns without access up to fifty thousand inhabitants. Conclusion The expansion was slow, with rapid and significant increase in the 80‟s, but consistently over time, showing that the State of Sao Paulo consolidated this important public health measure as part of state‟s health policy. Despite this positive development, there was an interruption in 35% of cities that implemented the measure until 1988. Considering that all counties have water treatment systems and the national legislation provides that all systems including fluoridation as a phase of treatment, there remains still the challenge of deploying and maintaining this resource in 99 municipalities. Despite all they are small populations, their populations are entitled to this benefit and it is up to public authorities to make this right a reality, to ensure the reduction of inequalities in health.

Evolução da cobertura da fluoretação da água de abastecimento público no Estado de São Paulo, Brasil, no período de 1956 a 2009