Relative effects of pre- and posteruption water fluoride on caries experience of permanent first molars

OBJECTIVES: Previous studies have attributed the caries-preventive effects of preeruption (PRE) and posteruption (POST) exposure to fluoridated water based on data collected before and after the commencement or discontinuation of water fluoridation. This study aims to determine the relative pre- and posteruption exposure effects of fluoridated water on caries experience of 6-15-year-old Australian children based on individual residential histories. METHODS: Parental questionnaires covering residential history of participants were linked to their oral examinations conducted between June 1991 and May 1992 by the School Dental Services of South Australia and Queensland. Percentage of lifetime exposed to optimally fluoridated water PRE and POST was calculated with respect to the eruption age for first permanent molars. Combined pre- and posteruption categories were created to test PRE against POST exposure: PRE & POST = 0, PRE < POST, PRE = POST in the range 0-90 percent of lifetime exposure, PRE > POST, and PRE & POST > or = 90 percent lifetime exposure. These categories were used as indicator variables with PRE and POST = 0 as reference in an analysis of first permanent molar DMFS scores. The linear regression model controlled for important potential confounders. RESULTS: Participation rates were 69.7 percent in South Australia and 55.6 percent in Queensland with 9,690 and 10,195 participants, respectively. Pre- and posteruption exposures were strongly correlated (r =. 74; P < .01). Compared to the reference, the categories PRE > POST, PRE = POSTin the range 0-90 percent, and PRE and POST > or = 90 percent showed significantly lower caries levels. CONCLUSIONS: The findings indicated that preeruption exposure was required for a caries-preventive effect and that exposure after eruption alone did not lower caries levels significantly. However, the maximum caries-preventive effects of fluoridated water were achieved by high pre- and posteruption exposure.     

Dental caries experience in schoolchildren in fluoridated and non-fluoridated communities in Western Australia

A cross-sectional survey was undertaken in 1987 to measure the difference in caries experience in schoolchildren between a fluoridated (0.8 mg/L F-) and a non-fluoridated region (0.1-0.4 mg/L F-). 3436 children aged 5-15 yr were examined. Children in the non-fluoridated region had a higher caries experience than those in the fluoridated region. Mean differences were 1.06 dfs (95% CI = 0.66 to 1.47, P less than 0.001) and 0.48 DFS (95% CI = 0.23 to 0.72, P less than 0.001). After adjusting for potential confounding factors (fluoride tablet consumption, socioeconomic status, number of fissure-sealed surfaces, and mobility between regions) the relative risk of not being caries-free in the non-fluoridated region compared with the fluoridated region was 1.43 (95% CI = 1.21-1.70, P less than 0.0001) for the primary dentition and 1.39 (95% CI = 1.18-1.63, P less than 0.0001) for the permanent dentition.     

Indigenous Australian dental health: a brief review of caries experience

The indigenous community in Australia is an at risk population for oral diseases such as dental caries. The majority of communities are isolated and dental services in these areas are limited. Oral hygiene standards are poor and this combined with a diet rich in refined carbohydrates has led to high incidences of dental caries. In addition, diabetes, which is related to obesity (and a diet high in sugar and fat) has been linked to increases in oral disease. Caries prevalence was found to be low in areas where fluoridation levels in the water were high. The fact that the fluoride supplementation appears to improve oral health to a significant degree suggests that implementation of fluoride treatment programmes for school children and, where viable, fluoridation of water sources would be appropriate. In addition, dental education programmes should receive high priority. As with the rest of the community, these preventive measures will result in less need for emergency dental treatment in the future, better oral health for the community and reduced financial burden on the State. It is under these circumstances that oral health planners and providers must, in consultation with the relevant community representatives, develop appropriate mechanisms to address the needs of this group. The development of strategies that integrate with the plethora of general health strategies currently being implemented is just one means of achieving improved oral health outcomes for indigenous Australians.     

Dental Caries and Dental Fluorosis at Varying Water Fluoride Concentrations

Objectives : The purpose of this study was to investigate the relationships between caries experience and dental fluorosis at different fluoride concentrations in drinking water. The impact of other fluoride products also was assessed. Methods : This study used data from the 1986–87 National Survey of US Schoolchildren. Fluoride levels of school water were used as an indicator of the children's water fluoride exposure. The use of fluoride drops, tablets, professional fluoride treatments, and school fluoride rinses were ascertained from caregiver questionnaires. Only children with a single continuous residence ( n =18,755) were included in this analysis. Results : The sharpest declines in dfs and DMFS were associated with increases in water fluoride levels between 0 and 0.7 ppm F, with little additional decline between 0.7 and 1.2 ppm F. Fluorosis prevalence was 13.5 percent, 21.7 percent, 29.9 percent, and 41.4 percent for children who consumed <0.3, 0.3 to <0.7, 0.7 to 1.2, and >1.2 ppm F water. In addition to fluoridated water, the use of fluoride supplements was associated with both lower caries and increased fluorosis. Conclusion : A suitable trade-off between caries and fluorosis appears to occur around 0.7 ppm F. Data from this study suggest that a reconsideration of the policies concerning the most appropriate concentrations for water fluoridation might be appropriate for the United States.     

Dental caries in a cohort of very young American Indian children

Objectives: This paper reports the prevalence and severity of caries in a group of 16‐month‐old American Indian children. Methods: The study is an ongoing longitudinal study of risk factors for caries in children from a Northern Plains Tribal community. Children were examined for caries and risk factor data collected at approximately 1, 4, 8, 12, and 16 months of age. Surface‐specific caries data were collected and the presence of precavitated “white spot” lesions was recorded at the subject level. Results: The mean age was 15.4 months for the sample of 232 children. Caries prevalence was 31.9 percent, while an additional 29.3 percent had white spot lesions only. Mean dmfs was 1.57, and ranged from 0 to 44 surfaces. Nearly 3 percent of all erupted tooth surfaces were affected and maxillary central incisors had the highest prevalence of caries (22 percent). Conclusions: Among the very youngest children, dental caries prevalence was very high among these American Indian children.     

Declining prevalence of dental caries in school children in Singapore

OBJECTIVE: Dental health surveys of school children in Singapore from past decades were reviewed to document reductions in prevalence of dental caries.
MATERIALS AND METHODS: Surveys were carried out in schools by the Dental Division, Ministry of Health in 1970, 1979, 1984, 1989 and 1994.A sample size of approximately 5000 school children representing 1.2% of the school population aged 6 to 18 years old was examined in each survey.
RESULTS: Survey data showed an increase in the proportion of children free of caries in the permanent dentition from 30% in 1970 to 58.7% in 1994. The DMFT index for 6 to 18 year old children has dropped from 2.98 in 1970, 2.61 in 1979, 1.97 in 1984, 1.61 in 1989 to 1.05 in 1994.
CONCLUSION: Fluoridation of public water supplies together with the adoption of preventive dental health programmes by the State and professional bodies is credited as the major factor in caries reduction.     

Relationship between fluoridation and socioeconomic status on dental caries experience in 5-year-old New Zealand children

This article examines the relationship between fluoridation and socioeconomic status on caries experience, as measured by the dmf index, in 5-yr-old New Zealand children in the city of Dunedin (fluoridated in 1967) and in adjacent non-fluoride communities. The children were subdivided into six socioeconomic status groups (SES 1, professional and managerial-SES 6, unskilled workers), but then for simplicity they were combined to form three groups. A two-way analysis of variance demonstrated that interaction between fluoride history and socioeconomic status was not significant. In all three SES groups, dmf was higher in non-fluoride communities, but the difference was significant only in SES group (5&6) (P less than 0.01). Caries experience increased with decreasing socioeconomic status in both fluoride and non-fluoride communities, but this effect was only significant between SES groups (1&2) and (3&4) in the fluoridated community (P less than 0.05), and between SES groups (3&4) and (5&6) in non-fluoride communities (P less than 0.01). These results are compared with those of similar studies, and it is concluded that so far, the relationship between fluoridation and socioeconomic status on caries experience remains equivocal. A note of caution is sounded regarding the interpretation of such results, and the difficulties faced when comparing studies is discussed.     

Effect on caries experience of lifetime residents after 10 years of fluoridation in Townsville, Australia

An oral health survey was conducted in the tropical city of Townsville 10 years after its water supply was fluoridated to a level of 0.7 parts/106. The results of the calibration of examiners prior to the survey are presented. Checks on the consistency and comparability of the results obtained by each examiner during the survey show that the results are reliable and reproducible. Dental caries experience of both primary and permanent teeth was found to be significantly lower in Townsville than in 16 non-fluoridated towns. Comparisons are also made between the prevalence of caries in Townsville and four naturally fluoridated towns.     

Dental caries experience and prevalence of children afraid of dental treatment

The aim of this study was to examine the clinical outcome with regard to dental caries of high self reported dental anxiety in a group of Scottish secondary schoolchildren. 1103 children participated in the study, mean age 14 yr (sd 0.35 yr), and the prevalence of high dental anxiety was 7.1% (95% CI = 5.6%, 8.6%). When these children were compared with their contemporaries their DMFT and all its components were higher but only the mean MT reached statistical significance after adjusting for gender and social class. Children with a high dental anxiety were 62% more likely to have at least 1 missing tooth due to caries. In addition this group when compared to the rest of the study population, had a significantly lower mean number of teeth fissure sealed and a lower proportion of children with sealants. No similar trend was obvious for children who had a high general fear. The dentally anxious more accurately perceived their treatment need and were more likely to defer, cancel or not turn up for dental appointments.     

The geodemographic distribution of caries experience in neighboring fluoridated and nonfluoridated populations

OBJECTIVE: This study compares the geodemographic distribution of caries experience in neighboring fluoridated and nonfluoridated populations. METHODS: All 5-year-old children living in fluoridated (N=1,422) and nonfluoridated (N=4,779) areas of Cheshire, UK, were examined by trained and calibrated examiners. The Target Market level of the Super Profiles geodemographic classification was used to produce market penetration ranking reports for caries experience. The same area types were compared in fluoridated and nonfluoridated populations. Lorenz curves and Gini coefficients were generated from the outputs of the penetration rankings. RESULTS: There was a 12.4 percent difference in prevalence and a 29.4 percent difference in dmft between fluoridated (dmft>0=32.4%, dmft=1.01) and nonfluoridated (dmft>0=37.0%, dmft=1.43) areas. The area types at the top of both penetration rankings were deprived in nature and those at the bottom were affluent. The Gini coefficients in each area were 22.7 and 23.7 percent. CONCLUSIONS: The results demonstrate that water fluoridation is effective at preventing dental disease after controlling for confounding factors. In both populations the majority of disease was not confined to a small number of deprived area types. This undermines the contention that a targeted approach to caries prevention is a practical option.     

Associations Between Exposure to Fluoridated Drinking Water and Dental Caries Experience among Children in Two Australian States

Objectives : This study assessed associations between exposure to fluoride in water and dental caries experience among children in two Australian states. Methods : Cross-sectional data were obtained from 9, 690 South Australian children aged 5–15 years and 10, 195 Queensland children aged 5–12 years. School dental service practitioners recorded DMFS and dmfs data. A questionnaire to parents gained information about residential history that was used to calculate children's percent of lifetime exposed to fluoridated water. Results : Greater exposure to fluoride in water was associated with lower dmfs and DMFS in both states (P<. 01), although in South Australia the effect for DMFS was statistically significant only after controlling for extent of unknown fluoridation exposure and for fluoride supplements. Caries-fluoridation associations were stronger for dmfs compared with DMFS and for Queensland (5% of population fluoridated) compared with South Australia (70% of population fluoridated). Effects for DMFS persisted after controlling for socioeconomic factors. Conclusions : Fluoridation was associated with lower caries experience. The weaker association with DMFS in South Australia may be due to less caries and more fissure sealants in that state, and is consistent with a "diffusion" effect, whereby a high proportion of the population exposed to fluoridation diminishes differences among exposure groups.     

昆明市儿童龋病和氟牙症流行状况调查

目的 通过对昆明市儿童龋病和氟牙症的流行病学调查,为该区开展饮水加氟预防龋齿提供可行性依据,并为昆明市龋病和氟牙症长期流行病学研究提供基础数据.方法 采用分层、整群随机抽样方法,调查5、12岁2个年龄组儿童各212、1 149人,调查内容包括5、12岁儿童龋病患病现状以及12岁儿童氟牙症流行现状.结果 昆明市5岁儿童...     

Dental caries experience of 16–17-year-old naval recruits related to the water fluoride level in their home town

Abstract Out of 6694 recruits who joined the Royal Navy between September 1979 and February 1981. 1983 (30%) had lived all their lives in one locality. Information on the fluoride level, between 1963 and 1980, in the water supply to each of the recruits' homes was obtained. The examiner recording the dental status of each recruit did not know where the recruit had lived. Some of the information on fluoride levels was imprecise or of variable quality so the final analyses were restricted to 1332 16–17-year-old subjects. The overall mean DMFT for the 1332 recruits was 9.72. There was a consistent fall in caries experience with increasing water fluoride level although the difference between the caries experience of recruits from low and high fluoride areas (about 20% for mean DMFT) was smaller than that observed in other studies. A possible explanation for this smaller difference is that some of the subjects did not receive fluoridated water early in life.     

Three-year report on caries prevention using fluoride varnishes for caries risk children in a community with fluoridated water

Abstract – The Benifit of seminnual application of the sodium fluoride varnish Duraphat^(R) and the silane fluoride varnish Fluor Protector^(R) was studied in 11–13-year-old children with high caries activity and lifelong exposure to fluoridated drinking water (1–1.2 parts/10⁶). Annual clinical and radiographic examinations were made of 62 children in the Duraphat group and 70 children in the Fluor Protector group. Fluoride varnish was applied semiannually using the half-moth technique. After 3 years, for the Duraphat group mean total DMES increments on the control side were 6.2 and on the test side 4.3 ( P <0.001); for the Fluor Protector group the DMES increments were 4.9 and 4.4, respectively (NS). The caries reductions were 30% and 11%. Since ther were no differences between initial mean DMES scores of the groups, it is possible that the lower increment in the Fluor Protector control side compatred to the Duraphat control side was due to fluoride ions from Fluor Protector crossing the midline and providing protection on the control side as well. Therefore, we conclude that Duraphat proved effective, but definite conslusion of the effect of Fluor Protector cannot be made. Children with the highest DMES increment on the control side (duraphat) gained most from the applications.