Caries in the primary dentition, after discontinuation of water fluoridation, among children receiving comprehensive dental care

Abstract – The city of Kuopio in central Finland had fluoridated piped water for 33 years, beginning in 1959. Due to strong opposition by various civic groups, water fluoridation was stopped at the end of 1992. There is little information on the consequences of stopping fluoridation in a community with comprehensive dental care for all children and adolescents, who are frequently exposed to different fluoride measures both at home and in the dental office. Objectives: The aim of this repeated cross‐sectional survey was to examine how discontinuation of water fluoridation in Kuopio affected caries in the primary dentition. Changes in the mean dmfs values between 1992 and 1995 in Kuopio were compared to those in Jyväskylä, a low‐fluoride community that has repeatedly been used as the reference area for Kuopio. Methods: In 1992 and 1995, independent random samples of all children aged 3, 6 and 9 years were drawn in Kuopio and Jyväskylä. The total number of subjects examined was 421 in 1992 and 894 in 1995. Calibrated dentists registered caries clinically and radiographically. Results: In all age groups both in 1992 and 1995, the point estimates for mean dmfs values were lower in the non‐fluoridated town. In both towns, the observed mean dmfs values were smaller in 1995 than in 1992. Conclusion: Despite discontinuation of water fluoridation, no increase of caries frequency in primary teeth was observed in Kuopio within a three‐year period.