Caries prevalence in a rural Chilean community after cessation of a powdered milk fluoridation program

OBJECTIVE: The milk fluoridation scheme established in Codegua, Chile, between 1994 and 1999 demonstrated the effectiveness of powdered milk as a community-based vehicle for fluoride to prevent dental caries. The present study aimed to compare caries prevalence in both the Codeguan control and test communities, three years after ending fluoride distribution through the powdered milk fluoridation scheme, to assess whether the benefits of such milk fluoridation were still present in the test community. METHODS: Children 3-6 years old living in Codegua (test community) and La Punta (control community) were examined for dental caries at their educational facilities by three trained and calibrated examiners using natural light, dental mirrors, and sickle probes. Differences in caries prevalence (dmfs) by year of the study were tested for statistically significant differences using the Mann-Whitney U test. RESULTS: Findings from Codegua (1999-2002) indicate that the dental caries experience increased in all age groups following the termination of powdered milk fluoridation. These differences reached levels of statistical significance in the 3-, 4-, and 5- year old group (P < .03). Comparing results from Codegua and La Punta (2002), no statistically significant differences were found. CONCLUSIONS: Termination of the powdered milk fluoridation scheme resulted in a deterioration of the dental health of children. After three years, dental caries prevalence was higher than that reached at the end of the scheme and equivalent to that of the control community without fluoride exposure. These results emphasize the need to establish and maintain an alternative mechanism of community-based fluoridation of proven effectiveness for the prevention of dental caries in communities where water fluoridation is not available.