Increasing prevalence of dental fluorosis for children both from fluoridated and non-fluoridated communities are now well documented. Along with recent studies purporting possible adverse health effects from fluorides, this proven public health intervention is again being challenged. This study was undertaken to determine the prevalence of dental fluorosis for children from fluoridated and non-fluoridated areas in British Columbia. In addition, children and parents were provided with an opportunity to express concerns about the aesthetics of the child's anterior teeth. Children from representative schools in two communities were surveyed using the Tooth Surface Index of Fluorosis (TSIF). Questionnaires were sent home to parents to detail their child's use of various fluoride preventive practices and residence histories. Completed questionnaires were returned and exams were performed on 1131 children. Of those examined, 60% had dental fluorosis on at least two tooth surfaces, only 8% had scores ranging from "2" to "6", and 52% were classified with a score of "1". Parental and child ratings on the aesthetics or color of the child's teeth suggests that there are few children with aesthetic problems in the TSIF category of "1". While concerns of parents were more common, the actual source of those concerns was not assessed in the questionnaire. Not unexpectedly, children with fluorosis on anterior teeth ranging between TSIF scores of "2" to "6" appear to have increased concerns about tooth color. Data from children with confirmed residence histories from fluoridated communities suggest that the occurrence of aesthetic problems in these children is rare.
An increase in the prevalence of dental fluorosis among children in North America is well documented. Published reports of the relationship between the occurrence of dental fluorosis and early exposure to various fluorides and the use of different types of infant feeding practices have begun to provide insights into possible causes for this increase. This study was designed to investigate this issue for children living in a non-fluoridated and a fluoridated community in British Columbia, Canada. Parents or guardians completed a questionnaire which detailed exposure to different types of fluorides and infant feeding practices during the first 6 yr of life. Completed questionnaires were returned and examinations were performed on 1131 children. 60% of children had dental fluorosis, and only 8% presented with scores of 2 or greater. Logistic regression analyses showed that the use of infant formula and parental educational attainment were significantly associated with the occurrence of dental fluorosis in the range of scores from 2 to 6. Despite these statistically significant findings, these variables actually had little additional predictive value beyond a chance occurrence in determining which children would have dental fluorosis.
This study was undertaken to determine the prevalence of dental caries in children ages 6-14, from fluoridated and non-fluoridated areas in British Columbia, Canada, and the effects of receiving certain fluoride preventive procedures during childhood. Children from two communities were surveyed using a modified Decayed, Missing and Filled Tooth Surface Index (D1D2MFS). Questionnaires on the use of various fluoride preventive practices and residence histories during childhood were collected. Completed questionnaires were returned and exams were performed on 1131 children. Crude caries prevalence scores for the different fluoride exposure groups were tested for differences in dental age and the level of educational attainment of parents and/or guardians. No significant group differences were found. The 110 children with lifelong exposure only to fluoridated water had 35%, or 0.88 (S.D. = 2.91), fewer decayed or filled tooth surfaces per child (P < 0.07) than children with no reported exposure to systemic fluorides. For the 122 children who had taken fluoride supplements for 4 yr or more, 0.67 fewer decayed and filled tooth surfaces (26% reduction) were observed per child when compared to children with no exposure to fluoridated water or supplements. For children who used fluoride supplements for less than 4 yr, no significant benefits were observed. Approximately 75% of the caries prevalence for control and fluoride-exposed groups was on pit and fissured surfaces. Reductions by surface type showed savings on both smooth and pit and fissured surfaces.
This analysis of the effect of dental manpower, productivity, work‐week, and income on the costs and availability of dental services makes for interesting reading.
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