Caries and Fluorosis Prevalence in Communities with Different Concentrations of Fluoride in the Water

Abstract

The need to defluoridate and fluoridate the water supplies in areas with drinking water naturally containing above–optimal (≥2.5 mg/l) and suboptimal (≤0.3 mg/l) fluoride concentration and caries and fluorosis prevalence of 12–year–old schoolchildren were assessed in Italy. In the low–fluoride area, 48.4% children were caries–free (DMFT = 0) and the DMFT and DMFS were 1.5 and 2.6; in the high–fluoride area, 46.8% had a DMFT = 0 and the values of the indices were 1.4 and 1.6, respectively. Multiple logistic regression analysis showed a significant association in the caries–free status according to parents' employment status (OR = 1.2, 95% CI = 1.1–1.3) and children's sweets consumption, since children who consumed sweets at least once a day had an adjusted odds ratio of 1.8 (95% CI = 1.4–2.3) compared to those with a lower consumption. Multiple linear regression analysis showed that DMFT and DMFS were significantly higher in children with a lower socioeconomic status and in those who consumed sweets at least once a day, with the DMFS significantly associated also with the area of residence. DT and FT scores were higher in the high– and low–fluoride areas, respectively. No evidence of fluorosis was reported in 94.5 and 55.3% of children in the low– and high–fluoride areas, respectively. The Community Fluorosis Index (CFI) for all permanent teeth was significantly higher in the high–fluoride area, 0.8, than the value, 0.1, found in the low–fluoride community. Our results substantiate the difficulties in defining universal guidelines for the fluoridation or defluoridation of drinking water and the need for an epidemiological approach to the decision as to fluoridate and defluoridate the water supply.

The correlation between the DMFT of the 12-year-old children and the concentration of fluorine in drinking water from the Southeast region of the Republic of Macedonia

“…In this study also the Community Fluorosis Index (CFI) for all permanent teeth was significantly higher in the high-fluoride area, 0.8, than the value, 0.1, found in the low-fluoride community [23].…”

Teeth of the Renaissance: A paleopathological and historic-medical study on the jaws of the Medici Family

“…These data strongly suggest the presence of environmental circumstances, which could have determined these conditions: as a matter of fact, it was already noted in the past that people living close to Naples suffered from endemic dental fluorosis [17][18][19][20]. Studies carried out in some Italian regions some years ago have demonstrated that the Community Fluorosis Index for all permanent teeth is significantly higher in highfluoride area, 0.8, than the value, 0.1, found in the low-fluoride community, determining the necessity to defluoridate and fluoridate the water supplies in areas with drinking water naturally containing above-optimal (Z2.5 mg/l) and suboptimal (r0.3 mg/l) fluoride concentration [21]. As known, fluoride catalyzes the diffusion of calcium and phosphate into the tooth surface, which in turn remineralizes the crystalline structures in a dental cavity.…”

Perfil epidemiológico de cárie dentária em crianças de 12 anos de idade, residentes em cidades fluoretadas e não fluoretadas, na Região Centro-Oeste do Estado de São Paulo, Brasil

“…Pinto (1997) afirma que o quadro epidemiológico brasileiro, em termos de saúde bucal, reflete com nitidez algumas das principais características da nossa sociedade: economia não estável, agudas desigualdades salariais e sociais, sistema educacional com ênfase na formação de nível superior, produção agrícola voltada para a exportação, grande número de pessoas de baixa renda e em estado de pobreza relativa ou absoluta. As tendências mundiais em relação à saúde bucal demonstram o declínio na incidência e prevalên-cia de cárie (Murray, 1994) e o aumento da prevalência da fluorose (Angelillo et al, 1999); tais ocorrências não estão distribuídas de forma homogênea em toda a população. Há concentração da doença cárie e as necessidades de tratamento em uma pequena parcela da população (20-40%), sendo que a maior parte apresenta-se praticamente livre de cárie (40-60%), esta ocorrência é conhecida como "fenômeno da polarização".…”