Prevalence and Severity of Dental Caries and Fluorosis in 8 Year-old Children With or Without Fluoride Supplementation

Abstract

One of the most effective and studied measures in the prevention of caries is the use of fluoride, which has the property to reduce their incidence and severity. In Chile, 75 % of the population receives it the drinking water. In 1984, WHO recommended the use of milk as an alternative vehicle. In Chile, the Fluoridated School Feeding Program (FSFP) was introduced in 1994, using this alternative in rural areas without fluoride in water. The objective of the study was to compare prevalence and severity of dental caries and dental fluorosis in 8-year-old children of four state schools: two with fluoride supplementation in drinking water or milk and two without any fluoride program. Epidemiological, descriptive, comparative, observational and cross-sectional study with a sample of 140 8-year-old children, with no systemic diseases and who had lived in the same place since birth: 50 schoolchildren from an area with fluoridated water; 40 from an area with fluoridated milk and 50 from a zone without supplementation of F. The percentage of caries-free children was obtained with the methodology described by the WHO, for severity the dmft and DMFT indexes were used. To quantify the prevalence and severity of dental fluorosis, Dean Index was used. 38 % of the children were caries-free in the community with fluoridated water (CFW); 0 % in the community with fluoridated milk (FSFP) and 10 % in the community with no fluoride program established (CNF). The difference between CFW with CNF is statistically significant (p<0.05). The prevalence of fluorosis is significantly higher for CFW (48.8 %) than FSFP (35 %) and CNF (16 %). Conclusion: The contribution of fluoride in drinking water causes a decrease in the prevalence and severity of dental caries in children of 8 years of age, and an increase in the prevalence of dental fluorosis.

Community interventions and strategies for caries control in Latin American and Caribbean countries

“…The use of fluoridated milk as a community level intervention has been reported in some rural areas of Chile. 17 However, targeting culturally appropriate, economically sustainable caries control interventions to rural populations and native ethnic groups such as indigenous people (> 45 million and over 800 ethnic groups), quilombolas (African-origin), and riverside Amazonian people remains a crucial challenge.…”

“…The remaining relevant studies included in this report focused on the use of fluoride varnishes in Brazil, 36 Chile, 37 Dominican Republic, 38 and El Salvador, 39 and on the use of a combination of fluoride mouth-rinses and APF gels in Brazil 18,35 and Peru 30 . Some publications were more comprehensive and documented several strategies for fluoride use within the same country, such as in Chile, 17 Cuba, 16 Brazil, 18 Colombia, 29 Haiti, 19 and Peru, 30 or reported one or more strategies adopted in several LACC. 20,26,27 The remaining studies reported one specific strategy adopted in a single Latin American and Caribbean country.…”

Manejo estético de la fluorosis dental: Microabrasión, infiltración de resina y clareamiento externo.

“…La prevalencia de fluorosis dental (FD) en Chile, es significativamente mayor en las comunidades con agua fluorada; y aunque el rol de los fluoruros en la prevención de caries es indiscutido e inocuo usado en la justa medida, las secuelas de su consumo excesivo se verifican principalmente en niños y jóvenes (1) .…”