Rise and Fall of Caries Prevalence in German Towns with Different F Concentrations in Drinking Water

Künzel, W; Fischer, Thomas

doi:10.1159/000262393

Cited by 36 publications

(55 citation statements)

References 3 publications

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“…Already at a low level, caries prevalence decreased even further. This trend was statistically documented for the fluoridated cities Chemnitz (formerly KarlMarx-Stadt) and Plauen [Künzel and Fischer, 1997] and for Spremberg and Zittau [Künzel, 1997]. The observations are also in agreement with those made by Kalsbeek and Verrips [1990] after the cessation of water fluoridation in Tiel/Culemborg.…”

supporting

confidence: 64%

“…As in recent experiences in East German towns [Künzel and Fischer, 1997], caries prevalence in La Salud remained stable at a low level after the cessation of water fluoridation. A similar development has been reported for the Czech capital Prague [Lekesová et al, 1996], where reduced caries prevalence of 1.8 DMFT of 12-year-olds, due to water fluoridation, remained stable (i.e.…”

Section: Caries Prevalencesupporting

confidence: 52%

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Caries Prevalence after Cessation of Water Fluoridation in La Salud, Cuba

Künzel

Fischer²

1999

Caries Res

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In the past, caries has usually increased after cessation of water fluoridation. More recently an opposite trend could be observed: DMFT remaining stable or even decreasing further. The aim of the present study conducted in La Salud (Province of Habana) in March 1997 was to analyse the current caries trend under the special climatic and nutritional conditions of the subtropical sugar island Cuba, following the cessation, in 1990, of water fluoridation (0.8 ppm F). Diagnostic evaluations were carried out using the same methods as in 1973 and 1982. Boys and girls aged 6–13 years (N = 414), lifelong residents in La Salud, were examined. Between 1973 and 1982 the mean DMFT had decreased by 71.4%, the mean DMFS by 73.3% and the percentage of caries–free children had increased from 26.3 to 61.6%. In 1997, following the cessation of drinking water fluoridation, in contrast to an expected rise in caries prevalence, DMFT and DMFS values remained at a low level for the 6– to 9–year–olds and appeared to decrease for the 10/11–year–olds (from 1.1 to 0.8) and DMFS (from 1.5 to 1.2). In the 12/13–year–olds, there was a significant decrease (DMFT from 2.1 to 1.1; DMFS from 3.1 to 1.5), while the percentage of caries–free children of this age group had increased from 4.8 (1973) and 33.3 (1982) up to 55.2%. A possible explanation for this unexpected finding and for the good oral health status of the children in La Salud is the effect of the school mouthrinsing programme, which has involved fortnightly mouthrinses with 0.2% NaF solutions (i.e. 15 times/year) since 1990.

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supporting

confidence: 64%

Section: Caries Prevalencesupporting

confidence: 52%

Caries Prevalence after Cessation of Water Fluoridation in La Salud, Cuba

Künzel

Fischer²

1999

Caries Res

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“…Cross-sectional study after 5 years Attwood & Blinkhorn 1991Scotland, 1983 dmft, DMFT 3 years after Caries prevalence in no-longer-fluoridated fluoridation ceased community increased and was almost equal to that of non-fluoridated control community. Künzel & Fischer 1997, Germany, 1990 6 to 15 Cross-sectional Caries decline in no-longer-fluoridated Künzel et al, 2000 DMFT community to lowest recorded level. Substantial confounding factors were introduced at the public health level and in the health care delivery models.…”

Section: Multivariate Modelmentioning

confidence: 99%

“…Some reports from settings still affected by relatively high caries activity have indicated that, after fluoridation was discontinued, caries experience increased [Stephen et al, 1987;Attwood and Blinkhorn, 1991;Thomas et al, 1995]. This assessment, however, is problematic when such discontinuation takes place in communities where caries prevalence was declining [Kalsbeek et al, 1993;Künzel and Fischer, 1997;, particularly if the study design encompassed several cross-sectional samples [Maupomé et al, 2001]. A recent study that investigated a temporary cessation of fluoridation found that an 11-month break had little effect on caries in primary molars [Burt et al, 2000].…”

mentioning

confidence: 99%

Tooth–Surface Progression and Reversal Changes in Fluoridated and No–Longer– Fluoridated Communities over a 3–Year Period

et al. 2001

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Objective: To compare permanent tooth surface–specific progression/reversal changes between fluoridation–ended (F–E) and still–fluoridated (S–F) communities in British Columbia, Canada, over a 3–year period. Methods: D1D2MFS examinations were contrasted for 2,964 schoolchildren in 1993/94 (grades 2, 3, 8 and 9) and 1996/97 (grades 5, 6, 11 and 12). Generalized Estimating Equation (GEE) models explored the relation between progression/reversal changes and fluoridation status, age, gender, socioeconomic status, and dietary/fluoride histories. Results: Within a scenario of low levels of caries overall, few children had multiple surfaces progressing. At least one smooth surface progressed in 31.4% of subjects; at least one pit–and–fissure (PF) surface progressed in 43.1% of subjects. At least one smooth surface reverted in 89% of subjects who had reversible stages; at least one PF surface reverted in 23.8% of subjects who had reversible stages. GEE (smooth) indicated that odds ratios of progression were twice as large in the F–E site compared to the S–F site, and slightly increased in older participants and in participants exposed to more fluoride technologies. GEE (PF) also indicated that progression was slightly more common in the F–E site; more frequent snacking and lower parental educational attainment had modest associations with increased progression in PF surfaces. For the two types of surfaces, GEE models demonstrated that unerupted surfaces were less likely to progress than sound surfaces. No associations were found between reversals and independent variables. Conclusion: Progressions were found to be weakly linked to socio–demographic factors; baseline surface statuses were better predictors of progression. Using the current definitions for disease transitions, F–E communities had more frequent progressions than a S–F community.

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“…However, the caries decline coincided with several other trends, including the introduction of fluoridated salt in 1992, a decrease in national sugar consumption in 1993 (down to 1967 levels of intake), and complete restructuring of the dental care system after reunification. [12] A further study of other former East German cities suggested that the caries decline was unlikely to be caused by any one single factor, but that the availability of topical fluorides probably had the greatest impact. The authors concluded that for Germany "from our point of view, water fluoridation would still seem to be reasonable in all heavily-populated industrial areas with high or increasing caries prevalence."…”

Section: Fluoridation Around the Worldmentioning

confidence: 97%

Water fluoridation: It really is this simple

2017

Br Dent J

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(RSNZ), and the Ministry of Health, to review the scientific evidence for and against the efficacy and safety of fluoridation of public water supplies. After discussion between the parties, it was agreed that the Office of the PMCSA and the RSNZ would establish a panel to undertake a review. This review would adhere strictly to the scientific issues of safety and efficacy (or otherwise), but take into account the various concerns that have been raised in the public domain about the science and safety of fluoride. It would not consider the ethical and philosophical issues that have surrounded fluoridation and influenced legal proceedings lately. The Prime Minister gave his consent for the Office of the PMCSA to be involved and funding was provided by Councils through your office and by the Ministry of Health.We are pleased to advise the report is being delivered on the timetable agreed. ProcessGiven this is inevitably an issue that arouses passions and argument, we summarise in some detail the process used.As this was the first formal scientific review conducted jointly between the Office of PMCSA and the Royal Society a memorandum of understanding for the process was developed and has been followed.The essence of the process was that the PMCSA appointed an experienced literature researcher to undertake the primary research and literature reviews. Following an initial scoping that included an extensive reading of the literature (informal, grey and peer reviewed) on the subject, a draft table of contents was agreed between the PMCSA and the President of the RSNZ. The RSNZ then appointed a panel of appropriate experts across the relevant disciplines that was approved by the PMCSA.A member of civil society with expertise in local body issues, Ms Kerry Prendergast, was invited to be an observer to the panel and to be included in the discussions and drafting to be sure that it met local body needs. The scientific writer then produced an early partial draft of the report that was presented to a meeting of the expert panel, and their input was sought both as to framing and interpretation of the literature. The panel paid particular attention to the claims that fluoride had adverse effects on brain development, on the risks of cancer, musculoskeletal and hormonal disorders -being the major areas where claims about potential harms have been made. Over the following weeks, the panel members joined in an iterative process with the scientific writer to develop the report. In its advanced form all the members of the panel, together with the PMCSA and the President of the RSNZ, agreed via email exchange on the final wording of the report and its executive summary. In this form it was sent out for international peer review by appropriate scientific experts in Australia, UK and Ireland. Following their suggestions (which were minor and did not affect the panel's conclusions), the report and executive summary were returned to the panel for comment. Findings and recommendationsThe report and its executive summary are very clear i...

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Rise and Fall of Caries Prevalence in German Towns with Different F Concentrations in Drinking Water

Cited by 36 publications

References 3 publications

Caries Prevalence after Cessation of Water Fluoridation in La Salud, Cuba

Caries Prevalence after Cessation of Water Fluoridation in La Salud, Cuba

Tooth–Surface Progression and Reversal Changes in Fluoridated and No–Longer– Fluoridated Communities over a 3–Year Period

Water fluoridation: It really is this simple

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