Water Fluoridation and Dental Caries in U.S. Children and Adolescents

Abstract

This cross-sectional study sought to evaluate associations between availability of community water fluoridation (CWF) and dental caries experience in the U.S. child and adolescent population. County-level estimates of the percentage of population served by CWF (% CWF) from the Centers for Disease Control and Prevention's Water Fluoridation Reporting System were merged with dental examination data from 10 y of National Health and Nutrition Examination Surveys (1999 to 2004 and 2011 to 2014). Dental caries experience in the primary dentition (decayed and filled tooth surfaces [dfs]) was calculated for 7,000 children aged 2 to 8 y and in the permanent dentition (decayed, missing, and filled tooth surfaces [DMFS]) for 12,604 children and adolescents aged 6 to 17 y. Linear regression models estimated associations between % CWF and dental caries experience with adjustment for sociodemographic characteristics: age, sex, race/ethnicity, rural-urban location, head-of-household education, and period since last dental visit. Sensitivity analysis excluded counties fluoridated after 1998. In unadjusted analysis, caries experience in the primary dentition was lower in counties with ≥75% CWF (mean dfs = 3.3; 95% confidence limit [CL] = 2.8, 3.7) than in counties with <75% CWF (mean dfs = 4.6; 95% CL = 3.9, 5.4), a prevented fraction of 30% (95% CL = 11, 48). The difference was also statistically significant, although less pronounced, in the permanent dentition: mean DMFS (95% CL) was 2.2 (2.0, 2.4) and 1.9 (1.8, 2.1), respectively, representing a prevented fraction of 12% (95% CL = 1, 23). Statistically significant associations likewise were seen when % CWF was modeled as a continuum, and differences tended to increase in covariate-adjusted analysis and in sensitivity analysis. These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth.

Factors associated with Oral Health-Related Quality of Life of preschool children in Southern Brazil

“…One of the reasons for dental caries to affect the quality of life is painful sensition [16][17] . Toothache leads to limitations in the oral functioning and emotional state of the child 18 , causing difficulty to relax and problems in school performance 19 , as well as difficulty sleeping 16 . In our study, older children presented the higher means of ECOHIS, corroborating previous studies 6,11 .…”

Trends in use of dental services by Brazilian pre‐school children considering Age‐Period‐Cohort Effect

“…Children with a high dmft scores were more likely to have gone to the dentist for other reasons than preventive care. Previous studies have demonstrated that higher dmft scores could increase the probability of a painful event occurring . Therefore, this could reflect the need to visit the dentist for treatment reasons, since pain is one of the main reasons for seeking dental health services…”

Prevalência e fatores associados à experiência de dor de dente em crianças de duas coortes de nascidos vivos: Ribeirão Preto - SP e São Luís - MA

“…As dores dentais podem ser originadas dos tecidos inervados do dente ou circundantes ao mesmo (Slade, 2001). Diversos fatores podem ser responsáveis pela sensação dolorosa nesta região, como a esfoliação dental, traumatismos dentários, doenças gengivais e a cárie dentária (Slade, 2001;Peres et al, 2005;Bastos et al, 2007;Boeira et al, 2012).…”

“…Diversos fatores podem ser responsáveis pela sensação dolorosa nesta região, como a esfoliação dental, traumatismos dentários, doenças gengivais e a cárie dentária (Slade, 2001;Peres et al, 2005;Bastos et al, 2007;Boeira et al, 2012). Em crianças, a maior ocorrência de dor de dente ocorre devido a cárie dentária (Boeira et al, 2012), que é uma doença crônica de elevada prevalência durante a infância (Organização Mundial de Saúde -OMS, 2012) e que possui um caráter multifatorial, podendo estar associada a fatores biológicos, comportamentais e socioeconômicos, (Fejerskov e Kidd, 2005;Selwits et al, 2007) dentre eles a presença de biofilme cariogênico, características salivares (capacidade tampão, pH e fluxo), consumo de açúcares (Shanmugam et al, 2013;Cunha-Cruz et al, 2013), renda e acesso ao serviço odontológico (Peres et al, 2000;Galindo et al, 2005;Noro et al, 2009;Lopes et al, 2013).…”

“…A prevalência de dor de dente entre crianças e adolescentes em países desenvolvidos varia entre 5 e 33% (Slade, 2001 (Bastos et al, 2008).…”