Quality of the water fluoridation and municipal-level indicators in a Brazilian metropolitan region

Belotti, Lorrayne; Frazão, Paulo; Esposti, Carolina Dutra Degli; Cury, Jaime Aparecido; Neto, Edson Theodoro dos Santos; Pacheco, Karina Tonini dos Santos

doi:10.4136/ambi-agua.2270

Cited by 7 publications

(16 citation statements)

References 9 publications

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“…It suggests that regions with higher values of this index have possible irregularities in the quality of public water supply. The relationship between the quality of fluoridation and the child mortality rate was also found in the study by Belotti et al (2018), undertaken in the Grande Vitória Metropolitan Region.…”

Section: Gdp (2015)supporting

confidence: 53%

“…The quality level of fluoridation in the state of ES was considered high in almost all the years surveyed. Belotti et al (2018) reported optimal fluoride levels in the metropolitan region of Great Vitória, where, despite some irregularities, the quality standard remained high. Other studies that analyzed the quality of fluoridation using the classification criteria for maximum benefit and low risk found results similar to those of this research, considering the same concentration range as appropriate (Buzalaf et al, 2013;Bergamo et al, 2015).…”

Section: Quality Of Fluoridationmentioning

confidence: 97%

“…-Percentage of extractions in relation to the total of dental procedures: the increase in the number of mutilating procedures may serve as a warning for the presence of possible flaws in the external control of water fluoridation, considering that the decline in the values of the DMFT index (index of decayed, missing and filled teeth) is related to cities that have fluoridated water (Belotti et al, 2018).…”

mentioning

confidence: 99%

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Surveillance of public water supply fluoridation and municipal indicators: an analysis in the state of Espirito Santo, Brazil

Mendonça¹,

Martinelli²,

Esposti³

et al. 2021

Rev. ambiente água

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This study investigated the demographic, socioeconomic, and municipal health indicators related to the quality of water fluoridation. An ecological study was carried out in Espirito Santo state (ES), based on data from the Drinking Water Quality Surveillance Information, from 2014 to 2017. The non-parametric Mann-Whitney and Spearman tests were applied to compare municipal indicators with the availability of information and the quality of fluoridation, respectively. Fluoridation quality was calculated to define the percentage of fluoride concentration values in each municipality within the range of the optimal level corresponding to the maximum benefit for preventing dental caries and minimum risk for the occurrence of dental fluorosis. The proportion of 80% or more samples were defined as a compliance criterion. In 2014, 62.8% of the municipalities had information available, and 16.7% performed analyses of fluoride concentration. The percentage of available data increased about 30%, in 2017, with 3.8% referring to fluoride. The quality of fluoridation remained high (> 80%) in ES in almost every year, except in 2014. The municipalities with the largest population, the highest GDP per capita, and the lowest coverage of the oral health team exhibited a greater availability of information about fluoride (p <0.05). The child mortality rate showed a strong negative correlation with the quality of fluoridation. The findings reinforce the importance of directing public policies that ensure the correct practices for monitoring and maintaining the quality of fluoridation.

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Section: Gdp (2015)supporting

confidence: 53%

Section: Quality Of Fluoridationmentioning

confidence: 97%

mentioning

confidence: 99%

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Surveillance of public water supply fluoridation and municipal indicators: an analysis in the state of Espirito Santo, Brazil

Mendonça¹,

Martinelli²,

Esposti³

et al. 2021

Rev. ambiente água

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“…While there is evidence supporting an association between public policy implementation and features of the territories, currently, the information on the relationship between maintaining an optimal level of fluoride over time and municipality-level characteristics related to sanitation, health, and economic and income inequality variables is scarce (Belotti et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Municipality-Level Characteristics Associated with Very Low to Good Quality of Water Fluoridation in São Paulo State, Brazil, in 2015

Belotti

Zilbovicius

Soares

et al. 2020

JDR Clinical & Translational Research

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Introduction: Community water fluoridation (CWF) is a measure of recognized importance due to its effectiveness in preventing tooth decay at the population level. However, for the maximum benefit to be achieved, the high-quality standard of CWF must be maintained over time. Objective: To analyze the municipality-level characteristics associated with quality of water fluoridation in São Paulo state, Brazil. Methods: An ecological study was performed using official data sources on fluoride concentration surveillance in 2015. The outcome was municipalities that have not met the quality standard, identified as those with less than 80% of water samples within the optimal level for caries prevention. The independent variables were municipality-level indicators related to demographics, economics, and sanitation characteristics. Crude and adjusted prevalence ratios were estimated using Poisson regression with robust variance. Results: In total, 43.4% municipalities exhibited the outcome. Adjusted by Gini index, the prevalence ratio was 32% higher in municipalities with lower annual gross domestic product per capita. Adjusted by social responsibility index and earlier variables, the prevalence was higher in the municipalities with higher per capita expenditure on sanitation and health surveillance, where the urban population rate was lower, and with a human development index ≤0.761. Adjusted by earlier variables, the prevalence ratio was twice and 3.5 times higher for municipalities, respectively, with per capita income less than or equal to US$574 and where the type of sanitation utility was municipal and private; 50% higher in those with less than 100,000 habitants; and 20% higher in those with a chlorine concentration nonconformity rate above 0.82%. Conclusions: To ensure high quality of CWF, additional management measures should be implemented in municipalities with less than 100,000 habitants, a higher chlorine concentration nonconformity rate, a lower per capita income, and where the type of sanitation utility was municipal or private. Knowledge Transfer Statement: The study showed that the quality of fluoridation was associated with municipality-level characteristics. The findings can be used by policy makers to identify and support municipalities that will need to improve fluoridation quality if they are to reach oral health goals.

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“…Em uma região fluoretada, para que o benefício da fluoretação da água de abastecimento público seja alcançado, é necessária a continuidade da medida ao longo do tempo e a manutenção regular dos teores do íon flúor considerados ótimos pré-estabelecidos 6,7 .…”

Section: Introductionunclassified

Fluoretação Da Água De Abastecimento Público: Produção E Disponibilidade Das Informações Em Questão

Belotti

Esposti

Cabral

et al. 2020

Rev. baiana de saúde pública

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A elaboração, formulação, execução e avaliação da qualidade da água, com envolvimento ativo da população, é fundamental para melhorar o modelo vigente de vigilância. O objetivo deste estudo foi analisar as informações disponíveis sobre o heterocontrole e controle da fluoretação da água para abastecimento público em uma região metropolitana brasileira. Foi realizado levantamento de documentos de gestão, de trabalhos científicos que incluiu textos nas línguas portuguesa e inglesa publicados entre 1953 e 2015, e de informações nos sites das prefeituras e da empresa de abastecimento. Foram identificados: o ano do levantamento dos dados; número de municípios incluídos; tema principal; autores/instituições; método de pesquisa; análise de concentração do fluoreto e qual o nível encontrado. Para as informações encontradas nos sites identificou-se o ano, a fonte, característica e trecho principal. Cinco textos científicos foram identificados referentes ao tema nos municípios estudados, além de informações baseadas em relatórios de gestão, disponíveis do Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal. As informações presentes nos sites da empresa e prefeituras eram superficiais e não foram encontrados dados de controle/heterocontrole da fluoretação. A socialização das informações sobre o controle da água e, em particular, sobre a fluoretação, é importante para inserir essa temática no debate sobre saúde bucal e para garantir a realização dessa política no resgate de uma água tratada, de qualidade, sem intermitência e com flúor. Palavras-chave: Vigilância sanitária ambiental. Controle da qualidade da água. Monitoramento da água. Fluoretação da água.

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Quality of the water fluoridation and municipal-level indicators in a Brazilian metropolitan region

Cited by 7 publications

References 9 publications

Surveillance of public water supply fluoridation and municipal indicators: an analysis in the state of Espirito Santo, Brazil

Surveillance of public water supply fluoridation and municipal indicators: an analysis in the state of Espirito Santo, Brazil

Municipality-Level Characteristics Associated with Very Low to Good Quality of Water Fluoridation in São Paulo State, Brazil, in 2015

Fluoretação Da Água De Abastecimento Público: Produção E Disponibilidade Das Informações Em Questão

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