Empresas de saneamento e a fluoretação da água dos sistemas de abastecimento: estudo ecológico nos municípios do Brasil, 2008/2010*

Abstract

Objective: to describe the characteristics of Brazilian sanitation utilities and municipalities according to the water supply system fluoridation situation. Methods: this was an ecological study using data from the National Survey of Basic Sanitation 2008, the Demographic Census 2010 and the Atlas of Human Development 2010. Results: of the 5,565 Brazilian municipalities, 60% had a fluoridation service; there was variation in fluoridation provision depending on the characteristics of the service providers and the municipality; the greater the coverage of water supply and sewerage and the higher the level of human development, the greater the provision of fluoridation (p<0.001); fluoridation provision was higher in municipalities where the sanitation utilities were mixed-capital companies (75%) and lower when the companies were private (27%) and also when the service was provided only by the municipal government (40%). Conclusion: there was an important dependence relationship between the characteristics of the companies and the provision of water fluoridation in Brazilian municipalities.

Deprived areas and community water fluoridation in Brazil: a multilevel approach for refocusing public policy

“…This study evaluated the effects of from regional characteristics, adjusted by factors associated with municipalities, on the lack of CWF provision. The associations between the outcomes and municipal characteristics reported in other studies were confirmed [ 3 - 5 ]. However, after the adjustment enabled by model 1, it was found that lower coverage of sewerage and wastewater collecting systems, lower human development, lower GDP per capita, and a higher percentage of expenditures spent on sanitation were strongly associated with a lack of CWF.…”

“…A study involving all Brazilian municipalities pointed out a possible relationship between the quality of sanitation services provided by companies and CWF. Municipalities with lower coverage of water and sewerage systems presented the lowest rates of CWF provision [ 5 ]. This information was refined in this research.…”

“…The level of human development and population size are connected with the provision of water fluoridation [ 1 , 4 ]. The provision of community water fluoridation (CWF) is also related to the coverage of sanitation services, provider characteristics, the percentage of the urban population, and the geographic location of the municipality in the country [ 5 , 6 ].…”

Características das empresas de saneamento associadas à fluoretação da água dos sistemas de abastecimento de municípios do Brasil, 2008

“…Although Law No. 6.050, approved by the National Congress in 1974 in Brazil, made fluoridation mandatory everywhere a water treatment plant exists, creating conditions to universalize access to fluorides, studies have shown that the provision of water fluoridation is extremely unequal, both among macro-regions 14 and among municipalities in the country 15 . Nonetheless, the significance of the effect of specific variables linked to the concessionaire on the provision of public policy in the presence of characteristics linked to the municipalities, including the Brazilian macro-region to which it belongs, was not further investigated.…”

Oral health-related quality of life among 12-year-olds

“…In the last decades, important advances have been made in the control of oral diseases in Brazil, mainly among schoolchildren 12,13 . These advances may be attributed to the fluoridation of the public water supply 14 , dissemination of fluoride toothpaste, decrease in sugar consumption 12 , as well as improvements in living conditions, and the implementation of public policies featured by expansion in health promotion actions 13 . However, dental caries and incidence of other oral diseases have increased due to the weakening of successful programs and policies 15 , with those most harmed being the most socially vulnerable 16 .…”