Association between Dental Caries and Fluorosis among South Australian Children

Abstract

There is an ongoing debate whether early exposure to fluoride is necessary. The effect of early exposure to fluoride needs to be understood to inform the appropriate population oral health policy. This study aimed to evaluate the effects of systemic fluoride intake in early childhood on caries experience of the permanent dentition observed at the age of 8 or 9 years, controlling for the effects of topical exposures to fluoride at the age of 5 years. The fluorosis experience of children was used as a proxy indicator for early exposure to fluoride, while exposures to fluoride at the age of 5 years, which were collected retrospectively, were used to control for the topical effect on permanent caries experience of the same children. Caries experience recorded at 8 or 9 years of age of 571 children was compared between groups with or without fluorosis. Bivariate analysis and multivariate analysis controlling for exposures to fluoride at the age of 5 years and other potential contributory factors were conducted. A quarter of the sample had very mild to mild fluorosis, while 15% had caries experience in the permanent dentition. Multivariate models showed that children who did not have fluorosis had a higher prevalence and severity of caries compared to those with fluorosis after controlling for other factors. In conclusion, there was a significant negative association between fluorosis status and caries experience in the permanent dentition.

Dental caries, fluorosis, and oral health behavior of children from Herat, Afghanistan

“…The latter were found less often than reported for other countries , which was not unexpected given the water fluoride concentrations measured, but highlights the possible need for water fluoridation as a means of caries prevention, especially for those who cannot afford or do not use fluoridated salt or toothpaste. In line with previous studies , we found significantly lower caries experiences in patients with fluorosis, but without significant association between the degree of fluorosis and caries experience. This might well be due to the generally low levels of fluorosis (and water fluoride), which permit statistical association with caries experience despite possible biological association.…”

Association between infant formula feeding and dental fluorosis and caries in Australian children

“…We recently reported a negative association between fluorosis on the maxillary incisors (an indicator of F exposure in early childhood) and permanent tooth caries experience, indicating some protective benefit of early exposure to F (39). Similar findings were reported in other populations (36,40).…”

Understanding Optimum Fluoride Intake from Population-Level Evidence

“…However, there is a lack of independence between the oral health ratings of these 2 conditions. A lower caries experience was associated with a greater probability of fluorosis and a higher fluorosis score (Do et al 2009). This trade-off was evident from multivariable logistic regression models of both child and parent ratings of oral health (Do and Spencer 2007a).…”