Caries Experience of 15-Year-Old Children in The Netherlands after Discontinuation of Water Fluoridation

Abstract

In 1973 the fluoridation of drinking water in the Dutch town of Tiel was discontinued. In order to monitor the effect of this measure, the caries experience in 15-year-old children was investigated annually from 1979 to 1988, both in Tiel and in Culemborg. In the latter town the drinking water had never been fluoridated. The caries data of 15-year-old children examined between 1968 and 1969 in Tiel (children having used fluoridated water from birth) and Culemborg were used as historical controls. In Tiel the mean number of DMFS increased between 1968/69 and 1979/80 from 10.8 to 12.7 (+18%) and decreased to 9.6 (––26%) in the following years; in 1987/88 the mean DMFS was 11% lower than in 1968/69. In Culemborg the mean DMFS score decreased between 1968/69 and 1987/88 from 27.7 to 7.7 (––72%). In 1968/69 the mean DMFS score in Tiel was 61% lower and in 1987/88 17% higher than in Culemborg. The question as to whether water fluoridation would have had an additional effect if it had been continued (presuming the application of existing preventive measures) cannot be answered, as there are no remaining communities with fluoridated water in The Netherlands.

Fluorosis dental en niños de 12 y 15 años del municipio de Andes Dental fluorosis in children

“…Por ello, aunque las estrategias de fluoruración masiva han demostrado ser efectivas como medidas de salud pública para el control de la caries dental; el conocimiento del principal efecto del flúor a nivel tópico, así como el hecho que en la actualidad se presenta la exposición a múltiples fuentes de flúor, que pueden derivar en ingesta por encima de los niveles óptimos; deben llevar a repensar el uso de fluoruros sistémicos y a favorecer el acceso de la población a fuentes tópicas. En este sentido, desde hace ya varios años se han hecho planteamientos que propenden por el reemplazo de fuentes sistémicas de fluoruros mediante el suministro a través fuentes de uso tópico (3,(34)(35)(36), argumentos que han cobrado más fuerza actualmente.…”

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

“…Independent variables were developed as described previously [Maupomé et Lemke et al 1970United States, 1960 Three def/DMF cross-sectional 4 years after fluoridation was discontinued surveys before, during and and just after it was re-implemented, def after fluoridation was stopped (112%) in kindergarten children, and DMFT in 7-, 9-and 11-year-olds had increased markedly (233%, 70% and 91%, respectively). Kalsbeek et al 1993Netherlands, 1973 Cross-sectional DMFS using Lower DMFS in fluoridated and no-longerbitewing radiographs fluoridated communities. Small initial DMFS Historic controls increase then decrease in no-longer-fluoridated Concomitant controls from community.…”

“…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].…”

Screening with Conventional and Digital Bite-Wing Radiography Compared to Clinical Examination Alone for Caries Detection in Low-Risk Children

“…As such, there has been a long tradition of bite-wing screening radiography in addition to a clinical examina tion for the detection of dental caries, as a basis for preva lence calculations and treatment decisions in schoolchil dren [Murray and Shaw, 1975;Sheiham, 1977;Mann et al, 1989;de Vries etal., 1990], Most previous studies stating the importance of radiographic screening as a supplement to clinical caries exami nation have been performed in populations with relatively high DMF-S scores [Stephen et al, 1988;de Vries et al, 1990]. The benefit of bite-wing screening may be reduced in present-day generations of children who experience less caries and infrequent approximal lesions [Ruiken et al, 1982[Ruiken et al, ,1986Bohannan et al, 1984;Graves and Stamm, 1985;Mandel, 1985], The prevalence of approximal caries in 14-to 15-year-olds has declined to approximately one third of what it was 20 years ago [Kalsbeek et al, 1993]. The predominant sites for caries development in western schoolchildren are, at present, fissures and pits at occlu sal, buccal, and oral surfaces of molars [Bohannan et al, 1984], Recently, advanced digital radiographic methods have been demonstrated useful for the assessment of caries in occlusal surfaces.…”