Dental Caries and Fluoride Exposure in Western Australia

Abstract

Most water supplies in Western Australia (WA) have been fluoridated since about 1968, but one region has persistently resisted. Supplement use has been encouraged there, and fluoride toothpaste is widely used. Caries prevalence and caries experience in children in Perth (F- 0.8 mg/L) have declined steadily since fluoridation, but in the Bunbury region (F- less than 0.2 mg/L), caries measures remain higher than in Perth. The purpose of this study was to correlate the magnitude and timing of fluoride exposure with caries experience. Altogether, 592 randomly selected children born in 1978 (mean age, 11.8 years) in Perth and the Bunbury region provided residence and fluoride exposure information for the periods from birth to four and from four to 12 years of age. Caries experience was recorded clinically in accordance with DMFT and WHO criteria. Sixty-one percent had been continuous residents of fluoridated areas from birth to four years, and 51% between the ages of four and 12 years. Fluoride supplement use was low. By the age of 1.5 years, 42% had used toothpaste. The prevalence of caries was 0.38 in Perth and 0.61 in the Bunbury region, and mean DMFT scores were 0.89 (SD, 1.39) and 1.57 (SD, 1.60), respectively. Bivariate analysis revealed all fluoride exposure to be associated with reduced caries experience, but there were large correlations between some variables. When unconditional logistic regression analysis was used, the most important (p less than 0.05) odds ratios associated with no caries experience were for residence in a fluoridated area from four to 12 years of age and early use of toothpaste.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental fluorosis decline after changes to supplement and toothpaste regimens

“…Insofar as fluoride supplements contribute to caries prevention, a contentious question, their reduced use should entail a greater risk of dental caries. The 12‐year‐old children examined in 1989/90 had caries experience levels of 0.89 DMFT in the Perth region and 1.57 DMFT in the Bunbury (nonfluoridated) region (26). In the present study, the corresponding caries experience scores were 0.31 (SD 0.75) DMFT in the fluoridated area and 0.28 (SD 0.77) DMFT in the nonfluoridated area, but since the current data are derived from 10‐year‐olds in 2000 against 12‐year‐olds in 1989/90, these figures are not directly comparable.…”

Dental Fluorosis, Dental Caries and Fluoride Exposure among 7-Year-Olds

“…1977]. The reliability of caries measurements, assessed using the method of error variance [Rugg-Gunn and Holloway, 1974], was calculated to be 0.84 [Riordan. 1991].…”

Caries progression in 12‐to 16‐year‐old schoolchildren in fluoridated and fluoride‐deficient areas in Brazil

“…Since the number of dentinal lesions in the non-fluoridated areas was greater, it was concluded that progression of lesions was faster in non-fluoridated areas than in lluoridated areas. In other words, the pre-eruptive effeet of water fiuoridation could not be observed when the total numbers of lesions, including enamel lesions, were compared (4,5), Two more recent studies, which monitored enamel caries in Australian and in Tanzanian child and adolescent populations, suggested that the posteruptive caries-preventive effect of fluoride in drinking water was just as important as the pre-eruptive eariespreventive effect, particularly for freesmooth surfaces and approximal surfaces, where constant exposure to low doses of fluoride can retard or arrest the rate of caries progression (6)(7)(8), Similar to the Dutch water fluoridation studies, these studies revealed that caries progression beyond the stage of enamel caries was markedly reduced in fluoridated areas in both countries, Ekanayake & Sheiham (9) examined the decline in caries rates in the 1960s and 1970s and found that in the 1970s the rate of caries progression for British schoolchildren was slower in fluoridated areas than in non-fluoridated areas, flowever, these rates were slower than those reported for a similar cohort of British children studied in the 1960s.…”