Systemic effect of water fluoridation on dental caries prevalence

Cho, Hyun-Jae; Jin, Bo-Hyoung; Park, Deok-Young; Jung, Se-Hwan; Lee, Heung-Soo; Paik, Dai‐Il; Bae, Kwang‐Hak

doi:10.1111/cdoe.12091

Cited by 25 publications

(39 citation statements)

References 32 publications

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“…Of the 14 interventions that included dental caries outcomes (ie, excluding the intervention in Brazil 30 ), eight included both tooth-level and tooth surface-level data 14 27 37 38 40 or surface-level data only, 16 19 35 and six included tooth-level data only. 23 25 28 34 41 42 Use of surface-level data is thought to be preferable if the aim is to evaluate a prevention initiative 43 such as cessation of CWF, against the backdrop of a general decline in prevalence of caries.…”

Section: Intervention Characteristicsmentioning

confidence: 99%

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Does cessation of community water fluoridation lead to an increase in tooth decay? A systematic review of published studies

McLaren

Singhal

2016

J Epidemiol Community Health

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BackgroundCessation of community water fluoridation (CWF) appears to be occurring with increasing frequency in some regions. Our objective was to comprehensively review published research on the impact of CWF cessation on dental caries.MethodsWe searched 13 multidisciplinary databases. Results were synthesised qualitatively and quantitatively.ResultsWe identified 15 instances of CWF cessation (‘intervention’) in 13 countries, which covered a broad time frame (1956–2003) and diverse geographical and political/economic contexts. Overall, results were mixed, but pointed more to an increase in caries postcessation than otherwise. For example, of the 9 studies with at least moderate methodological quality based on criteria we developed for this review, 5 showed an increase in caries postcessation. 3 studies did not show an increase in caries postcessation; however, important postcessation changes (eg, implementation of alternative fluoride delivery programmes) and/or large-scale social change may have contributed to those effects. Of the 3 study groupings that permitted quantitative synthesis, 2 showed statistically significant mean overall increase in caries postcessation; however, quantitative synthesis results must be interpreted cautiously.ConclusionsOverall, the published research points more to an increase in dental caries post-CWF cessation than otherwise. However, the literature is highly diverse and variable in methodological quality. To build this literature, it is important to exploit research opportunities presented by CWF cessation. Remaining knowledge gaps include the impact of CWF cessation on the distribution of dental caries (ie, equitable or not) and understanding the decision-making circumstances around CWF cessation.

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Section: Intervention Characteristicsmentioning

confidence: 99%

“…First, the studies in South Korea 14 and Japan 40 used CWF cessation as a way to study the impact of past exposure to CWF on current dental caries. Both studies support an enduring benefit of CWF.…”

Section: Intervention Characteristicsmentioning

confidence: 99%

Does cessation of community water fluoridation lead to an increase in tooth decay? A systematic review of published studies

McLaren

Singhal

2016

J Epidemiol Community Health

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“…Mechanistically, fluoride benefits teeth by inhibiting tooth demineralization, enhancing re‐mineralization, and inhibiting enzyme activity of plaque bacteria. While both a systemic (pre‐eruptive) and a topical (post‐eruptive) mechanism of impact have been studied intensively, experts now seem to agree that fluoride's major anti‐cariogenic effect is post‐eruptive; however, studies have continued to accrue that are consistent with some pre‐eruptive effect.…”

mentioning

confidence: 99%

Measuring the short‐term impact of fluoridation cessation on dental caries in Grade 2 children using tooth surface indices

McLaren

Patterson

Thawer

et al. 2016

Comm Dent Oral Epid

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ObjectivesTo examine the short‐term impact of fluoridation cessation on children's caries experience measured by tooth surfaces. If there is an adverse short‐term effect of cessation, it should be apparent when we focus on smooth tooth surfaces, where fluoride is most likely to have an impact for the age group and time frame considered in this study.MethodsWe examined data from population‐based samples of school children (Grade 2) in two similar cities in the province of Alberta, Canada: Calgary, where cessation occurred in May 2011 and Edmonton where fluoridation remains in place. We analysed change over time (2004/2005 to 2013/2014) in summary data for primary (defs) and permanent (DMFS) teeth for Calgary and Edmonton, for all tooth surfaces and smooth surfaces only. We also considered, for 2013/2014 only, the exposed subsample defined as lifelong residents who reported usually drinking tap water.ResultsWe observed, across the full sample, an increase in primary tooth decay (mean defs – all surfaces and smooth surfaces) in both cities, but the magnitude of the increase was greater in Calgary (F‐cessation) than in Edmonton (F‐continued). For permanent tooth decay, when focusing on smooth surfaces among those affected (those with DMFS>0), we observed a non‐significant trend towards an increase in Calgary (F‐cessation) that was not apparent in Edmonton (F‐continued).ConclusionsTrends observed for primary teeth were consistent with an adverse effect of fluoridation cessation on children's tooth decay, 2.5–3 years post‐cessation. Trends for permanent teeth hinted at early indication of an adverse effect. It is important that future data collection efforts in the two cities be undertaken, to permit continued monitoring of these trends.

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“…Second, to our best knowledge, this study is the first attempt to investigate the impact of water fluoridation programs on the whole nation of South Korea. So far, several previous studies of water fluoridation have been conducted, but most of those only investigated the impact of the programs at the community level [27–29]. Therefore, our findings would be effective evidence for establishing public health programs or policies.…”

Section: Discussionmentioning

confidence: 80%

The differences in healthcare utilization for dental caries based on the implementation of water fluoridation in South Korea

et al. 2016

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BackgroundThere were some debates about the water fluoridation program in South Korea, even if the program had generally substantial effectiveness. Because the out-of-pocket expenditures for dental care were higher in South Korea than in other countries, an efficient solution was needed. Therefore, we examined the relationship between the implementation of water fluoridation and the utilization of dental care.MethodsWe used the National Health Insurance Service National Sample Cohort. In this study, data finally included 472,250 patients who were newly diagnosed with dental caries during 2003–2013. We performed survival analysis using cox proportional hazard model, negative binomial-regression, and regression analyses using generalized estimating equation models.ResultsThere were 48.49 % outpatient dental care visit during study period. Individuals with water fluoridation had a lower risk of dental care visits (HR = 0.949, 95 % CI = 0.928–0.971). Among the individuals who experienced a dental care visit, those with water fluoridation program had a lower number of dental care visits (β = −0.029), and the period of water fluoridation had an inverse association with the dental care expenditures.ConclusionThe implementation of water fluoridation programs and these periods are associated with reducing the utilization of dental health care. Considering these positive impacts, healthcare professionals must consider preventive strategies for activating water fluoridation programs, such as changes in public perception and relations, for the effective management of dental care in South Korea.

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Systemic effect of water fluoridation on dental caries prevalence

Cited by 25 publications

References 32 publications

Does cessation of community water fluoridation lead to an increase in tooth decay? A systematic review of published studies

Does cessation of community water fluoridation lead to an increase in tooth decay? A systematic review of published studies

Measuring the short‐term impact of fluoridation cessation on dental caries in Grade 2 children using tooth surface indices

The differences in healthcare utilization for dental caries based on the implementation of water fluoridation in South Korea

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