Abstract
Aim
To test the correlation among dental caries, dental fluorosis, and the percentage of municipalities with optimal fluoridated water among Brazilian 12-year-old schoolchildren.
Subjects and methods
An ecological study was performed using primary data from the latest Brazilian Oral Health Survey. The units of analysis were the 26 states plus the Federal District of Brazil (n = 7328 schoolchildren). Dental caries was diagnosed according to the DMFT criteria and dental fluorosis according to Dean’s Index. Descriptive and analytical statistics (p < 0.05) were performed. Google My Maps® was used to display data by state.
Results
Mean DMFT ranged from 1.06 to 4.81 between states, whereas the prevalence rates of dental caries and dental fluorosis ranged from 37.3 to 78.2% and from 0 to 45.8% between states, respectively. In Brazil, 60.25% of the municipalities have an optimal fluoridated water supply. The percentage of municipalities with an optimal fluoridated water supply in each state ranged from 0 to 97.4%. Dental fluorosis was negatively correlated with mean DMFT (r = − 0.645; p < 0.001) and with dental caries (r = − 0.678; p < 0.001). The percentage of municipalities with optimal fluoridated water was negatively correlated with dental caries (r = − 0.678; p < 0.001) and positively correlated with dental fluorosis (r = 0.668; p < 0.001).
Conclusion
Lower prevalence of dental caries was found with the increasing percentage of municipalities with optimal fluoridated water and with the increasing prevalence of dental fluorosis.
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References
AlDosari AM, Akpata ES, Khan N (2010) Associations among dental caries experience, fluorosis and fluoride exposure from drinking water in Saudi Arabia. J Public Health Dent 70:220–226. https://doi.org/10.1111/j.1752-7325.2010.00169.x
Arnold FA (1957) Grand rapids fluoridation study—results pertaining to the eleventh year of fluoridation. Am J Public Health Nations Health 47:539–545
Bergamo ET, Barbana M, Terada RS, Cury JA, Fujimaki M (2015) Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis. Braz Oral Res 29:1–6. https://doi.org/10.1590/1807-3107BOR-2015.vol29.0047
Brasil (1974) Diário Oficial da União. Lei n° 6.050 de 24 de maio de 1974. Available from: http://www.jusbrasil.com.br/topicos/12121040/lei-n-6050-de-24-de-maio-de-1974
Brasil (2008) Ministério do Planejamento, Orçamento e Gestão. Pesquisa Nacional de Saneamento Básico. Available from: http://www.ibge.gov.br/home/estatistica/populacao/condicaodevida/pnsb2008/PNSB_2008.pdf
Brasil (2010) Ministério da Saúde. SB Brasil 2010. Pesquisa Nacional de Saúde Bucal. Resultados Principais. Available from: http://dab.saude.gov.br/CNSB/sbbrasil/
Cury JA, Oliveira MJ, Martins CC, Tenuta LM, Paiva SM (2010) Available fluoride in toothpastes used by Brazilian children. Braz Dent J 21(5):396–400
Cury JA, Tenuta LM (2014) Evidence-based recommendation on toothpaste use. Braz Oral Res 28:1–7. https://doi.org/10.1590/S1806-83242014.50000001
da Silva JV, Machado FC, Ferreira MA (2015 Aug) Social inequalities and the oral health in Brazilian capitals. Cien Saude Colet 20(8):2539–2548
Dean HT (1934) Classification of mottled enamel diagnosis. J Am Dent Assoc 21:1421–1426
Do LG, Miller J, Phelan C, Sivaneswaran S, Spencer AJ, Wright C (2014) Dental caries and fluorosis experience of 8–12-year-old children by early life exposure to fluoride. Community Dent Oral Epidemiol 42:553–562. https://doi.org/10.1111/cdoe.12106
Do LG, Spencer AJ, Ha DH (2009) Association between dental caries and fluorosis among south Australian children. Caries Res 43:366–373. https://doi.org/10.1159/000235580
Fawell J, Bailey K, Chilton J, Dahi E, Fewtrell L, Magara Y (2006) Fluoride in Drinking-water. Iwa Publishing, London
Franzolin Sde O, Gonçalves A, Padovani CR, Francischone LA, Marta SN (2010) Epidemiology of fluorosis and dental caries according to different types of water supplies. Cien Saude Colet 15:1841–1847
Freire MC, Reis SC, Figueiredo N, Peres KG, Moreira RS, Antunes JL (2013) Individual and contextual determinants of dental caries in Brazilian 12-year-olds in 2010. Rev Saude Publica 47:40–49
Iheozor-Ejiofor Z, Worthington HV, Walsh T, O’Malley L, Clarkson JE, Macey R et al (2015) Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 6:CD010856. https://doi.org/10.1002/14651858.CD010856.pub2
Jiménez-Farfán MD, Hernández-Guerrero JC, Juaréz-López LA, Jacinto-Alemán LF, de la Fuente-Hernanández J (2011) Fluoride consumption and its impact on oral health. Int J Environ Res Public Health 8(1):148–160. https://doi.org/10.3390/ijerph8010148
Jordão LM, Vasconcelos DN, Moreira Rda S, Freire Mdo C (2015) Dental fluorosis: prevalence and associated factors in 12-year-old schoolchildren in Goiânia, Goiás. Rev Bras Epidemiol 18:568–577. https://doi.org/10.1590/1980-5497201500030004
Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W (2015) Global burden of untreated caries: a systematic review and metaregression. J Dent Res 94:650–658. https://doi.org/10.1177/0022034515573272
Martins CC, Paiva SM, Lima-Arsati YB, Ramos-Jorge ML, Cury JÁ (2008) Prospective study of the association between fluoride intake and dental fluorosis in permanent teeth. Caries Res 42:125–133. https://doi.org/10.1159/000119520
Martins CC, Paiva SM, Cury JA (2011) Effect of discontinuation of fluoride intake from water and toothpaste on urinary excretion in young children. Int J Environ Res Public Health 8:2132–2141. https://doi.org/10.3390/ijerph8062132
Mullen J (2005) History of water fluoridation. Br Dent J 199:1–4
Narbutaitè J, Vehkalahti MM, Milciuvienè S (2007) Dental fluorosis and dental caries among12-yr-old children from high- and low-fluoride areas in Lithuania. Eur J Oral Sci 115:137–142
Onoriobe U, Rozier RG, Cantrell J, King RS (2014) Effects of enamel fluorosis and dental caries in quality of life. J Dent Res 93:972–979. https://doi.org/10.1177/0022034514548705
Paiva SM, Lima YB, Cury JA (2003) Fluoride intake by Brazilian children from two communities with fluoridated water. Community Dent Oral Epidemiol 31:184–191
Roncalli AG, Sheiham A, Tsakos G, Watt RG (2015) Socially unequal improvements in dental caries levels in Brazilian adolescents between 2003 and 2010. Community Dent Oral Epidemiol 43:317–324. https://doi.org/10.1111/cdoe.12156
Schwendicke F, Doost F, Hopfenmuller W, Meyer-Lueckel H, Paris S (2015) Dental caries, fluorosis, and oral health behavior of children from Herat, Afghanistan. Community Dent Oral Epidemiol 43:521–531
Vettore MV, Aqeeli A (2016) The roles of contextual and individual social determinants of oral health-related quality of life in Brazilian adults. Qual Life Res 25:1029–1042. https://doi.org/10.1007/s11136-015-1118-0
Walsh T, Worthington HV, Glenny AM, Appelbe P, Marinho VC, Shi X (2010) Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 20:CD007868. https://doi.org/10.1002/14651858.CD007868.pub2
World Health Organization (1997) Oral health surveys, basic methods. World Health Organization, Geneva
World Health Organization (2017) WHO’s oral health country/area profile programme (CAPP) database. Caries distribution world-wide and in relation to socioeconomic inequalities within and between countries. Available from: http://www.mah.se/CAPP/Country-Oral-Health-Profiles
Acknowledgments
This study was supported by the Brazilian Ministry of Health, the Brazilian Coordination of Higher Education, Ministry of Education (CAPES), the Research Foundation of the State of Minas Gerais (FAPEMIG), and the National Council for Scientific and Technological Development (CNPQ), Brazil.
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Firmino, R.T., Bueno, A.X., Martins, C.C. et al. Dental caries and dental fluorosis according to water fluoridation among 12-year-old Brazilian schoolchildren: a nation-wide study comparing different municipalities. J Public Health (Berl.) 26, 501–507 (2018). https://doi.org/10.1007/s10389-018-0901-0
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DOI: https://doi.org/10.1007/s10389-018-0901-0