Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/113405
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Type: Journal article
Title: Contemporary evidence on the effectiveness of water fluoridation in the prevention of childhood caries
Author: Spencer, A.
Do, L.
Ha, D.
Citation: Community Dentistry and Oral Epidemiology, 2018; 46(4):407-415
Publisher: Wiley
Issue Date: 2018
ISSN: 0301-5661
1600-0528
Statement of
Responsibility: 
A. John Spencer, Loc G. Do, Diep H. Ha
Abstract: Water fluoridation's effectiveness has been reaffirmed by systematic reviews. However, most of the included nonrandomised controlled before and after studies were conducted pre-1975. Opportunity for such studies is limited in a steady state of community fluoridation programmes. As an alternative for evidence to support or refute the effectiveness of water fluoridation, this study used data from a recent national child oral health study to examine associations between lifetime exposure to fluoridated water (%LEFW) and childhood caries.A population-based study of child oral health in Australia was conducted in 2012-2014, using complex sampling and weighting procedures. Parents provided detailed household information and children underwent oral epidemiological examination by trained examiners. Residential history from birth was used to calculate %LEFW. Caries prevalence (dmfs/DMFS>0) and experience (dmfs/DMFS) in both primary (age 5-8) and permanent dentitions (age 9-14) were estimated. Socioeconomic factors that were significantly different by %LEFW were then used as covariates in multivariable log-Poisson regression models for each caries outcome by %LEFW.A total of 24 664 children had complete data. Caries prevalence and experience were higher among 5-8-year-old children with lower %LEFW (46.9%; 4.27 surfaces) than those with 100%LEFW (31.5%; 1.98 surfaces) and for the 9-14-year-old children with lower %LEFW (37.0%; 1.34 surfaces) than those with 100%LEFW (25.0%; 0.67 surfaces). In the multivariable models, the prevalence ratios for primary and permanent caries were significant for the two lower exposure groups against the 100%LEFW group. Similarly, the mean ratios for primary dmfs were significant for all three lower exposure groups and for permanent DMFS were significant for the two lower exposure groups against the 100%LEFW group. Mean ratios for the 0%LEFW compared to the 100%LEFW group were 2.10 (1.83-2.40) for dmfs and 1.82 (1.57-2.10) for DMFS.Analysis of contemporary data representative of the Australian child population found consistent associations between %LEFW and childhood caries, which persisted when socioeconomic differences were adjusted across exposure groups, supporting the continued effectiveness of water fluoridation.
Keywords: Children; Contemporary evidence; Dental caries; Population-based study; Water fluoridation
Rights: © 2018 John Wiley & Sons A/S.
RMID: 0030090279
DOI: 10.1111/cdoe.12384
Grant ID: http://purl.org/au-research/grants/nhmrc/1016326
Appears in Collections:Dentistry publications

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