Contribution of water fluoridated to facial aesthetics in a context of low prevalence of caries

Abstract

Background: Fluoridated water adds a preventive benefit against caries, even in epidemiological scenarios with a low prevalence of the disease. It is not known whether in such contexts this public health technology has an impact on facial aesthetics, as the preventive effect of fluoridated water on anterior, aesthetically relevant, and posterior teeth groups is different. In this article this possible effect is evaluated. Methods: Two ssimultaneous, epidemiological census population surveys, were carried out in two Brazilian cities with low prevalence of caries: Silveiras (fluoridated), and São José do Barreiro (not fluoridated). The values ​​of the Decayed, Missing and Filling Teeth - DMFT index were organized according to their distribution by two teeth groups, called “anterior” and “posterior”. In order to make comparisons and evaluate the meaning of the values ​​found in the census, the proportions of the participation of anterior teeth groups at the age of 12 years were calculated in databases of epidemiological population surveys of caries made available by the Collaborating Center of the Ministry of Health of São Paulo University, carried out in Santos-1995 (fluoridated), in Suzano-2012 (fluoridated), as well as the research São Paulo State- SB-SP-2015 (fluoridated and not). Results: The mean DMFT index was 1.7 (sd=1.9) in Silveiras, and 2.6 (sd=3.4) in São José do Barreiro. The average DMFT was: 1.73 (1.57-1.89) in Santos, 1.21 (1.02-1.39) in Suzano, 1.89 São Paulo state (exposed fluoridation) and 2.38 (not exposed). The percentage share of anterior teeth groups in the composition of the DMFT values, at 12 years of age, was: Silveiras 4.33, São José do Barreiro 14.11, Santos 4.08, Suzano 4.44, and in São Paulo state 4.54 (exposed) and 7.54 (not exposed). Conclusion: Water fluoridation produces epidemiological effects on anterior teeth groups, even in contexts of low disease prevalence. This effect is relevant in permanent teeth, helping to prevent losses and preserve dental occlusion, thereby improving facial esthetics.