Effects of Community Water Fluoridation on Dental Caries Disparities in Adolescents.

Go Matsuo,Richard Gary Rozier,Jun Aida,Ken Osaka

doi:10.3390/ijerph17062020

Abstract

Despite improvements in the prevalence of dental caries, disparities are still observed globally and in the U.S. This study examined whether community water fluoridation (CWF) reduced dental caries disparities in permanent teeth of 10- to 19-year-old schoolchildren in North Carolina. We used cross-sectional data representing K-12 schoolchildren in North Carolina (NC) public schools. A poisson regression model was used to determine whether the association between children’s parental educational attainment and the prevalence of dental caries of children differed by children’s lifetime CWF exposure. We analyzed data on 2075 students. Among the children without any CWF exposure in their life, statistically significant caries disparities by parental educational attainment were observed. Compared to the children of parents with more than high school education, the relative risk for those with a parent with a high school education was 1.16 (95% CI = 1.01, 1.33) and those with less than a high school education was 1.27 (95% CI = 1.02, 1.60). In contrast, these disparities were not observed among children exposed to CWF throughout their lives. Socioeconomic disparities in dental caries were not observed among 10–19-year-old schoolchildren with lifetime CWF exposure. CWF seemed to reduce dental caries disparities.

Highlights

Despite a decline in the prevalence of dental caries, untreated caries in permanent teeth was the most prevalent condition found in the Global Burden of Disease Study [1]
In Model 1, students whose parents were less educated had a statistically significant greater dental caries experience than those whose parents were highly educated (high school graduate: Prevalence ratio (PR) = 1.18; 95% confidence interval (CI) = 1.08, 1.28; less than high school graduate: PR = 1.16; 95% CI = 1.01, 1.32)
This trend was observed in Model 2

Summary

Introduction

Despite a decline in the prevalence of dental caries, untreated caries in permanent teeth was the most prevalent condition found in the Global Burden of Disease Study [1]. This issue is is characterized by persistent global inequalities [2,3,4]. Eliminating oral health disparities is among the national goals of the U.S [6,7]. Interventions to address health disparities need to be carried out at multiple levels using upstream approaches [8,9,10]. Policies for structural changes in the environment, such as community water fluoridation (CWF) or healthy food and nutrition, are important upstream strategies in addition to usual policies focusing on proximal influences on oral health such as oral health behaviors [10,11]

Objectives

Methods

Results

Conclusion