Objectives: In December 2008, artificial water fluoridation was introduced for the first time to the Logan-Beaudesert district in the state of Queensland, Australia. The aim of this study was to evaluate the effects of water fluoridation in the primary dentition in this community after a period of 36 months. Methods: Children aged 4-9 years with clinical examinations and bitewing radiographs (BWs) taken before water fluoridation (pre-F) were randomly selected as comparison controls for age matched children who had been exposed to a mean period of 36 months of water fluoridation (post-F). A total of 201 sets of pre-F BWs from children (mean age 6.95 ± 1.05 years) and 256 sets of post-F BWs from children (mean age 7.19 ± 1.23 years) attending schools in the district were randomly selected. Caries experience in the primary dentition was determined as decayed, missing or filled teeth/surfaces (dmft/dmfs). Results: The caries prevalence for the pre-F group was 87% compared to 75% in the post-F group (Odds ratio (OR): 0.44, 95% CI: 0.27-0.72). Overall, there was a 19 percent reduction of mean dmft from 4.54 in the pre-F group to 3.66 in the post-F group (p = 0.005). After fluoridation, the dmfs was reduced from 6.68 to 5.17 (p = 0.0056). The distal surfaces of maxillary first primary molars experienced the greatest reduction (26%) in caries experience after water fluoridation (p < 0.001). Conclusions: After only 36 months of water fluoridation there was a significant drop in caries prevalence from 87 to 75% and a 19% reduction in caries experience in a community with one of the highest caries rates in Australia.

1.
Armfield JM: Public water fluoridation and dental health in New South Wales. Aust N Z J Public Health 2005;29:477-483.
2.
Armfield JM: The extent of water fluoridation coverage in Australia. Aust N Z J Public Health 2006;30:581-582.
3.
Armfield JM: The benefits of water fluoridation across areas of differing socio-economic status. Aust Dent J 2008;53:180-183.
4.
Armfield JM: Community effectiveness of public water fluoridation in reducing children's dental disease. Public Health Rep 2010;125:655-664.
5.
Armfield JM, Beckwith K: Oral health behaviours; in Do L, Spencer AJ (eds): The beginning of change: Queensland child oral health survey 2010-2012. Queensland Health and Australian Research Centre for Population Oral Health, University of Adelaide, 2014.
6.
Armfield JM, Spencer AJ: Dental health behaviours among children 2002-2004: the use of fluoride toothpaste, fluoride tablets and drops, and fluoride mouthrinse. Dental Statistics and Research Canberra, Australian Institute of Health and Welfare, 2012.
7.
Australian Bureau of Statistics: Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2006. http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2033.0.55.0012006?OpenDocument.
8.
Australian Bureau of Statistics: Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2011. http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2033.0.55.0012011?OpenDocument.
9.
Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E: Beyond the DMFT: the human and economic cost of early childhood caries. J Am Dent Assoc 2009;140:650-657.
10.
Cobiac LJ, Vos T: Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries in Australia. Community Dent Oral Epidemiol 2012;40:369-376.
11.
Evans RW, Hsiau AC, Dennison PJ, Patterson A, Jalaludin B: Water fluoridation in the Blue Mountains reduces risk of tooth decay. Aust Dent J 2009;54:368-373.
12.
Fleiss JL, Levin B, Paik MC: Statistical Methods for Rates and Proportions, ed 3. Hoboken, NJ, John Wiley, 2003.
13.
Ford D, Seow WK, Kazoullis S, Holcombe T, Newman B: A controlled study of risk factors for enamel hypoplasia in the permanent dentition. Pediatr Dent 2009;31:382-388.
14.
Gowda S, Thomson WM, Foster Page LA, Croucher NA: What difference does using bitewing radiographs make to epidemiological estimates of dental caries prevalence and severity in a young adolescent population with high caries experience? Caries Res 2009;43:436-441.
15.
Ha DH, Amarasena N, Crocombe L: The dental health of Australia's children by remoteness: child dental health survey Australia 2009; in Dental statistics and research series No. 63. Canberra, Australian Institute of Health and Welfare, 2013.
16.
Jones CM, Taylor GO, Whittle JG, Evans D, Trotter DP: Water fluoridation, tooth decay in 5 year olds, and social deprivation measured by the Jarman score: analysis of data from British dental surveys. Brit Med J 1997;315:514-517.
17.
Jones CM, Worthington H: Fluoridation: the relationship between water fluoridation and socioeconomic deprivation on tooth decay in 5-year-old children. Br Dent J 1999;186:397-400.
18.
Koh R: Caries prevention for children in a low socio-economic community. MPhil thesis, University of Queensland, St Lucia, Australia, 2014.
19.
McLaren L, Emery JC: Drinking water fluoridation and oral health inequities in Canadian children. Can J Public Health 2012;103:S49-S56.
20.
Morgan MV, Adams GG, Bailey DL, Tsao CE, Fischman SL, Reynolds EC: The anticariogenic effect of sugar-free gum containing CPP-ACP nanocomplexes on approximal caries determined using digital bitewing radiography. Caries Res 2008;42:171-184.
21.
Newman B, Seow WK, Kazoullis S, Ford D, Holcombe T: Clinical detection of caries in the primary dentition with and without bitewing radiography. Aust Dent J 2009;54:23-30.
22.
O'Mullane D, Whelton HP, Costelloe P, Clarke D, McDermott S, McLoughlin J: The results of water fluoridation in Ireland. J Public Health Dent 1996;56:259-264.
23.
Palmer JD, Anderson RJ, Downer MC: Guidelines for prevalence studies of dental caries. Community Dent Health 1984;1:55-66.
24.
Pitts NB: Systems for grading approximal carious lesions and overlaps diagnosed from bitewing radiographs. Proposals for future standardization. Community Dent Oral Epidemiol 1984;12:114-122.
25.
Pitts NB: Score system for behaviour of radiologically diagnosed approximal carious lesions. Community Dent Oral Epidemiol 1985;13:268-272.
26.
Plonka KA, Pukallus ML, Barnett A, Holcombe TF, Walsh LJ, Seow WK: A controlled, longitudinal study of home visits compared to telephone contacts to prevent early childhood caries. Int J Paediatr Dent 2013a;23:23-31.
27.
Plonka KA, Pukallus ML, Barnett AG, Holcombe TF, Walsh LJ, Seow WK: A longitudinal case-control study of caries development from birth to 36 months. Caries Res 2013b;47:117-127.
28.
Plonka KA, Pukallus ML, Holcombe TF, Barnett AG, Walsh LJ, Seow WK: Randomized controlled trial: a randomized controlled clinical trial comparing a remineralizing paste with an antibacterial gel to prevent early childhood caries. Pediatr Dent 2013c;35:8-12.
29.
Public Health Information Development Unit Australia: Population health profile of the Logan Area Division of General Practice: supplement. Adelaide, Australia, Commonwealth of Australia, Public Health Information Development Unit, 2007.
30.
Queensland Government Statistician's Office: Queensland Regional Profile: Logan City Local Government Area. http://statistics.oesr.qld.gov.au/qld-regional-profiles, 2014.
31.
Rugg-Gunn AJ, Do L: Effectiveness of water fluoridation in caries prevention. Community Dent Oral Epidemiol 2012;40:55-64.
32.
Saliba NA, Moimaz SA, Casotti CA, Pagliari AV: Dental caries of lifetime residents in Baixo Guandu, Brazil, fluoridated since 1953 - a brief communication. J Public Health Dent 2008;68:119-121.
33.
Seow WK, Clifford H, Battistutta D, Morawska A, Holcombe T: Case-control study of early childhood caries in Australia. Caries Res 2009;43:25-35.
34.
Slade GD, Sanders AE, Do L, Roberts-Thomson K, Spencer AJ: Effects of fluoridated drinking water on dental caries in Australian adults. J Dent Res 2013;92:376-382.
35.
Slade GD, Spencer AJ, Davies MJ, Stewart JF: Influence of exposure to fluoridated water on socioeconomic inequalities in children's caries experience. Community Dent Oral Epidemiol 1996;24:89-100.
36.
Wenzel A: Current trends in radiographic caries imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80:527-539.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.