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Pollick H. Community Water Fluoridation Benefits US Children From Poor Families More Than Those From More Affluent Families. J Evid Based Dent Pract 2019; 19:213-216. [PMID: 31326061 DOI: 10.1016/j.jebdp.2019.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Association Between Water Fluoridation and Income-Related Dental Caries of US Children and Adolescents. Sanders AE, Grider WB, Maas WR, Curiel JA, Slade GD. JAMA Pediatr 2019;173(3):288-90. SOURCE OF FUNDING National Institute of Dental and Craniofacial Research of the National Institutes of Health under award number UH2DE025494. TYPE OF STUDY/DESIGN Cross-sectional study.
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Bhoopathi V, Vishnevetsky A, Mirman J. Pediatric dentists who accept new Medicaid-enrolled children report higher willingness to advocate for community water Fluoridation. BMC Oral Health 2019; 19:115. [PMID: 31200715 PMCID: PMC6570849 DOI: 10.1186/s12903-019-0812-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/31/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Dentists, who advocate for Community Water Fluoridation (CWF), can help decrease the dental caries disparity gap between low and high socioeconomic groups. Advocating for CWF, a cause that promotes oral health at the population level is an altruistic behavior. Dentists who accept and provide services to Medicaid-insured children, who are from low socioeconomic backgrounds, are also considered altruistic. We tested the association between accepting new Medicaid-insured children every month, and willingness to advocate for CWF programs in pediatric dentists (PDs). METHODS In 2016, a 22-item pilot tested online survey was sent to 5394 PD members of the American Academy of Pediatric Dentistry. Descriptive analysis and a multiple adjusted logistic regression model was conducted. RESULTS Dentists who accept new Medicaid-insured children every month (OR: 1.62; 95% CI: 1.06-2.47; p = 0.02) were more willing to advocate for CWF compared to their counterparts. Those practicing primarily in rural (OR = 4.67; 95% CI: 1.82-11.9; p = 0.001), and urban areas (OR = 2.27; 95%CI: 1.05-4.89; p = 0.04), and those willing to promote fluoridated water consumption to parents in the clinic (OR = 3.40; 95% CI: 1.87-6.21; p = < 0.0001) were significantly more likely to be willing to advocate for CWF. PDs trained in public health advocacy during pediatric residency alone (OR = 2.37; 95% CI: 1.24-4.51; p = 0.009), or during both pre-doctoral dental education and pediatric residency (OR = 3.51; 95% CI: 1.87-5.6; p = < 0.0001) were more willing to advocate for CWF compared to their counterparts. CONCLUSIONS PDs who accepted new Medicaid-insured children every month were more willing to advocate for CWF programs compared to those who did not.
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Affiliation(s)
- Vinodh Bhoopathi
- Department of Pediatric Dentistry and Community Oral Health Sciences, Temple University Maurice H. Kornberg School of Dentistry, 3223 N Broad Street, Philadelphia, Pennsylvania 19140 USA
| | | | - Jennifer Mirman
- Temple University Maurice H. Kornberg School of Dentistry, 3223 N Broad Street, Philadelphia, Pennsylvania 19140 USA
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Yang Y, Zhao Q, Liu Y, Liu X, Chu Y, Yan H, Fan Y, Huo S, Wang L, Lou Q, Guo N, Sun D, Gao Y. FRZB1 rs2242070 polymorphisms is associated with brick tea type skeletal fluorosis in Kazakhs, but not in Tibetans, China. Arch Toxicol 2018; 92:2217-2225. [PMID: 29785637 DOI: 10.1007/s00204-018-2217-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/03/2018] [Indexed: 11/26/2022]
Abstract
Skeletal fluorosis is a metabolic bone and joint disease caused by excessive accumulation of fluoride in the bones. Compared with Kazakhs, Tibetans are more likely to develop moderate and severe brick tea type skeletal fluorosis, although they have similar fluoride exposure. Single nucleotide polymorphisms (SNPs) in frizzled-related protein (FRZB) have been associated with osteoarthritis, but their association with the risk of skeletal fluorosis has not been reported. In this paper, we investigated the association of three SNPs (rs7775, rs2242070 and rs9288087) in FRZB1with brick tea type skeletal fluorosis risk in a cross-sectional case-control study conducted in Sinkiang and Qinghai, China. A total of 598 individuals, including 308 Tibetans and 290 Kazakhs, were enrolled in this study, in which cases and controls were 221 and 377, respectively. The skeletal fluorosis was diagnosed according to the Chinese diagnostic criteria of endemic skeletal fluorosis (WS192-2008). The fluoride content in tea water or urine was detected using the fluoride ion electrode. SNPs were assessed using the Sequenom MassARRAY system. Binary logistic regressions found evidence of association with rs2242070 AA genotype in only Kazakh participants [odds ratio (OR) 0.417, 95% CI 0.216-0.807, p = 0.009], but not in Tibetans. When stratified by age, this protective effect of AA genotype in rs2242070 was pronounced in Kazakh participants aged 46-65 (OR 0.321, 95% CI 0.135-0.764, p = 0.010). This protective association with AA genotype in rs2242070 in Kazakhs also appeared to be stronger with tea fluoride intake > 3.5 mg/day (OR 0.396, 95% CI 0.182-0.864, p = 0.020). Our data suggest there might be differential genetic influence on skeletal fluorosis risk in Kazakh and Tibetan participants and that this difference might be modified by tea fluoride intake.
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Affiliation(s)
- Yanmei Yang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Qiaoshi Zhao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Yang Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Xiaona Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Yanru Chu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Huazhu Yan
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Yumei Fan
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Simeng Huo
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Limei Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Qun Lou
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Ning Guo
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China.
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province and Ministry of Health (23618504), Harbin, 150081, Heilongjiang, China.
- Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin, 150081, Heilongjiang, China.
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Arora S, Kumar JV, Moss ME. Does water fluoridation affect the prevalence of enamel fluorosis differently among racial and ethnic groups? J Public Health Dent 2017; 78:95-99. [DOI: 10.1111/jphd.12258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 09/26/2017] [Accepted: 10/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jayanth V. Kumar
- California Department of Public Health, Chronic Disease Control Branch; Sacramento CA USA
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Prolactin rs1341239 T allele may have protective role against the brick tea type skeletal fluorosis. PLoS One 2017; 12:e0171011. [PMID: 28152004 PMCID: PMC5289533 DOI: 10.1371/journal.pone.0171011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/14/2017] [Indexed: 01/25/2023] Open
Abstract
Objective Prolactin (PRL) has been reported to be associated with increased bone turnover, and increased bone turnover is also a feature of skeletal fluorosis (SF). Autocrine/paracrine production of PRL is regulated by the extrapituitary promoter and a polymorphism in the extrapituitary PRL promoter at -1149 (rs1341239) is associated with disturbances of bone metabolism in other diseases. Here, we have investigated the possibility that the rs1341239 polymorphism is associated with SF, which results from the consumption of brick tea. Design We conducted a cross-sectional study in Sinkiang, Qinghai, Inner Mongolia in China. Demography survey questionnaires were completed and physical examination and X-ray diagnoses were used to diagnose SF. Brick tea water fluoride intake (IF) and urinary fluoride (UF) were tested by an F-ion selective electrode method. A Sequenom MassARRAY system was used to determine PRL gene polymorphisms. Results Subjects who were younger than 45 years of age and carried the T allele had a significantly decreased risk of SF [OR = 0.279 (95%CI, 0.094–0.824)] compared to those carrying the homozygous G allele. This phenomenon was only observed in Kazakh subjects [OR = 0.127 (95%CI, 0.025–0.646)]. Kazakh females who carried T alleles has a decreased risk of SF [OR = 0.410 (95%CI, 0.199–0.847)]. For Kazakh subjects which IF is less than 3.5 mg/d, a decreased risk of SF was observed among the participants who carried T alleles [OR = 0.118 (95%CI, 0.029–0.472)]. Overall, subjects with 1.6–3.2 mg/L UF and carried T alleles had a significantly decreased risk of SF [OR = 0.476 (95%CI, 0.237–0.955)] compared to homozygous G allele carriers. This phenomenon was only observed in Kazakh subjects [OR = 0.324 (95%CI, 0.114–0.923)]. Conclusions Our results suggested that the PRL rs1341239 T allele decreases the risk of brick tea SF.
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Kumar JV, Tavares V, Kandhari P, Moss M, Jolaoso IA. Changes in Caries Experience, Untreated Caries, Sealant Prevalence, and Preventive Behavior Among Third-Graders in New York State, 2002-2004 and 2009-2012. Public Health Rep 2015; 130:355-61. [PMID: 26346760 DOI: 10.1177/003335491513000414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study assessed changes in caries experience, untreated caries, sealant prevalence, and preventive behavior among third-grade children in New York State to monitor progress toward state health objectives. METHODS We analyzed children's data from the 2002-2004 (n=10,865) and 2009-2012 (n=6,758) New York State Oral Health Survey. We calculated differences in weighted percentages and 95% confidence intervals for caries experience, untreated caries, sealant prevalence, and preventive behavior. We used logistic regression procedures to assess the independent effects and interaction terms on dental caries experience. RESULTS The percentage of children with dental caries and untreated caries decreased from 54.1% and 33.0% in 2002-2004 to 45.2% and 23.6% in 2009-2012, respectively. While this decrease was not uniform across income subgroups, the prevalence of sealants, a key measure of the use of preventive services, increased significantly from 16.7% to 36.0% among lower-income children. CONCLUSIONS Measurable improvement in reducing dental caries prevalence among third-grade children has been made in New York State, but this improvement was not uniform across subgroups. Specifically, disease prevalence among lower-income children remained high, underscoring the need to strengthen existing programs and identify additional policy and programmatic interventions.
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Affiliation(s)
- Jayanth V Kumar
- New York State Department of Health, Bureau of Dental Health, Albany, NY ; University at Albany, School of Public Health, Albany, NY
| | | | - Priyanka Kandhari
- New York State Department of Health, Bureau of Dental Health, Albany, NY
| | - Mark Moss
- New York State Department of Health, Bureau of Dental Health, Albany, NY
| | - I Adeyemi Jolaoso
- Berkshire Medical Center, Department of Dentistry, Pittsfield, MA ; Department of Dentistry, Community Health Programs, Great Barrington, MA
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Wu J, Wang W, Liu Y, Sun J, Ye Y, Li B, Liu X, Liu H, Sun Z, Li M, Cui J, Sun D, Yang Y, Gao Y. Modifying Role of GSTP1 Polymorphism on the Association between Tea Fluoride Exposure and the Brick-Tea Type Fluorosis. PLoS One 2015; 10:e0128280. [PMID: 26046522 PMCID: PMC4457801 DOI: 10.1371/journal.pone.0128280] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 04/23/2015] [Indexed: 11/26/2022] Open
Abstract
Background Brick tea type fluorosis is a public health concern in the north-west area of China. The association between SNPs of genes influencing bone mass and fluorosis has attracted attention, but the association of SNPs with the risk of brick-tea type of fluorosis has not been reported. Objective To investigate the modifying roles of GSTP1 rs1695 polymorphisms on this association. Methods A cross-sectional study was conducted. Brick-tea water was tested by the standard of GB1996-2005 (China). Urinary fluoride was tested by the standard of WS/T 89-2006 (China). Skeletal fluorosis was diagnosed by X-ray, the part we scheduled was forearm, shank, and pelvic, then diagnosed the skeletal fluorosis by the standard of WS/192-2008 (China). Gene polymorphism was tested by Sequenom MassARRAY system. Result The prevalence rate in different ethnical participants was different: Tibetan individuals had the highest prevalence rate of skeletal fluorosis. There were significant differences in genotype frequencies of GSTP1 Rs1695 among different ethnical participants (p<0.001): Tibetan, Mongolian and Han subjects with homozygous wild type (GSTP1-AA) genotype were numerically higher than Kazakh and Russian subjects (p<0.001). Compared to Tibetan participants who carried homozygous A allele of GSTP1 Rs1695, Tibetan participants who carried G allele had a significantly decreased risk of skeletal fluorosis (OR = 0.558 [95% CI, 0.326-0.955]). For Kazakh participants, a decreased risk of skeletal fluorosis among carriers of the G allele was limited to non high-loaded fluoride status (OR = 0. 166 [95% CI, 0.035–0.780] vs. OR = 1.478 [95% CI, 0.866–2.552] in participants with high-loaded fluoride status). Neither SNP-IF nor SNP-age for GSTP1 Rs1695 was observed. Conclusion The prevalence rate of the brick tea type fluorosis might have ethnic difference. For Tibetan individuals, who had the highest prevalence rate, G allele of GSTP1 Rs1695 might be a protective factor for brick tea type skeletal fluorosis.
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Affiliation(s)
- Junhua Wu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Wei Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Yang Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Jing Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Yan Ye
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Bingyun Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Xiaona Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Hongxu Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Zhenqi Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Mang Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Jing Cui
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
| | - Yanmei Yang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
- * E-mail: (YY); (YG)
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China
- * E-mail: (YY); (YG)
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Blinkhorn AS, Byun R, Mehta P, Kay M. A 4-year assessment of a new water-fluoridation scheme in New South Wales, Australia. Int Dent J 2015; 65:156-63. [PMID: 25913418 DOI: 10.1111/idj.12166] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To monitor the changes in dental caries prevalence of 5- to 7-year-old children living in a fluoridated area, a newly fluoridated area and in an area without water fluoridation, in NSW, Australia. METHODS Dental caries prevalence was recorded for 5- to 7-year-old children, living in the three study locations, by six trained and calibrated examiners in 2008, 2010 and 2012. A questionnaire recorded demographic data, toothbrushing behaviour and sugary drink consumption. Caries experience was measured using the decayed, missing, and filled teeth (dmft) index for primary teeth, the percentage of children who were caries free and the significant caries index. Univariate analysis was undertaken to determine independent predictors of caries. RESULTS The caries prevalence changed over time. In 2008, the mean dmft index was 1.40 for the fluoridated area, 2.02 for the area about to fluoridate and 2.09 for the unfluoridated control. By 2012, these mean dmft scores were 0.69, 0.72 and 1.21, respectively. In the two areas where children received fluoridated water, the significant caries index was 2.30 for the fluoridated area and 2.40 for the newly fluoridated area. The significant caries score for children in the unfluoridated location was 3.93. Multivariate analysis showed that over time the differences in dental caries prevalence between the established fluoride area and the newly fluoridated area diminished. However, children in the unfluoridated control area continued to demonstrate significant differences in the mean number of decayed teeth compared with children in the fluoridated comparator sites, and the proportions of children free from decay were significantly higher in the fluoridated areas than in the unfluoridated area. CONCLUSION Fluoridation of public water supplies in Gosford and Wyong offers young children better dental health than those children who do not have access to this public health measure.
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Affiliation(s)
| | - Roy Byun
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia.,South Western Local Health District, Sydney, NSW, Australia
| | - Pathik Mehta
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Meredith Kay
- Breast Screen NSW, Northern Sydney and Central Coast Local Health Districts, St Leonards, NSW, Australia
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Do LG, Miller J, Phelan C, Sivaneswaran S, Spencer AJ, Wright C. Dental caries and fluorosis experience of 8-12-year-old children by early-life exposure to fluoride. Community Dent Oral Epidemiol 2014; 42:553-62. [DOI: 10.1111/cdoe.12106] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 03/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Loc G. Do
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide SA Australia
| | - Jenifer Miller
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide SA Australia
| | - Claire Phelan
- The Centre for Oral Health Strategy; Sydney NSW Australia
| | | | - A. John Spencer
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide SA Australia
| | - Clive Wright
- The Centre for Oral Health Strategy; Sydney NSW Australia
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Pollick HF. Concerns about Water Fluoridationl IQI and Osteosarcoma Lack Credible Evidence. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 12:91-4. [PMID: 16523988 DOI: 10.1179/oeh.2006.12.1.91] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Tchouaket E, Brousselle A, Fansi A, Dionne PA, Bertrand E, Fortin C. The economic value of Quebec's water fluoridation program. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2013; 21:523-533. [PMID: 24293810 PMCID: PMC3837190 DOI: 10.1007/s10389-013-0578-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 05/31/2013] [Indexed: 11/07/2022]
Abstract
AIM Dental caries is a major public health problem worldwide, with very significant deleterious consequences for many people. The available data are alarming in Canada and the province of Quebec. The water fluoridation program has been shown to be the most effective means of preventing caries and reducing oral health inequalities. This article analyzes the cost-effectiveness of Quebec's water fluoridation program to provide decision-makers with economic information for assessing its usefulness. METHODS An approach adapted from economic evaluation was used to: (1) build a logic model for Quebec's water fluoridation program; (2) determine its implementation cost; and (3) analyze its cost-effectiveness. Documentary analysis was used to build the logic model. Program cost was calculated using data from 13 municipalities that adopted fluoridation between 2002 and 2010 and two that received only infrastructure grants. Other sources were used to collect demographic data and calculate costs for caries treatment including costs associated with travel and lost productivity. RESULTS The analyses showed the water fluoridation program was cost-effective even with a conservatively estimated 1 % reduction in dental caries. The benefit-cost ratio indicated that, at an expected average effectiveness of 30 % caries reduction, one dollar invested in the program saved $71.05-$82.83 per Quebec's inhabitant in dental costs (in 2010) or more than $560 million for the State and taxpayers. CONCLUSION The results showed that the drinking-water fluoridation program produced substantial savings. Public health decision-makers could develop economic arguments to support wide deployment of this population-based intervention whose efficacy and safety have been demonstrated and acknowledged.
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Affiliation(s)
- Eric Tchouaket
- Department of Nursing, Université du Québec en Outaouais (UQO), Saint-Jérôme Campus, Saint-Joseph Street, Room J-3204, Saint-Jérôme, Quebec Canada J7Z 0B7
| | - Astrid Brousselle
- Community Health Sciences Department, Canada Research Chair in Evaluation and Health System Improvement, Longueuil, Canada
| | - Alvine Fansi
- Institut National d’Excellence en Santé et Services Sociaux du Québec, Montreal, Canada
| | | | - Elise Bertrand
- Public Health Directorate for the Laurentides Region, Laurentides, Canada
| | - Christian Fortin
- Ministry of Health and Social Services of Quebec, Québec, Canada
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Abstract
There is much that we know about fluoride as it relates to human health in general and dental health in particular. Some of the information that is known concerning water fluoridation and dental fluorosis is listed. What we do not know about fluoride is discussed in more detail, namely the efficacy of lower levels of fluoride in drinking water, the effect of discontinuing fluoride in drinking water in the absence of additional preventive measures, the prevalence of fluorosis and whether or not this presents a cosmetic problem. Other issues discussed include the actual amount of fluoride ingested from all sources, whether low-fluoride dentifrices are as efficacious as conventional dentifrices in caries protection and reducing enamel fluorosis, the role of socioeconomic factors in determining caries prevalence, and the effects of bottled water use on caries prevalence in fluoridated communities.
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Kumar JV, Adekugbe O, Melnik TA. Geographic variation in medicaid claims for dental procedures in New York State: role of fluoridation under contemporary conditions. Public Health Rep 2010; 125:647-54. [PMID: 20873280 PMCID: PMC2925000 DOI: 10.1177/003335491012500506] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We conducted an evaluation to determine if the number of claims reimbursed for caries-related procedures for children in the New York State Medicaid program varied by county fluoridation coverage. METHODS We calculated the mean number of claims per recipient for children in each county separately for the treatment of caries and all other procedures not related to caries using the 2006 Medicaid claims data. RESULTS Compared with the predominantly fluoridated counties, the mean number of restorative, endodontic, and extraction procedures per recipient was 33.4% higher in less fluoridated counties. The mean number of claims per child for caries-related services was inversely correlated with the extent of fluoridation in a county (Spearman's correlation coefficient = -0.54, p < 0.0001), but claims for non-caries related services were not. CONCLUSIONS These findings, when added to the already existing weight of evidence, have implications for promoting policies at the federal and state levels to strengthen the fluoridation program.
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Affiliation(s)
- Jayanth V Kumar
- Oral Health Surveillance & Research, Bureau of Dental Health, New York State Department of Health, Albany, NY 12337, USA.
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Dawson DV. Preliminary Evidence of an Association Between COL1A2 Polymorphisms and Dental Fluorosis in a Population with High Fluoride Exposure. J Evid Based Dent Pract 2010; 10:96-8. [DOI: 10.1016/j.jebdp.2010.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Affiliation(s)
- J V Kumar
- Bureau of Dental Health, New York State Department of Health, Room 542, Empire State Plaza Tower, Albany, NY 12237, USA.
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Abstract
BACKGROUND Increased public access to fluoride has decreased the prevalence of caries and increased the prevalence of fluorosis staining. This article provides a case report involving a conservative method of removing fluorosis stain, as well as describes an in vitro test of the method. CASE DESCRIPTION A healthy man sought treatment at New York University College of Dentistry for removal of severe, dark brown fluorosis staining on his anterior teeth. To remove the stain, the treating clinician used a microabrasive material, which leaves enamel intact, instead of a tooth-whitening agent, which requires removal of all affected enamel. METHODS To demonstrate that enamel structure is not disturbed by the microabrasive material, the authors performed a study using scanning electron microscopy, or SEM. They viewed enamel structure under SEM at x1,000 magnification. They viewed untreated microabraded enamel and compared it with enamel that had been treated for 20 seconds with 37 percent phosphoric acid. RESULTS An etch pattern was not discernible on the tooth treated with the microabrasive material. The enamel prisms remained intact and the cores were not exposed. CLINICAL IMPLICATIONS Microabrasion removes intrinsic fluorosis stain effectively while protecting enamel. In this case, an enamel shade of brown not in the range of any tooth color shade guide was reduced.
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Affiliation(s)
- Kenneth Allen
- New York University College of Dentistry, New York, NY 10010, USA.
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18
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Abstract
The overall reduction in caries prevalence and severity in the United States over recent decades is largely due to widespread exposure to fluoride, most notably from the fluoridation of drinking waters. Despite this overall reduction, however, caries distribution today remains skewed, with the poor and deprived carrying a disproportionate share of the disease burden. Dental caries, like many other diseases, is directly related to low socioeconomic status (SES). In some communities, however, caries experience has now diminished to the point where the need for continuing water fluoridation is being questioned. This paper argues that water fluoridation is still needed because it is the most effective and practical method of reducing the SES-based disparities in the burden of dental caries. There is no practical alternative to water fluoridation for reducing these disparities in the United States. For example, a school dental service, like those in many other high-income countries, would require the allocation of substantial public resources, and as such is not likely to occur soon. But studies in the United States, Britain, Australia, and New Zealand have demonstrated that fluoridation not only reduces the overall prevalence and severity of caries, but also reduces the disparities between SES groups. Water fluoridation has been named as one of the 10 major public health achievements of the 20th century by the Centers for Disease Control and Prevention, and promoting it is a Healthy People objective for the year 2010. Within the social context of the United States, water fluoridation is probably the most significant step we can take toward reducing the disparities in dental caries. It therefore should remain as a public health priority.
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Affiliation(s)
- Brian A Burt
- University of Michigan School of Public Health, Room 3006, 109 Observatory Street, Ann Arbor, MI 48109-2029, USA.
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Beltrán-Aguilar ED, Griffin SO, Lockwood SA. Prevalence and trends in enamel fluorosis in the United States from the 1930s to the 1980s. J Am Dent Assoc 2002; 133:157-65. [PMID: 11868834 DOI: 10.14219/jada.archive.2002.0139] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The National Survey of Dental Caries in U.S. School Children: 1986-1987 conducted by the National Institute of Dental Research, or NIDR, remains the only source of national data about the prevalence of enamel fluorosis. The authors analyze these data and describe changes in the prevalence of enamel fluorosis since the 1930s, as reported by H. Trendley Dean. METHODS A sample of children comparable to those described in the 1930s was selected from the NIDR data set among children living in households served by public water systems during the child's first eight years of life. The type of water system (that is, natural, optimal and suboptimal) for each household had been recorded in the NIDR data set using data from the 1985 U.S. Fluoridation Census. The NIDR data set included information about the children's history of fluoride exposure obtained from parents. RESULTS In the 1986-1987 period, the prevalence of enamel fluorosis (ranging from very mild to severe) was 37.8 percent among children living in residences with natural fluoride (0.7 to 4.0 parts per million fluoride ions, or F-), 25.8 percent in the optimal fluoride group (0.7 to 1.2 ppm F- and 15.5 percent in the suboptimal fluoride group (< 0.7 ppm F-). The largest increase in fluorosis prevalence from the 1930s to the 1980s was in the suboptimal fluoride group (6.5 to 15.5 percent). CONCLUSIONS AND CLINICAL IMPLICATIONS Exposure to multiple sources of fluoride may explain the increase in enamel fluorosis from the 1930s to the 1980s. The exposure to fluoride from sources such as dietary supplements has decreased since the 1980s because of reductions in the recommended dosage, but these changes occurred too late to have an effect on the study cohort. Evidence of simultaneous use of systemic fluorides indicates the need to reinforce guidelines for the appropriate use of fluorides and promote research on measuring total fluoride exposure.
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Affiliation(s)
- Eugenio D Beltrán-Aguilar
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.
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Sohn W, Heller KE, Burt BA. Fluid consumption related to climate among children in the United States. J Public Health Dent 2001; 61:99-106. [PMID: 11474921 DOI: 10.1111/j.1752-7325.2001.tb03373.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Recommended fluoride concentrations in US public water systems are between 0.7-1.2 ppm, depending on the mean daily maximum temperature. This range assumes that water intake is higher in warmer than in cooler climates, based on research from the 1950s. The aim of this analysis is to relate fluid consumption among American children aged 1-10 years to the local climate under modern conditions. METHODS The quantities of daily total fluid intake per body weight (ml/kg) and plain water intake per body weight (ml/kg) of children were calculated from the 24-hour recall diet survey in the third National Health and Nutrition Examination Survey (NHANES III, 1988-94). The mean daily maximum temperature from 1961 to 1990, averaged for the month during which the NHANES III exam was conducted, was obtained for each survey location from the US Local Climate Historical Database. Multiple regression analysis was conducted using SAS and SUDAAN. RESULTS Fluid intake was significantly associated with age, sex, socioeconomic status (SES), and race and ethnicity. No significant association could be found between the amount of either total fluid or plain water intake and mean daily maximum temperature, either before and after controlling for sex, age, SES, and race or ethnicity. CONCLUSIONS Results indicate that there is no evidence that fluid consumption among children is significantly related to mean temperature in modern conditions. This suggests that the national temperature-related guidelines for fluoride concentration in drinking water may be due for reevaluation.
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Affiliation(s)
- W Sohn
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, 1101 North University Street, Ann Arbor, MI 48109-1078, USA.
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Heller KE, Sohn W, Burt BA, Feigal RJ. Water consumption and nursing characteristics of infants by race and ethnicity. J Public Health Dent 2001; 60:140-6. [PMID: 11109210 DOI: 10.1111/j.1752-7325.2000.tb03319.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this project was to determine racial/ethnic differences in water consumption levels and nursing habits of children younger than 2 years old. METHODS Data from the 1994-96 Continuing Survey of Food intakes by individuals (CSFII) were used for these analyses. Water consumption and breast-feeding data on 946 children younger than 2 years old were used. RESULTS For black non-Hispanic children younger than 2 years old (n = 121), 5.3 percent of the children were currently being breast fed. This percentage was less than that seen in other racial/ethnic groups. For white non-Hispanic children (n = 620), this percentage was 10.8 percent; for Hispanic children (n = 146), 12.2 percent; for "other" children, 18.5 percent (n = 59). Black non-Hispanic children had the highest total water consumption (128.6 ml/kg/day) among all groups, white non-Hispanic had the lowest (113.2 ml/kg/day). These differences were not statistically significant in multivariate regression modeling. Black non-Hispanic children also drank more tap water (21.3 ml/kg/day) than white non-Hispanic children (12.7 ml/kg/day) and Hispanic children (14.9 ml/kg/day). The difference was statistically significant in multivariate regression modeling. CONCLUSIONS The differences in breast feeding and water consumption observed among black children younger than 2 years of age could be a factor in the observed higher levels of fluorosis in black children compared to other children.
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Affiliation(s)
- K E Heller
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA.
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Abstract
OBJECTIVE The association between low birth weight and dental fluorosis was explored in a cross-sectional study to explain the higher prevalence of dental fluorosis among African-American children. METHODS Birth weight data on 960 children were obtained from the New York State Birth Registry. Data on race, fluoride exposure, sociodemographic characteristics, and dental fluorosis were available from a cross-sectional study conducted in Newburgh and Kingston. Associations among birth weight, race, and fluoride exposure from fluoridated water, regular use of supplements, brushing before the age of 2 years, and subject-level dental fluorosis were explored using logistic regression procedures. RESULTS The regression coefficients for the main effects and the two-way interaction effects associated with low birth weight, race, and fluoride exposure were not statistically significant. Even after controlling for low birth weight and fluoride exposure, African-American children had a statistically significant higher odds ratio (OR = 2.0). An analysis of the data limited to mandibular permanent first molars showed similar effects, except for evidence of effect modification in low birth weight children exposed to fluoride supplements. CONCLUSIONS Lower birth weight did not explain the higher prevalence of dental fluorosis observed among African-American children.
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Affiliation(s)
- J V Kumar
- Bureau of Dental Health, New York State Department of Health, Albany, NY 12237-0619, USA.
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Kumar J, Swango P, Haley V, Green E. Intra-oral distribution of dental fluorosis in Newburgh and Kingston, New York. J Dent Res 2000; 79:1508-13. [PMID: 11005736 DOI: 10.1177/00220345000790071301] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous studies of intra-oral distribution of dental fluorosis in low-fluoride areas reported that teeth that formed later in life were more frequently affected compared with the early-forming teeth. The steady increase of plasma fluoride with age, even under constant fluoride exposure, has been suggested as a possible mechanism for this clinical manifestation. To determine the intra-oral distribution of Dean's Index scores and the effect of fluoride exposure on early- and late-forming teeth, we analyzed data collected on 2193 seven- to 14-year-old lifelong residents of fluoridated or non-fluoridated areas. Logistic regression procedures were used to determine the effects of fluoridation, early brushing, daily supplements, and other socio-demographic variables on early- and late-forming teeth. The results show that the occurrence of very mild or greater levels of fluorosis in the upper anterior teeth was 7 to 10% in the fluoridated area and 5 to 9% in the nonfluoridated area. In the fluoridated area, the occurrence of fluorosis increased from anterior to posterior teeth. Both early- and late-forming teeth were affected by exposure to fluoridation, daily fluoride supplement use, or brushing before the age of two years. This analysis showed that the esthetic consequence of exposure to multiple sources of fluoride was less dramatic, as evidenced by the lower frequency in upper anterior teeth compared with posterior teeth. The longer maturation process of the posterior teeth and the thicker enamel appear to be the likely explanation for the higher occurrence of dental fluorosis in posterior teeth.
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Affiliation(s)
- J Kumar
- Bureau of Dental Health, New York State Department of Health Corning Tower, Albany 12237-0619, USA.
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Kumar JV, Swango PA. Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications. Community Dent Oral Epidemiol 1999; 27:171-80. [PMID: 10385354 DOI: 10.1111/j.1600-0528.1999.tb02007.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This analysis was conducted to determine the changes in the effect of exposure to fluoridation and other sources of fluoride on dental fluorosis in children attending Newburgh and Kingston school districts in New York State. METHODS Data for this analysis were obtained from two surveys conducted in the 1986 and 1995 school years. Analyses were limited to 3500, 7-14-year-old lifelong residents of a fluoridated or a nonfluoridated community. Dean's classification and DMFS index were used for recording dental fluorosis and caries, respectively. A questionnaire was used to collect fluoride exposure data. Regression procedures were used to estimate the effect of fluoridation, fluoride supplements, and brushing before the age of 2 years on dental fluorosis. RESULTS Children examined in 1996 were at higher risk for both questionable and very mild to severe dental fluorosis if they received fluoride from water or daily tablet use, or started brushing before the age of 2 years. The increase in risk from 1986 to 1995 was greater for African-American children. CONCLUSION This analysis showed that the risk of developing dental fluorosis did not decline over time in these communities. Continuous exposure to water fluoridation had an observable effect on dental fluorosis. However, implementation of fluoridation in Newburgh Town did not result in an increase in dental fluorosis prevalence.
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Affiliation(s)
- J V Kumar
- Bureau of Dental Health, New York State Department of Health, Albany 12237-0619, USA.
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Kumar JV, Swango PA. Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications. Community Dent Oral Epidemiol 1998. [DOI: 10.1111/j.1600-0528.1998.tb02007.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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