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Original Article
Impact of water fluoridation on dental caries decline across racial and income subgroups of Brazilian adolescents
Rafael Aiello Bomfim, Paulo Frazão
Epidemiol Health. 2022;44:e2022007.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022007
  • 25,102 View
  • 466 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of this study was to assess the impact of community water fluoridation (CWF) on differences in dental caries decline across racial and socioeconomic subgroups of Brazilian adolescents.
METHODS
Two nationwide Brazilian population-based oral health surveys were used (Brazilian Oral Health Survey 2003 and 2010). In total, 7,198 adolescents from 15 years to 19 years old living in 50 cities investigated in both surveys were included. The mean numbers of untreated decayed teeth (DT) according to racial (Whites vs. Browns/Blacks) and socioeconomic subgroups (at or above the minimum wage per capita vs. under) were analysed. Difference-in-differences negative binomial regressions were adjusted by schooling, age, and sex. Decayed, missing, and filled teeth and DT prevalence, calculated as a categorical variable, were used in sensitivity analyses.
RESULTS
The adjusted difference of reduction in DT was similar across socioeconomic subgroups (β=-0.05; 95% confidence interval [CI], -0.45 to 0.35) and favoured, but not to a significant degree, Whites (β=-0.34; 95% CI, -0.74 to 0.04) compared to Brown/Blacks in fluoridated areas. In non-fluoridated areas, significant differences were observed in the mean number of DT, favouring the higher socioeconomic subgroup (β=-0.26; 95% CI, -0.53 to -0.01) and Whites (β=-0.40; 95% CI, -0.69 to -0.11) in relation to their counterparts. The sensitivity analyses confirmed the findings.
CONCLUSIONS
The similar reduction in DT across income subgroups suggests that CWF has had a beneficial effect on tackling income inequalities in dental caries within a 7-year timeframe.
Summary
Key Message
Community Water Fluoridation tackled income and racial inequalities in dental caries in adolescents aged 15-19 years between 2003 and 2010 in Brazil.

Citations

Citations to this article as recorded by  
  • Water Fluoridation and Dental Caries Prevention Globally: A Systematic Review and Meta-Analysis
    C.F.D. Nascimento, L.A.D.S. Gindri, M.N. de Oliveira, L.R. Paranhos, F.N. Hugo
    JDR Clinical & Translational Research.2026; 11(2): 107.     CrossRef
  • A vigilância da fluoretação da água de abastecimento público na perspectiva dos técnicos das secretarias municipais de saúde: estudo transversal, Goiás, 2022-2023
    Higor Andrade de Oliveira Gonçalves, Leandro Brambilla Martorell, Maria do Carmo Matias Freire
    Epidemiologia e Serviços de Saúde.2026;[Epub]     CrossRef
  • Surveillance of public water supply fluoridation from the perspective of municipal health department technicians: a cross-sectional study, Goiás, 2022–2023
    Higor Andrade de Oliveira Gonçalves, Leandro Brambilla Martorell, Maria do Carmo Matias Freire
    Epidemiologia e Serviços de Saúde.2026;[Epub]     CrossRef
  • Evolution of income inequalities in the caries experience of 5-year-old children in Brazil between 2010 and 2023
    Armando Cabral de Lira Neto, Isabela Ficagna Oshiro, Luiza De Carli Grieleitow, Maria Letícia Barbosa Raymundo, Amanda Barbosa Oliveira, Yuri Wanderley Cavalcanti, Roger Keller Celeste, Rafael Aiello Bomfim
    Revista Brasileira de Epidemiologia.2026;[Epub]     CrossRef
  • Evolução das desigualdades de renda na experiência de cárie em crianças de 5 anos no Brasil entre 2010 e 2023
    Armando Cabral de Lira Neto, Isabela Ficagna Oshiro, Luiza De Carli Grieleitow, Maria Letícia Barbosa Raymundo, Amanda Barbosa Oliveira, Yuri Wanderley Cavalcanti, Roger Keller Celeste, Rafael Aiello Bomfim
    Revista Brasileira de Epidemiologia.2026;[Epub]     CrossRef
  • Unhealthy dietary habits and sedentary behavior drive untreated dental caries among adolescents: A population-based study
    Leticia Pereira de Barros, Luiza De Carli Grieleitow, Rafael Aiello Bomfim
    Scientific Reports.2025;[Epub]     CrossRef
  • Water fluoridation for the prevention of dental caries
    Zipporah Iheozor-Ejiofor, Tanya Walsh, Sharon R Lewis, Philip Riley, Dwayne Boyers, Janet E Clarkson, Helen V Worthington, Anne-Marie Glenny, Lucy O'Malley
    Cochrane Database of Systematic Reviews.2024;[Epub]     CrossRef
COVID-19: Perspective
Magnifying the importance of collecting race, ethnicity, industry, and occupation data during the COVID-19 pandemic
Sai Krishna Gudi, Sophia M. George, Komal Krishna Tiwari
Epidemiol Health. 2021;43:e2021095.   Published online November 6, 2021
DOI: https://doi.org/10.4178/epih.e2021095
  • 26,072 View
  • 92 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
The contagiousness of coronavirus disease-2019 (COVID-19) led to the imposition of historical lockdowns in various countries. No scientific mind could have made accurate projections of the tremendous impact that COVID-19 would have on nations, communities, and the global-wide economy. Meanwhile, millions of workers have lost their jobs, while healthcare workers are overwhelmed and are reaching a state of mental and physical exhaustion. With the uncontrollable spread, researchers have been working to identify factors associated with COVID-19. In this regard, race, ethnicity, industry, and occupation have been found to be predominant factors of interest. However, unfortunately, the unavailability of such information has been a difficult reality. Since race, ethnicity, and employment are essential social determinants of health and could serve as potential risk-factors for COVID-19, collecting such information may offer important context for prioritising vulnerable groups. Thus, this perspective aims to highlight the importance and need for collecting race, ethnicity, and occupation-related data to track and treat the racial/ethnic groups that have been most strongly affected by the COVID-19 pandemic. Collecting such data will provide valuable insights and help public health officials recognise workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.
Summary
Key Message
As essential social determinants of health, collecting and recording the race/ethnicity, occupation and industry information will provide valuable insights and help public health officials identify workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.

Citations

Citations to this article as recorded by  
  • Use of Different Inclusion Criteria to Compare COVID-19 Hospital Admission Rates by Race and Ethnicity: A Cohort Study
    Joshua Longcoy, Zeynep Isgor, Sumihiro Suzuki, Elizabeth Lynch, Heng Wang, David Ansell, Tricia J. Johnson
    Healthcare.2025; 13(4): 381.     CrossRef
  • The relationship between administratively recorded ethnicity and outcomes for people admitted to Australian intensive care units with COVID-19
    Carys Jones, Hannah Rotherham, Andrew Udy, Ary Serpa Neto, Nadia Chaves, Lewis Campbell, Alex Brown, Aaliya Ibrahim, Aidan Burrell
    Australian Critical Care.2025; 38(4): 101228.     CrossRef
  • Evaluating COVID-19 Risk to Essential Workers by Occupational Group: A Case Study in Massachusetts
    Beth M. Haley, Prasad Patil, Jonathan I. Levy, Keith R. Spangler, Koen F. Tieskens, Fei Carnes, Xiaojing Peng, R. Monina Klevens, T. Scott Troppy, M. Patricia Fabian, Kevin J. Lane, Jessica H. Leibler
    Journal of Community Health.2024; 49(1): 91.     CrossRef
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