Epidemiology and Health

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

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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 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

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