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Epidemiol Health > Accepted Articles
Epidemiology and Health 2022;e2022007.
DOI: https://doi.org/10.4178/epih.e2022007    [Accepted] Published online Jan 3, 2022.
Impact of water fluoridation on dental caries decline across racial and income subgroups of Brazilian adolescents
Rafael Aiello Bomfim1  , Paulo Frazão2 
1Federal University of Mato Grosso do Sul, Campo Grande, Brazil
2Public Health School - University of São Paulo, São Paulo, Brazil
Correspondence  Rafael Aiello Bomfim ,Email: aiello.rafael@gmail.com
Received: Aug 14, 2021  Accepted after revision: Dec 15, 2021
Abstract
Objectives:
To assess the impact of community water fluoridation (CWF) on differences in dental caries decline across racial and socioeconomic subgroups of Brazilian adolescents.
Method:
Two nationwide Brazilian population-based oral health surveys were used (SBBrazil 2003-2010). Seven thousand one hundred ninety-eight adolescents from 15 to 19 years old living in fifty cities investigated in both surveys were included. Mean values of untreated decayed teeth (DT) according to racial (Whites versus Browns/Blacks) and socioeconomic subgroups (at or above one minimum wage per capita versus under) were analyzed. Difference-in-Differences negative binomial regressions were adjusted by schooling, age, and sex. Decayed, missing, and filled teeth (DMFT) and decayed teeth prevalence were used for sensitivity analysis.
Results:
The adjusted difference of reduction in DT was similar for socioeconomic subgroups [β = -0.05 (-0.45, 0.35)] and favoured but not to a significant degree the Whites [β = -0.34 (-0.74, 0.04)] compared to Brown/Blacks in the fluoridated area. Significant reduction differences were observed in decayed teeth favouring the higher socioeconomic subgroup [β= -0.26 (-0.53,-0.01)] and the Whites [β= -0.40 (-0.69,-0.11)] in relation to their counterparts in the non-fluoridated area. Sensitivity analysis confirmed the findings.
Conclusions:
A similar reduction in DT across income subgroups suggests the beneficial effect of CWF to tackle income inequalities in dental caries within a 7-year timeframe.
Keywords: fluoridation; oral health; public health
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