Method: All children attending the seven schools in the Lithgow LGA which received their water supply from the Lithgow council were invited to take part in a dental survey. Dental fluorosis was determined using the Dean Fluorosis Index. Wet maxillary central incisors were examined in shaded natural daylight and these teeth were also photographed. Both intra- and inter-examiner calibration was periodically carried out. Questionnaire data concerning fluorosis risk factors were also gathered. Univariate and multivariate logistic regression analysis were conducted using Epi-Info software.
Results: The response rate was 45%. The prevalence of fluorosis (very mild or more) in non-fluoridated Lithgow was 27% (CFI = 0.45). Fluorosis scores derived from the photographs were closely equivalent to the clinical scores (Cohen's kappa = 0.80). Risk of fluorosis in this cross-sectional study was associated with type of toothpaste used, age at commencement of toothbrushing, and exposure elsewhere to fluoridated water.
Conclusion: Since use of both fluoridated toothpaste and fluoridated water are fluorosis risk factors, the fluoridation of the Lithgow LGA water supply should be monitored carefully.
Acknowledgement: Funding grant from NSW Health Centre for Oral Health Strategy.