The Effectiveness of a School Based Milk Fluoridation Programme

Objective: To compare levels of caries experience in children attending schools in Wirral that have a fluoridated milk programme with children in a similar community, which does not have a fluoridated milk programme. Method: A descriptive, cross-sectional study measuring caries experience in first permanent molars. Children were examined on a 'intention to treat' basis and the effect of clustering of children in schools was taken into account. 690 children in Wirral (test group)and 1835 children in Sefton (comparison group)were examined for caries experience (DMFT/ DT/ DFS)in 2003. The mean ages of the children examined in the test and comparison groups were 10.79 and 10.83 years respectively. Results: Mean DMFT/ DT/ DFS values were 1.01 / 0.59 / 1.20 respectively in the test group and 1.46 /1.02 /1.89 respectively in the comparison group. Multiple linear regression analysis taking clustering of children within schools into account and with the Index of Multiple Deprivation 2000 as an explanatory variable gave the coefficients and p-values for DMFT / DT / DFS of 0.49(p<0.001)/ 0.43(p<0.001) / 0.74 p<0.001)respectively. Conclusion: There is strong evidence that a community fluoridated milk programme, as configured in Wirral, provides a reduction in caries experience with 13% less children with caries experience and 16% less children with active decay in their first permanent molars.