Impact of Water Fluoridation, Socio-Demographic and Behavioural Factors on Caries
Objectives: To assess the association between community water fluoridation (CWF) at 0.6 to 0.8 ppm, socio-demographic and behavioural factors and caries prevalence and severity in primary teeth of 8-year-old children in Cork-Kerry in 2016-17.
Methods: Following ethical approval, a random sample of 8-year-old children in Cork-Kerry were examined for dentinal caries in primary teeth (d3vcmft(cde)). Parents completed demographic and oral health behaviour questionnaires. Children were categorised as having lifetime or no exposure to CWF (Full-CWF/No-CWF). Multi-variable regression (negative binomial Hurdle model) assessed the association between CWF, socio-demographic variables, dental visiting, infant feeding, dietary and toothbrushing behaviours and caries prevalence (proportion with d3vcmft(cde) > 0) and severity (mean d3vcmft(cde) among children with caries). Significance level was P < 0.05.
Results: Of 1521 8-year-olds examined for caries, 375 (25%) with Full-CWF and 770 (51%) with No-CWF were included in the analysis. Having Full-CWF (vs. No-CWF) was associated with lower caries prevalence (56% Full-CWF vs. 65% No-CWF, P = 0.001) and severity (mean d3vcmft(cde) 3.7 Full-CWF vs. 4.2 No-CWF, P = 0.002). Brushing with toothpaste once/day or less (vs. twice/day or more), using a glass to rinse after toothbrushing (vs. other rinse method/no rinsing), having sweet foods/drinks more than once/day between meals (vs. once/day or less), having regularly taken a baby bottle into bed and having visited the dentist (vs. never) were associated with higher caries prevalence. Medical card ownership, having sweet foods/drinks more than once/day between meals (vs. once/day or less) and having visited the dentist (vs. never) were associated with higher severity of caries.
Conclusions: In primary teeth of 8-year-old children, CWF at 0.6 to 0.8 ppm was associated with lower prevalence and severity of dentinal caries. Socio-demographic and modifiable behavioural factors were associated with higher caries prevalence and severity.