Gary D. Slade|William B. Grider|William R. Maas|Anne E. Sanders
Water Fluoridation and Dental Caries in U.S. Children and Adolescents
University of North Carolina at Chapel Hill|United States Census Bureau|University of North Carolina at Chapel Hill
fluoridation americas drinking water among great public health achievements 20th century yet paucity studies past 3 decades investigating dental health benefits usthis crosssectional study sought evaluate associations availability community water fluoridation cwf dental caries experience us child adolescent population countylevel estimates percentage population served cwf cwf centers disease control preventions water fluoridation reporting system merged dental examination data 10 national health nutrition examination surveys 1999 2004 2011 2014 dental caries experience primary dentition decayed filled tooth surfaces dfs calculated 7000 children aged 2 8 permanent dentition decayed missing filled tooth surfaces dmfs 12604 children adolescents aged 6 17 linear regression models estimated associations cwf dental caries experience adjustment sociodemographic characteristics age sex raceethnicity ruralurban location headofhousehold education period since last dental visit sensitivity analysis excluded counties fluoridated 1998 unadjusted analysis caries experience primary dentition lower counties 75 cwf mean dfs 33 95 confidence limit cl 28 37 counties 75 cwf mean dfs 46 95 cl 39 54 prevented fraction 30 95 cl 11 48 difference also statistically significant although less pronounced permanent dentition mean dmfs 95 cl 22 20 24 19 18 21 respectively representing prevented fraction 12 95 cl 1 23 statistically significant associations likewise seen cwf modeled continuum differences tended increase covariateadjusted analysis sensitivity analysis findings confirm substantial cariespreventive benefit cwf us children benefit pronounced primary teeth