Dental caries and dental fluorosis according to water fluoridation among 12-year-old Brazilian schoolchildren: a nation-wide study comparing different municipalities
To test the correlation among dental caries, dental fluorosis, and the percentage of municipalities with optimal fluoridated water among Brazilian 12-year-old schoolchildren.
Subjects and methods
An ecological study was performed using primary data from the latest Brazilian Oral Health Survey. The units of analysis were the 26 states plus the Federal District of Brazil (n = 7328 schoolchildren). Dental caries was diagnosed according to the DMFT criteria and dental fluorosis according to Dean’s Index. Descriptive and analytical statistics (p < 0.05) were performed. Google My Maps® was used to display data by state.
Mean DMFT ranged from 1.06 to 4.81 between states, whereas the prevalence rates of dental caries and dental fluorosis ranged from 37.3 to 78.2% and from 0 to 45.8% between states, respectively. In Brazil, 60.25% of the municipalities have an optimal fluoridated water supply. The percentage of municipalities with an optimal fluoridated water supply in each state ranged from 0 to 97.4%. Dental fluorosis was negatively correlated with mean DMFT (r = − 0.645; p < 0.001) and with dental caries (r = − 0.678; p < 0.001). The percentage of municipalities with optimal fluoridated water was negatively correlated with dental caries (r = − 0.678; p < 0.001) and positively correlated with dental fluorosis (r = 0.668; p < 0.001).
Lower prevalence of dental caries was found with the increasing percentage of municipalities with optimal fluoridated water and with the increasing prevalence of dental fluorosis.
KeywordsDental caries Dental fluorosis Epidemiology Fluoridation Fluorides
This study was supported by the Brazilian Ministry of Health, the Brazilian Coordination of Higher Education, Ministry of Education (CAPES), the Research Foundation of the State of Minas Gerais (FAPEMIG), and the National Council for Scientific and Technological Development (CNPQ), Brazil.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- Bergamo ET, Barbana M, Terada RS, Cury JA, Fujimaki M (2015) Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis. Braz Oral Res 29:1–6. https://doi.org/10.1590/1807-3107BOR-2015.vol29.0047 CrossRefGoogle Scholar
- Brasil (1974) Diário Oficial da União. Lei n° 6.050 de 24 de maio de 1974. Available from: http://www.jusbrasil.com.br/topicos/12121040/lei-n-6050-de-24-de-maio-de-1974
- Brasil (2008) Ministério do Planejamento, Orçamento e Gestão. Pesquisa Nacional de Saneamento Básico. Available from: http://www.ibge.gov.br/home/estatistica/populacao/condicaodevida/pnsb2008/PNSB_2008.pdf
- Brasil (2010) Ministério da Saúde. SB Brasil 2010. Pesquisa Nacional de Saúde Bucal. Resultados Principais. Available from: http://dab.saude.gov.br/CNSB/sbbrasil/
- Dean HT (1934) Classification of mottled enamel diagnosis. J Am Dent Assoc 21:1421–1426Google Scholar
- Fawell J, Bailey K, Chilton J, Dahi E, Fewtrell L, Magara Y (2006) Fluoride in Drinking-water. Iwa Publishing, LondonGoogle Scholar
- World Health Organization (1997) Oral health surveys, basic methods. World Health Organization, GenevaGoogle Scholar
- World Health Organization (2017) WHO’s oral health country/area profile programme (CAPP) database. Caries distribution world-wide and in relation to socioeconomic inequalities within and between countries. Available from: http://www.mah.se/CAPP/Country-Oral-Health-Profiles