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Community water fluoride cessation and rate of caries-related pediatric dental treatments under general anesthesia in Alberta, Canada

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Abstract

Objective

This study examined the rate of caries-related dental treatments under general anesthesia (GA) in fluoridated and non-fluoridated communities in Alberta, Canada, between 2010 and 2019.

Methods

This retrospective, population-based study included all children (\(<\) 12 years of age) living in Calgary (non-fluoridated) and Edmonton (fluoridated) who underwent caries-related dental treatments under GA at publicly funded facilities. Demographics and dental data were extracted from health administrative databases for three time periods of 2010/11 (pre-cessation), 2014/15, and 2018/19 (post-cessation).

Results

Among 2659 children receiving caries-related treatments under GA, the mean (SD) and median (IQR) age were 4.8 (2.3) and 4 (3–6) years, respectively, and 65% resided in the non-fluoridated area. The analysis revealed that the cessation of water fluoridation was significantly associated with an increased rate of caries-related GA events per 10,000 children in both age groups (0–5 and 6–11 years), with a more pronounced effect in 0–5-year-olds in non-fluoridated areas. The risk of dental treatments under GA was also positively associated with post-cessation time.

Conclusion

Discontinuing water fluoridation appears to negatively affect young children’s oral health, potentially leading to a significant increase in caries-related dental treatments under GA and oral health disparities in this pediatric population.

Résumé

Objectif

Cette étude a examiné la fréquence des traitements dentaires liés aux caries sous anesthésie générale (AG) dans les communautés fluorées et non fluorées en Alberta, Canada, entre 2010 et 2019.

Méthodes

Cette étude rétrospective, basée sur la population, a inclus tous les enfants (< 12 ans) vivant à Calgary (non fluorée) et à Edmonton (fluorée) qui ont subi des traitements dentaires liés aux caries sous AG dans des établissements financés par des fonds publics. Les données démographiques et dentaires ont été extraites des bases de données administratives de la santé pour trois périodes : 2010/11 (pré-arrêt), 2014/15 et 2018/19 (post-arrêt).

Résultats

Parmi les 2 659 enfants recevant des traitements liés aux caries sous AG, l’âge moyen (DS) et la médiane (IQR) étaient de 4,8 (2,3) et 4 (3–6) ans, respectivement, et 65 % résidaient dans la zone non fluorée. L’analyse a révélé que l’arrêt de la fluoration de l’eau était significativement associé à une augmentation du taux d’événements liés aux caries sous AG parmi 10 000 enfants dans les deux groupes d’âge (0–5 et 6–11 ans), avec un effet plus prononcé chez les 0–5 ans dans les zones non fluorées. Le risque des traitements dentaires sous AG était également positivement associé au temps post-arrêt.

Conclusion

La cessation de la fluoration de l’eau semble avoir un impact négatif sur la santé bucco-dentaire des jeunes enfants, entraînant potentiellement une augmentation significative des traitements dentaires liés aux caries sous AG et des disparités en matière de santé bucco-dentaire dans cette population pédiatrique.

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Availability of data and material

Data used for this study were made available from the National Ambulatory Care Reporting System (NACRS) database through the Alberta Health Services after obtaining proper ethics approval.

Code availability

The authors may be able to provide it upon request.

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Funding

This study was funded by the University of Alberta, School of Dentistry Fund, for Dentistry (#FFD-2020–08).

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Authors and Affiliations

  1. Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada

    Elnaz Yazdanbakhsh, Babak Bohlouli, Steven Patterson & Maryam Amin

Authors
  1. Elnaz Yazdanbakhsh
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  2. Babak Bohlouli
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  3. Steven Patterson
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  4. Maryam Amin
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Contributions

All authors contributed significantly to the study design and result interpretation. EY conceived the idea, designed the study, conducted data analysis, interpreted the results, and drafted the manuscript. BB contributed to the study design, performed statistical analysis, and reviewed the manuscript. SP contributed to result interpretation and manuscript revision. MA conceived the idea, designed the study, interpreted the results, and contributed to manuscript drafting and review. All authors have approved the final manuscript.

Corresponding author

Correspondence to Maryam Amin.

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Ethics approval

This study was approved by the Health Research Ethics Board of the University of Alberta (Pro00095759).

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The authors declare no competing interests.

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Yazdanbakhsh, E., Bohlouli, B., Patterson, S. et al. Community water fluoride cessation and rate of caries-related pediatric dental treatments under general anesthesia in Alberta, Canada. Can J Public Health 115, 305–314 (2024). https://doi.org/10.17269/s41997-024-00858-w

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