title: Dental caries and dental fluorosis among schoolchildren who were lifelong residents of communities having either low or optimal levels of fluoride in drinking water.
abstract: OBJECTIVE
  This paper reports findings for dental caries and dental fluorosis in 8-10- and 13-16-year-old schoolchildren who were lifelong residents of communities having either naturally occurring low (Broken Bow and Holdrege, NE; < 0.3 ppm) or optimal (Kewanee, IL; 1 ppm) levels of fluoride in drinking water.
  
  
  METHODS
  Findings are reported for participants who received both dental caries and dental fluorosis examinations (n = 495). The DMFS and TSIF indices, respectively, were used to assess dental caries and dental fluorosis.
  
  
  RESULTS
  The mean DMFS score adjusted for age, sealant presence, and fluoride use was significantly lower in Kewanee (1.8) than was the adjusted mean caries score in either Holdrege (2.9) or Broken Bow (3.6). Adjusted mean DMFS scores in Broken Bow and Holdrege were not statistically different. The mean percent of fluorosed tooth surfaces per person, adjusted for age and use of dietary fluoride supplements, was similar in the three communities (approximately 15%); more than 80 percent of tooth surfaces in all participants were fluorosis-free.
  
  
  CONCLUSIONS
  Findings from the present study suggest that water fluoridation still is beneficial and that dental sealants can play a significant role in preventing dental caries. In addition, findings from this survey appear to support the premise that the difference in dental fluorosis prevalence between fluoridated and nonfluoridated communities has narrowed considerably in recent years.
authors.affiliation: National Institute of Dental Research, Division of Intramural Research, Bethesda, MD 20892-6401, USA. selwitzr@de45.nidr.nih.gov
authors.forename: R H
authors.initials: RH
authors.lastname: Selwitz
authors.forename: R E
authors.initials: RE
authors.lastname: Nowjack-Raymer
authors.forename: A
authors.initials: A
authors.lastname: Kingman
authors.forename: W S
authors.initials: WS
authors.lastname: Driscoll
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000032:analysis* / Q000627:therapeutic use; D002648:Child; D016001:Confidence Intervals; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control; D019587:Dietary Supplements; D005459:Fluorides / Q000008:administration & dosage / Q000032:analysis* / Q000627:therapeutic use; D005460:Fluorides, Topical / Q000008:administration & dosage / Q000627:therapeutic use; D009050:Fluorosis, Dental / Q000453:epidemiology*; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D015999:Multivariate Analysis; D009329:Nebraska / Q000453:epidemiology; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D015995:Prevalence; D013607:Tablets; D014100:Toothpastes / Q000627:therapeutic use; D014881:Water Supply / Q000032:analysis*
chemical_list: D002327:Cariostatic Agents; D005460:Fluorides, Topical; D010895:Pit and Fissure Sealants; D013607:Tablets; D014100:Toothpastes; D005459:Fluorides