title: Patterns of dental caries following the cessation of water fluoridation.
abstract: OBJECTIVE
  To compare prevalence and incidence of caries between fluoridation-ended and still-fluoridated communities in British Columbia, Canada, from a baseline survey and after three years.
  
  
  METHODS
  At the baseline (1993/4 academic year) and follow-up (1996/7) surveys, children were examined at their schools. Data were collected on snacking, oral hygiene, exposure to fluoride technologies, and socio-economic level. These variables were used together with D1D2MFS indices in multiple regression models.
  
  
  RESULTS
  The prevalence of caries (assessed in 5,927 children, grades 2, 3, 8, 9) decreased over time in the fluoridation-ended community while remaining unchanged in the fluoridated community. While numbers of filled surfaces did not vary between surveys, sealed surfaces increased at both study sites. Caries incidence (assessed in 2,994 life-long residents, grades 5, 6, 11, 12) expressed in terms of D1D2MFS was not different between the still-fluoridating and fluoridation-ended communities. There were, however, differences in caries experienced when D1D2MFS components and surfaces at risk were investigated in detail. Regression models did not identify specific variables markedly affecting changes in the incidence of dental decay.
  
  
  CONCLUSIONS
  Our results suggest a complicated pattern of disease following cessation of fluoridation. Multiple sources of fluoride besides water fluoridation have made it more difficult to detect changes in the epidemiological profile of a population with generally low caries experience, and living in an affluent setting with widely accessible dental services. There are, however, subtle differences in caries and caries treatment experience between children living in fluoridated and fluoridation-ended areas.
authors.affiliation: Faculty of Dentistry, University of British Columbia, Vancouver, Canada. gerardo.maupome@kp.org
authors.forename: G
authors.initials: G
authors.lastname: Maupomé
authors.forename: D C
authors.initials: DC
authors.lastname: Clark
authors.forename: S M
authors.initials: SM
authors.lastname: Levy
authors.forename: J
authors.initials: J
authors.lastname: Berkowitz
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001955:British Columbia / Q000453:epidemiology; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D003733:Dental Caries Susceptibility; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D005247:Feeding Behavior; D005260:Female; D005457:Fluoridation / Q000706:statistics & numerical data; D005459:Fluorides / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009910:Oral Hygiene; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D015995:Prevalence; D012044:Regression Analysis; D012923:Social Class
chemical_list: D002327:Cariostatic Agents; D010895:Pit and Fissure Sealants; D005459:Fluorides