Dental fluorosis decline after changes to supplement and toothpaste regimens.
In 1989/90, in 659 12-year-olds in Perth (F 0.8 mg/L) and the Bunbury region of Western Australia (WA) (F approximately 0.25 mg/L), dental fluorosis prevalences were 40.2% and 33.0%. Fluoride supplements (OR 4.63) and extended residence in a fluoridated area (OR 4.06) were significant risk factors; toothpaste ingestion variables had ORs greater than unity; in 1990, DMFT for this age group was 0.84. School Dental Service took steps to discourage supplement and toothpaste ingestion and to promote low fluoride toothpaste for children < 6 years of age.


OBJECTIVE
To evaluate the effect of this campaign on fluorosis and caries.


METHODS
Between May-July 2000, 582 10-year-olds were examined for dental fluorosis (TF index) and dental caries (DMFT) in school dental clinics.


RESULTS
Fluorosis prevalence was 22.2% in Perth and 10.8% in the Bunbury region. Overall prevalence was 18.0% and of this, 80.2% was TF 1, 17.9% was TF 2 and just 1.9% was TF 3. In 1989/90, 79 children had used supplements before the age of 4 year; in 2000 only 40 had done so (P < 0.001). Mean DMFT values in Perth and Bunbury were 0.32 and 0.28 (P > 0.05). Low F toothpaste, unavailable in 1989/90, had been used by 24.5%. The only significant risk factor was residence, OR 2.0.


CONCLUSIONS
Fluorosis prevalence seems to have fallen in parallel with a reduction in discretionary intake from supplements and toothpaste. No increase in dental caries experience was recorded. Because the teeth examined in this study were at risk of fluorosis in 1992-95, very soon after policies changed, and because people are slow to change health habits, it seems reasonable to expect a further improvement when teeth mineralised in the late 1990s become visible.
Riordan
Paul J
PJ
Perth Dental Hospital & Community Dental Services, Perth, Western Australia, Australia. riordan@q-net.net.au
D000704:Analysis of Variance; D002648:Child; D004245:DMF Index; D019587:Dietary Supplements; D005260:Female; D005457:Fluoridation; D005459:Fluorides / Q000008:administration & dosage* / Q000009:adverse effects*; D009050:Fluorosis, Dental / Q000453:epidemiology* / Q000209:etiology*; D006291:Health Policy; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012111:Residence Characteristics; D018709:Statistics, Nonparametric; D014100:Toothpastes / Q000737:chemistry; D014904:Western Australia / Q000453:epidemiology
D014100:Toothpastes; D005459:Fluorides