[Fluoride mouth-rinsing to prevent dental caries in a Brazilian municipality with fluoridated drinking water].
OBJECTIVE
To compare the prevalence of dental caries in two groups of schoolchildren: (1) schoolchildren participating in a weekly 0.2% sodium fluoride mouth-rinsing program and (2) schoolchildren not participating in the program.


METHODS
This cross-sectional study was conducted in the city (municipality) of Londrina, in the state of Paraná, Brazil; the city has fluoridated drinking water. We examined 367 12-year-old children: 190 participants in the weekly mouth-rinsing program (51.8%) and 177 nonparticipants (48.2%). The prevalence of caries was determined based on the scores for decayed, missing, and filled teeth and for decayed, missing, and filled surfaces. The examinations were performed by three examiners, with nearly perfect agreement in their diagnosis of caries (kappa = 0.90). The dependent variable was dental caries. The independent variables were: participation or nonparticipation in the mouth-rinsing program, attending a private school or a public school, frequency of tooth-brushing, amount of toothpaste used, consumption of sweets between meals, and visits to the dentist.


RESULTS
The decayed, missing, and filled teeth score (mean and standard deviation) at 12 years of age was 0.85 +/- 0.059 overall, 1.0 +/- 0.058 for program participants, and 0.70 +/- 0.060 for nonparticipants. The decayed, missing, and filled surfaces score (mean and standard deviation) was 1.16 +/- 0.017, with it ranging from a low of 0.34 in one private school to a high of 1.66 in one public school. Bivariate analysis showed an association between caries (P < 0.05) and the following variables: attending a public school, participating in the mouth-rinsing program, and consuming sweets between meals more than once a day. In the multivariate analysis, attending a public school (P = 0.0004) and consuming sweets (P = 0.001) remained associated with the presence of caries.


CONCLUSIONS
The weekly mouth-rinsing program was not associated with a decreased prevalence of caries, in either the public schools or the private schools. However, additional research is needed to assess the cost-effectiveness of fluoride mouthrinsing programs in populations with a higher prevalence of caries. Given the caries prevalence that we found in the schoolchildren whom we studied, the resources allocated to the fluoride mouth-rinsing program for them should probably be used to pay for other health-promotion activities with them.
Iwakura
Maria Luiza Hiromi
ML
Universidade Estadual de Londrina, Departamento de Medicina Oral e Odontologia Infantil, Rua Pernambuco 540, CEP 86020-070, Londrina, PR, Brasil. oscar@sercomtel.com.br
Morita
Maria Celeste
MC
D002648:Child; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005457:Fluoridation; D005459:Fluorides; D006801:Humans; D008297:Male; D009067:Mouthwashes; D015995:Prevalence; D014505:Urban Population
D009067:Mouthwashes; D005459:Fluorides