title: Lifetime fluoridation exposure and dental caries experience in a military population.
abstract: While there is good evidence of caries-preventive benefits of fluoride in drinking water among children and adolescents, there is little information about effectiveness of water fluoridation among adults.
  
  
  OBJECTIVE
  To determine whether exposure to fluoride in drinking water is associated with caries experience in Australian Defence Force (ADF) personnel.
  
  
  METHODS
  Cross-sectional study of 876 deployable ADF personnel aged 17-56 years. At each person's mandatory annual dental examination, military dentists recorded the number of decayed, missing and filled teeth (DMFT) using visual, tactile and radiographic criteria. Participants also completed a questionnaire, listing residential locations in each year from 1964 to 2003. People were classified into four categories according to the percentage of their lifetime living in places with fluoridated water: <10%, 10% to <50%, 50% to <90% and > or =90%. Mean DMFT was compared among those categories of fluoridation exposure and the association was evaluated statistically using analysis of variance to adjust for age, sex, years of service and rank.
  
  
  RESULTS
  Without adjustment for confounders, the mean DMFT (+/-95% confidence interval) was 6.3 +/- 0.8 for <10% fluoridation exposure, 7.8 +/- 0.8 for 10% to <50% exposure, 7.5 +/- 0.7 for 50% to <90% exposure and 4.6 +/- 0.6 for > or =90% exposure (P < 0.01). However, age was inversely associated with mean DMFT and in the <10% exposure group, 91% of people were aged <35 years. Service rank was also significantly associated with both fluoridation exposure and DMFT. After adjustment for all covariates, mean DMFT was 24% lower among people in the two groups with > or =50% exposure compared with the <10% exposure group.
  
  
  CONCLUSIONS
  Degree of lifetime exposure to fluoridated drinking water was inversely associated with DMFT in a dose-response manner among this adult military population.
authors.affiliation: Centre for Military and Veteran's Health, School of Population Health, University of Qld, Qld, Australia. g.mahoney@uq.edu.au
authors.forename: Gregory
authors.initials: G
authors.lastname: Mahoney
authors.forename: Gary D
authors.initials: GD
authors.lastname: Slade
authors.forename: Scott
authors.initials: S
authors.lastname: Kitchener
authors.forename: Adrian
authors.initials: A
authors.lastname: Barnett
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D005260:Female; D005457:Fluoridation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011446:Prospective Studies; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult