title: Geographical distribution of dental caries prevalence and associated factors in young adults in Finland.
abstract: Oral health of the young has been reported to be associated with the place of residence, due to differences in socio-economic status. The results of studies on the effect of fluoride in drinking water on caries prevalence have been contradictory. The main aim of our study was to investigate the geographical distribution of dental caries prevalence in Finland and analyse possible regional, associated factors. Oral health of 13,564 men born between 1990 and 1992 was screened using a method based on criteria of the World Health Organization for epidemiological studies by 15 calibrated dentists in 20/24 garrisons of the Finnish Defence Forces in 2011. Mean DMFT and DT values in provinces were calculated. Multilevel analysis was applied to the data using generalized linear mixed models and a logit link function. The binary outcome variable was the cariological treatment need (yes/no) and the garrison was treated as random effect. Mean DMFT and DT values varied significantly between provinces in Finland. Increased levels of fluoride in drinking water, Swedish as the main language in the municipality, and living in urban areas were protective factors against cariological treatment need. Dentist density did not affect caries prevalence. The geographical distribution of dental caries further supported estimates of the protective effects of high fluoride levels in drinking water, Swedish as the main language in the municipality, as well as living in urban areas. Effect of fluoride on caries prevalence still exists, and association with the socio-economic status was confirmed.
authors.affiliation: Institute of Dentistry, FI–90014 University of Oulu, Oulu, Finland. lkamppi@paju.oulu.fi
authors.forename: A
authors.initials: A
authors.lastname: Kämppi
authors.forename: T
authors.initials: T
authors.lastname: Tanner
authors.forename: J
authors.initials: J
authors.lastname: Päkkilä
authors.forename: P
authors.initials: P
authors.lastname: Patinen
authors.forename: M-R
authors.initials: MR
authors.lastname: Järvelin
authors.forename: L
authors.initials: L
authors.lastname: Tjäderhane
authors.forename: V
authors.initials: V
authors.lastname: Anttonen
mesh_terms: D000328:Adult; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D003815:Dentists / Q000600:supply & distribution; D005387:Finland / Q000453:epidemiology; D005459:Fluorides / Q000032:analysis; D006801:Humans; D007802:Language; D016014:Linear Models; D008297:Male; D008889:Military Personnel; D055361:Multilevel Analysis; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013548:Sweden / Q000208:ethnology; D014505:Urban Population / Q000706:statistics & numerical data; D014881:Water Supply; D055815:Young Adult
chemical_list: D005459:Fluorides