A 4-year assessment of a new water-fluoridation scheme in New South Wales, Australia.
OBJECTIVE
To monitor the changes in dental caries prevalence of 5- to 7-year-old children living in a fluoridated area, a newly fluoridated area and in an area without water fluoridation, in NSW, Australia.


METHODS
Dental caries prevalence was recorded for 5- to 7-year-old children, living in the three study locations, by six trained and calibrated examiners in 2008, 2010 and 2012. A questionnaire recorded demographic data, toothbrushing behaviour and sugary drink consumption. Caries experience was measured using the decayed, missing, and filled teeth (dmft) index for primary teeth, the percentage of children who were caries free and the significant caries index. Univariate analysis was undertaken to determine independent predictors of caries.


RESULTS
The caries prevalence changed over time. In 2008, the mean dmft index was 1.40 for the fluoridated area, 2.02 for the area about to fluoridate and 2.09 for the unfluoridated control. By 2012, these mean dmft scores were 0.69, 0.72 and 1.21, respectively. In the two areas where children received fluoridated water, the significant caries index was 2.30 for the fluoridated area and 2.40 for the newly fluoridated area. The significant caries score for children in the unfluoridated location was 3.93. Multivariate analysis showed that over time the differences in dental caries prevalence between the established fluoride area and the newly fluoridated area diminished. However, children in the unfluoridated control area continued to demonstrate significant differences in the mean number of decayed teeth compared with children in the fluoridated comparator sites, and the proportions of children free from decay were significantly higher in the fluoridated areas than in the unfluoridated area.


CONCLUSIONS
Fluoridation of public water supplies in Gosford and Wyong offers young children better dental health than those children who do not have access to this public health measure.
Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia.
Anthony S
AS
Blinkhorn
Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia.|South Western Local Health District, Sydney, NSW, Australia.
Roy
R
Byun
Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia.
Pathik
P
Mehta
Breast Screen NSW, Northern Sydney and Central Coast Local Health Districts, St Leonards, NSW, Australia.
Meredith
M
Kay
D001628:Beverages / Q000706:statistics & numerical data; D002253:Carbonated Beverages / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D019422:Dietary Sucrose / Q000008:administration & dosage; D005260:Female; D005457:Fluoridation / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D014094:Tooth, Deciduous / Q000473:pathology; D014099:Toothbrushing / Q000706:statistics & numerical data
D019422:Dietary Sucrose
Australia; Water fluoridation; dental caries; primary school children; trends over time