The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries

Objective: To assess the prevalence and severity of dental fluorosis and caries among Malaysian children following the reduction in fluoride concentration from 0.7 to 0.5 parts per million (ppm) in the public water supply. Methods: This study involved lifelong residents aged 9- and 12-year-olds in f...

Full description

Bibliographic Details
Main Authors: Mohd Nor, Nor Azlida, Chadwick, Barbara Lesley, Farnell, Damian J.J., Chestnutt, Ivor Gordon
Format: Article
Published: Wiley 2018
Subjects:
_version_ 1825721650211979264
author Mohd Nor, Nor Azlida
Chadwick, Barbara Lesley
Farnell, Damian J.J.
Chestnutt, Ivor Gordon
author_facet Mohd Nor, Nor Azlida
Chadwick, Barbara Lesley
Farnell, Damian J.J.
Chestnutt, Ivor Gordon
author_sort Mohd Nor, Nor Azlida
collection UM
description Objective: To assess the prevalence and severity of dental fluorosis and caries among Malaysian children following the reduction in fluoride concentration from 0.7 to 0.5 parts per million (ppm) in the public water supply. Methods: This study involved lifelong residents aged 9- and 12-year-olds in fluoridated and nonfluoridated areas in Malaysia (n = 1155). In the fluoridated area, children aged 12 years and 9 years were exposed to 0.7 and 0.5 ppm, respectively, at the times when maxillary central incisors developed. Standardized photographs of maxillary central incisors were blind scored for fluorosis using Dean's criteria. Dental caries was examined using ICDAS-II criteria. Results: The prevalence of fluorosis (Dean's score ≥ 2) among children in the fluoridated area (35.7%, 95% CI: 31.9%-39.6%) was significantly higher (P < 0.001) than children in the nonfluoridated area (5.5%, 95% CI: 3.6%-7.4%). Of those in the fluoridated area, the prevalence of fluorosis decreased from 38.4% (95% CI: 33.1%-44.3%) for 12-year-olds to 31.9% (95% CI: 27.6%-38.2%) for 9-year-olds, although this difference was not statistically significant (P = 0.139). The mean caries experience in the permanent dentition was significantly lower in the fluoridated area than in the nonfluoridated area for both age groups (P < 0.05). In the multivariate models, the difference in the differences of caries experience between fluoridated and nonfluoridated areas remained statistically significant. This suggests that caries-preventive effect is still maintained at 0.5 ppm. Conclusion: Findings indicate that the change in fluoride level from 0.7 to 0.5 ppm has reduced fluorosis and maintains a caries-preventive effect. Although there is a reduction in fluorosis prevalence, the difference was not statistically significant.
first_indexed 2024-03-06T05:53:35Z
format Article
id um.eprints-21238
institution Universiti Malaya
last_indexed 2024-03-06T05:53:35Z
publishDate 2018
publisher Wiley
record_format dspace
spelling um.eprints-212382021-04-28T01:54:58Z http://eprints.um.edu.my/21238/ The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries Mohd Nor, Nor Azlida Chadwick, Barbara Lesley Farnell, Damian J.J. Chestnutt, Ivor Gordon RK Dentistry Objective: To assess the prevalence and severity of dental fluorosis and caries among Malaysian children following the reduction in fluoride concentration from 0.7 to 0.5 parts per million (ppm) in the public water supply. Methods: This study involved lifelong residents aged 9- and 12-year-olds in fluoridated and nonfluoridated areas in Malaysia (n = 1155). In the fluoridated area, children aged 12 years and 9 years were exposed to 0.7 and 0.5 ppm, respectively, at the times when maxillary central incisors developed. Standardized photographs of maxillary central incisors were blind scored for fluorosis using Dean's criteria. Dental caries was examined using ICDAS-II criteria. Results: The prevalence of fluorosis (Dean's score ≥ 2) among children in the fluoridated area (35.7%, 95% CI: 31.9%-39.6%) was significantly higher (P < 0.001) than children in the nonfluoridated area (5.5%, 95% CI: 3.6%-7.4%). Of those in the fluoridated area, the prevalence of fluorosis decreased from 38.4% (95% CI: 33.1%-44.3%) for 12-year-olds to 31.9% (95% CI: 27.6%-38.2%) for 9-year-olds, although this difference was not statistically significant (P = 0.139). The mean caries experience in the permanent dentition was significantly lower in the fluoridated area than in the nonfluoridated area for both age groups (P < 0.05). In the multivariate models, the difference in the differences of caries experience between fluoridated and nonfluoridated areas remained statistically significant. This suggests that caries-preventive effect is still maintained at 0.5 ppm. Conclusion: Findings indicate that the change in fluoride level from 0.7 to 0.5 ppm has reduced fluorosis and maintains a caries-preventive effect. Although there is a reduction in fluorosis prevalence, the difference was not statistically significant. Wiley 2018 Article PeerReviewed Mohd Nor, Nor Azlida and Chadwick, Barbara Lesley and Farnell, Damian J.J. and Chestnutt, Ivor Gordon (2018) The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries. Community Dentistry and Oral Epidemiology, 46 (5). pp. 492-499. ISSN 0301-5661, DOI https://doi.org/10.1111/cdoe.12407 <https://doi.org/10.1111/cdoe.12407>. https://doi.org/10.1111/cdoe.12407 doi:10.1111/cdoe.12407
spellingShingle RK Dentistry
Mohd Nor, Nor Azlida
Chadwick, Barbara Lesley
Farnell, Damian J.J.
Chestnutt, Ivor Gordon
The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries
title The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries
title_full The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries
title_fullStr The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries
title_full_unstemmed The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries
title_short The impact of a reduction in fluoride concentration in the Malaysian water supply on the prevalence of fluorosis and dental caries
title_sort impact of a reduction in fluoride concentration in the malaysian water supply on the prevalence of fluorosis and dental caries
topic RK Dentistry
work_keys_str_mv AT mohdnornorazlida theimpactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries
AT chadwickbarbaralesley theimpactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries
AT farnelldamianjj theimpactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries
AT chestnuttivorgordon theimpactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries
AT mohdnornorazlida impactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries
AT chadwickbarbaralesley impactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries
AT farnelldamianjj impactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries
AT chestnuttivorgordon impactofareductioninfluorideconcentrationinthemalaysianwatersupplyontheprevalenceoffluorosisanddentalcaries