Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice

Abstract This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

Resumo Este estudo transversal avaliou a prevalência e severidade de cárie dentária e fluorose em crianças de 5 anos e adolescentes de 12 anos usuários de dentifrício fluoretado, em áreas com e sem água fluoretada. Os responsáveis pelas crianças e adolescentes responderam questionários para determinação de características socioeconômicas e demográficas e hábitos relacionados à saúde. Os indivíduos foram examinados e a cárie e a fluorose foram mensuradas pelos índices ceo-d / CPOD e TF, respectivamente. Foram realizadas análises descritivas, bivariadas e de regressão logística (p <0,05). Dos 692 participantes, 47,7% tinham 5 anos e 52,3% tinham 12 anos. A média de ceod / CPOD em crianças de 5/12 anos dos grupos de exposto e não exposto à água fluoretada foi 1,53 (± 2,47) e 3,54 (± 4,10) / 1,53 (± 1,81) e 3,54 (± 3,82), respectivamente. Crianças (OR = 2,86, IC 95% = 1,71-4,75) e adolescentes (OR = 1,95, IC 95% = 1,24-3,05) que não consumiram água fluoretada tiveram maior experiência de cárie. Entre os adolescentes, houve associação entre a água fluoretada e a prevalência de fluorose muito leve / leve (OR = 5,45, IC 95%: 3,23-9,19) e fluorose moderada (OR = 11,11, IC 95% = 4,43-27,87). Crianças e adolescentes que consumiram água fluoretada apresentaram menor prevalência e severidade de cárie dentária em comparação com aqueles que usaram apenas dentifrício fluoretado como fonte de flúor. Houve uma associação entre a fluoretação da água e fluorose muito leve / leve e moderada em adolescentes.

Does low-cost GIC have the same survival rate as high-viscosity GIC in atraumatic restorative treatments? A RCT

Abstract Atraumatic Restorative Treatment (ART) is one of the strategies used to control dental caries; it involves hand instruments for removal of carious tissue, and restorations using high-viscosity Glass Ionomer Cement (GIC). The present controlled clinical trial aimed to evaluate the performance of low-cost GIC indicated for ART in primary teeth, compared with high-viscosity GIC, after one year of follow-up. Two-to six-year-old children with dentin caries lesions on one or two surfaces of anterior and posterior teeth were selected. The children were randomly assigned to 2 groups according to the restorative material used: G1 (control) - Ketac Molar®; G2 (experimental) - Vitro Molar®. Treatments were performed in a school setting, following the guidelines of the ART. A total of 728 restorations were performed in 243 children. Descriptive analysis and Poisson regression were applied, with a significance level of p < 0.05. After 12 months, 559 (76.8%) restorations were re-evaluated. The success rate was evaluated by the prevalence ratio (PR), associated with restorations performed in primary second molars (PR = 1.21; 95%CI = 1.03-1.42), and with small (PR = 1.35; 95%CI = 1.14-1.60) or medium cavities (PR = 1.29; 95%CI = 1.08-1.55), using Ketac Molar® material (PR= 1.07; 95%CI = 1.01-1.15), considering p < 0.05. Small or medium restorations in primary second molars performed with high-viscosity GIC (Ketac Molar®) were more successful than restorations performed with low-cost GIC indicated for ART.