Dental Health of Children Before and After the Cessation of Water Fluoridation

Attwood, Derek (1992) Dental Health of Children Before and After the Cessation of Water Fluoridation. PhD thesis, University of Glasgow.

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Extensive research has established that dental caries experience can be reduced by adding optimum levels of fluoride to drinking water. However, it has been suggested that water fluoridation may be less effective where caries levels are falling, as in Britain and Europe. Earlier studies carried out before the period of temporal decline in caries prevalence, had shown increases in caries prevalence after fluoridation ended. The cessation of water fluoridation in Wigtown District in 1983 has provided the opportunity to study the effect of the cessation of water fluoridation in a period of declining caries incidence. Such a study will also throw some light on the benefit of introducing water fluoridation when caries experience is declining in the population. A series of studies of dental health in 5, 10 and 15 year old children resident in Stranraer, the main town in Wigtown District, in comparison with a similar non-fluoridated town, Annan were carried out in 1980, 1986, 1988 and 1991. These studies have used the same methodology and examiner, allowing secular trends to be examined over time and the monitoring of any changes in caries prevalence which may have resulted from the ending of water fluoridation. The sample in each study was all life-time residents in the age group in each town. The original data was analysed using the System for Planning and Epidemiological Evaluation of Dental Services (SPEED) suite of programmes on a main-frame computer. As this system did not provide surface data, it was felt that the programme should be revised to provide both DMFT and DMFS scores. With the widespread availability of micro computers, the opportunity was taken to change to a data analysis system operating on a micro computer. As a result a new Dental Analysis System (DAS) has been developed based on the modular concept of SPEED and utilising the Statistical Package for the Social Sciences (SPSS). DAS is a multi-module set of SPSS programmes, operating on both main-frame and micro computers, developed to process dental epidemiological data. The final study was analysed utilising DAS. The DAS system has also been tested on a number of other epidemiological studies in Britain and abroad. The 1980 study had demonstrated that caries prevalence in Stranraer children was up to 50 per cent lower than in the control town, Annan. In 1986, three years after fluoridation ceased, 5 year old children in Stranraer had a 65% lower mean dmft than the corresponding group in Annan. The 10 year old group were only 38% better than the Annan 10 year old children. Both age groups in Annan and the 5 year old groups showed a downward trend in keeping with the temporal decline in caries rates in Britain. However the 10 year old group in Stranraer had a marginally higher mean DMFT score in 1986 compared with 1980. This was thought to be an early indication of an adverse trend in caries levels in Stranraer. Five years after the cessation of fluoridation, the mean dmft/DMFT scores for 5 and 10 year olds had increased by 24% and 37% respectively (p < 0.01) by 1988, although the studies were carried out during a period when there has been a national reduction in caries prevalence. Over the same period, caries prevalence in Annan children has followed the national trend with a 23- 27% fall in mean scores (p < 0.01). As a result, caries prevalence in the study groups in the two towns in 1988 showed a difference of only 0.1 and 0.28 respectively in mean dmft/DMFT scores. These differences are not statistically significant. In 1991, caries levels in Stranraer 5 year olds were found to be slightly higher than in Annan, although the difference was not statistically significant. Caries prevalence in both towns was lower than the levels found in 1988. This appears to be in line with general trends in caries rates in Scotland. The results of this series of studies have confirmed that cessation of water fluoridation still leads to increases in caries levels, during a period of temporal decline. The studies have confirmed that water fluoridation would be beneficial in Scotland. It is hoped that water fluoridation will be restarted in Wigtownshire and these studies will provide a basis for the monitoring of the effects on dental health following its re-introduction.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Adviser: A S Blinkborn
Keywords: Dentistry
Date of Award: 1992
Depositing User: Enlighten Team
Unique ID: glathesis:1992-75325
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Nov 2019 21:02
Last Modified: 19 Nov 2019 21:02

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