Factors related to the difference in the incidence of caries between children in fluoridated and non-fluoridated areas

Sang-Jun Han; Yong-Bong Kwon; Se-Yeon Kim; Ji-Soo Kim; Jung-Ha Lee; Jin-Bom Kim

doi:10.11149/jkaoh.2018.42.4.136

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Han, Kwon, Kim, Kim, Lee, and Kim: Factors related to the difference in the incidence of caries between children in fluoridated and non-fluoridated areas

Original Article

Journal of Korean Academy of Oral Health 2018; 42(4): 136-144.

Published online: 28 December 2018

DOI: https://doi.org/10.11149/jkaoh.2018.42.4.136

Factors related to the difference in the incidence of caries between children in fluoridated and non-fluoridated areas

Sang-Jun Han¹, Yong-Bong Kwon¹, Se-Yeon Kim^1,², Ji-Soo Kim^1,², Jung-Ha Lee¹, Jin-Bom Kim^1,²

¹Department of Preventive & Community Dentistry, Pusan National University, Yangsan, Korea.

²BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan, Korea.

Corresponding Author: Jin-Bom Kim. Department of Preventive & Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: +82-51-510-8223, Fax: +82-51-510-8221, jbomkim@pusan.ac.kr

Received 17 August 2018 Revised 23 November 2018 Accepted 27 November 2018

Journal of Korean Academy of Oral Health

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The aim of this study is to analyze the differences in factors related to the incidence of dental caries between children in fluoridated and non-fluoridated areas and compared the DMFT and DMFS scores to confirm the effect of water fluoridation program (WFP) in Geoje and Changwon.

Methods

The oral health examination and questionnaire survey were conducted in fluoridated and non-fluoridatedareas. The number of surveyed children aged 8, 10, and 12 years in the fluoridated and non-fluoridatedarea of two cities was 1,524 and 1,383, respectively. Self-recorded questionnaires includedself-perception of their own dental health, daily toothbrushing frequency, intake frequency of cariogenicsweet snacks and beverages, experience of gingival bleeding, experience of unmet dental treatment,and use of oral hygiene device except for toothbrush and toothpaste. The prevalence of caries andfissure-sealant status were surveyed. The logistic regression analysis was used to analyze the differencein children's self-rated oral health status between the fluoridated and non-fluoridated area. The mean number of sealed teeth and surfaces, marginal means of the DMFT and DMFS scores adjusted for the difference in the samples' sex distribution, and region were compared between the fluoridated and nonfluoridated areas.

Results

In the fluoridated area, the experience rate of unmet dental treatments was higher among children aged 10 years, intake frequency of cariogenic sweet snacks and beverages were higher among the whole sample, and experience rate of professional fluoride application were lower than in the non-fluoridated area. The DMFT score for permanent dentition adjusted for differences in sex, region, and mean number of fissure-sealed teeth in the fluoridated area was significantly lower among whole samples and 8-, 10-, and 12-year-olds alone than in the non-fluoridated area.

Conclusions

WFP can alleviate oral health inequality because it is effective in reducing the incidence of caries among children is disadvantaged demographic, socioeconomic, and cultural contexts.

Keywords: Dental caries, DMFT, Oral health inequality, Fissure-sealant, Fluoride, Water fluoridation

Figures and Tables

Fig. 1

Cluster sampling of subjects. (A) Program, (B) Control.

Table 1

Mean number of fissure-sealed teeth and surfaces in permanent dentition

^*Subjects without water fluoridation program in Geoje and Changwon.

^†Subjects with water fluoridation program in Geoje and Changwon.

Table 2

Experience rate of unmet curative dental treatment needs, gingival bleeding, and self-perceived status of dental health

^*Subjects without water fluoridation program in Geoje and Changwon.

^†Subjects with water fluoridation program in Geoje and Changwon.

Table 3

Oral health-compromising and -enhancing behaviors

^*Subjects without water fluoridation program in Geoje and Changwon.

^†Subjects with water fluoridation program in Geoje and Changwon.

Table 4

Experience of unmet curative dental treatment needs and gingival bleeding, oral health-compromising behaviors (intake frequency of cariogenic snacks and beverages) and oral health-enhancing behaviors among children in water fluoridated program area compared to children in non-water fluoridated program area

Binary logistic regression model.

CI: Confidence Interval

Odds ratio (Exp(B)) is adjusted for gender, region (Geoje & Changwon) and age (only total).

Table 5

Self-perceived oral health status among children in water fluoridated program area compared to children in non-water fluoridated program area

Multinominal logistic regression model.

Independent variable: non-water fluoridated program area=0, water fluoridated program area=1.

Dependent variable: reference category=poor.

Odds ratio (Exp (B)) is adjusted for gender, region (Geoje & Changwon) and age (only total).

Table 6

Mean number of untreated decayed teeth and decayed surfaces in permanent dentition among children in non-water fluoridation program and water fluoridation program area

^*Subjects without water fluoridation program in Geoje and Changwon.

^†Subjects with water fluoridation program in Geoje and Changwon. Generalized linear model (distribution=poissson). Estimated marginal means were adjusted gender, area (Geoje & Changwon) and number of fissure sealed teeth or surfaces.

SE: standard error.

Table 7

Mean number of decayed, missing and filled teeth and decayed, missing and filled surfaces in permanent dentition among children in non-water fluoridation program and water fluoridation program area

^*Subjects without water fluoridation program in Geoje and Changwon.

^†Subjects with water fluoridation program in Geoje and Changwon.

Univariate analysis of variance.

Estimated marginal means were adjusted for gender, region (Geoje & Changwon) and number of fissure sealed teeth or surfaces.

SE: standard error.

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