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Enhanced anticaries action from drinking water containing 5 ppm fluoride.

H R Englander, P F DePaola

    Journal of the American Dental Association (1939)
    |January 1, 1979
    PubMed
    Summary

    Higher fluoride levels in drinking water significantly reduce dental caries in children. Even higher concentrations, like 5 ppm, showed greater protection than standard fluoridation, though cosmetic concerns like enamel fluorosis exist.

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    Area of Science:

    • Public Health
    • Pediatric Dentistry
    • Fluoride Research

    Background:

    • Dental caries remains a significant public health issue among adolescents.
    • Water fluoridation is a widely adopted strategy for caries prevention.
    • Optimal fluoride concentrations for dental health are continuously researched.

    Purpose of the Study:

    • To evaluate the impact of varying water fluoride concentrations on dental caries experience in adolescent schoolchildren.
    • To compare caries prevalence in communities with naturally high fluoride levels versus standard fluoridation.
    • To assess the dose-response relationship between fluoride intake and caries reduction.

    Main Methods:

    • Cross-sectional study involving 1,878 adolescent schoolchildren across seven US cities.

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  • Water samples analyzed for fluoride concentration (deficient, 1-2 ppm, and ~5 ppm).
  • Dental examinations recorded caries experience using DMF index (decayed, missing, or filled teeth).

    • Main Results:

    • Fluoridated water communities showed significantly lower caries experience (38-83% fewer mean DMF) compared to fluoride-deficient Boston.
    • Midland, Texas, with ~5 ppm fluoride, exhibited even lower caries rates than standard fluoridated areas.
    • Approximately 50% of children in Midland had no dental caries, indicating substantial protection.

    Conclusions:

    • Higher concentrations of fluoride in drinking water offer greater protection against human dental caries.
    • Naturally occurring fluoride levels around 5 ppm demonstrate superior caries prevention compared to standard fluoridation.
    • While higher fluoride is beneficial for caries prevention, concentrations above 1-2 ppm risk unesthetic enamel fluorosis.