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Longitudinal study of prevalence of enamel lesions in a fluoridated and non-fluoridated area
Insights
Water fluoridation significantly reduced caries progression in children, with most lesions remaining in the enamel stage. This study tracked enamel lesions in children aged 7-18 in fluoridated and non-fluoridated areas.
Area of Science:
- Pediatric Dentistry
- Public Health
Background:
- Dental caries remains a significant public health concern in children.
- Water fluoridation is a widely implemented preventive strategy for dental caries.
Purpose of the Study:
- To longitudinally assess the impact of water fluoridation on enamel lesion prevalence in children aged 7-18.
- To compare caries progression in children with lifelong access to fluoridated water versus those with low fluoride exposure.
Main Methods:
- Longitudinal study of 93 children in Tiel (1 ppm F-) and 103 in Culemborg (0.1 ppm F-).
- Examinations conducted every other year from age 7 to 15, with a follow-up at age 18.
- Assessment of buccal, occlusal, and approximal enamel lesions, with approximal lesions evaluated via bitewing radiographs.
Main Results:
- No significant difference in the total number of enamel lesions between fluoridated and non-fluoridated groups at ages 15 and 18.
- A higher percentage of lesions remained in the enamel stage in the fluoridated area (93% buccal, 86% approximal) compared to the non-fluoridated area (65% both).
- Caries progression beyond the enamel stage was markedly reduced in the fluoridated area, despite similar lesion initiation rates.
Conclusions:
- Water fluoridation effectively inhibits caries progression beyond the enamel stage, even if lesion initiation is not significantly altered.
- The study found no observable pre-eruptive effects of water fluoridation on the total number of enamel lesions.
- Lifelong water fluoridation plays a crucial role in managing dental caries severity in children.
Abstract:
The aim of this study was to examine longitudinally the effect of water fluoridation on the prevalence of enamel lesions in children 7-18 yr of age. 93 children in Tiel (1 ppm F-) and 103 children in Culemborg (0.1 ppm F-) were examined every other year at 7, 9, 11, 13 and 15 yr of age. A supplementary examination was carried out when these children reached the age of 18. Children in Tiel had access to water fluoridation from birth. The total number of lesions, including enamel lesions, on the buccal as well as on the occlusal surfaces was approximately the same in both areas in children 15 and 18 yr of age. Approximal lesions were scored on standardized bitewing radiographs. A large proportion of enamel lesions could not be detected on radiographs. In a fluoridated area a high percentage of all lesions remain in the stage of enamel caries lesions. On buccal surfaces 93% and on approximal surfaces 86% of all lesions had not progressed into the dentin. In Culemborg these percentages were 65 for approximal as well as for buccal surfaces. At the initiation of lesions, at younger ages, only a small retardation of the process was observed, but caries progression beyond the stage of enamel caries was markedly reduced in the fluoridated area. No pre-eruptive effect could be observed if the total number of lesions, including enamel lesions, from Tiel and Culemborg were compared.