Dental status of rural school children in a sub-optimal fluoride area

Past investigations by us have shown high levels of caries experience in rural coloured school children of the Western Cape. These studies were all undertaken in fluoride poor areas. In contrast studies of children in areas with optimal and higher concentrations of fluoride in their drinking water have shown lower DMFT scores. On a previous visit to the town of Fraserburg in the North Western Cape we observed fluorosis in children, although the fluoride content of the municipal drinking water was sub-optimal (0.68-0.78 ppm F-). The purpose of this study was therefore to measure the dental status of 6, 12 and 15 year old school children using the dmft, DMFT and Dean's Fluorosis Index according to the 1987 WHO guidelines. The examinations were done by two calibrated examiners using portable equipment. Results showed low mean dmft values of 3.31 +/- 3.90 and 0.22 +/- 0.86 for the 6 and 12 year olds respectively. The corresponding DMFT scores including that for 15 year olds were 0.08 +/- 0.35; 1.45 +/- 1.81 and 1.00 +/- 1.60 respectively and no significant statistical gender differences were observed (p>0.05). The mean fluorosis scores for 6, 12 and 15 year olds were 1.68 +/- 1.05; 2.78 +/- 1.34 and 2.90 +/- 1.58 respectively. For both the 12 and 15 year olds the severity of fluorosis ranged from no fluorosis to severe mottling and corrosion. It can be concluded that the results even at a sub-optimal fluoride level show a high similarity to the dental status of children in rural fluoride rich areas. Defluoridation of the Fraserburg municipal drinking water therefore becomes imperative and a concentration of 0.4 ppm F- is suggested. Furthermore the children have no access to dental services and this has led to accumulated needs which demand urgent addressing.