DENTAL CARIES AND DENTAL FLUOROSIS AT VARYING
WATER FLUORIDE CONCENTRATIONS

K E Heller, S A Eklund and B A Burt
Ann Arbor, Michigan, USA
Abstract from Journal of Public Health Dentistry 57 (3) 136-143 1997

Objectives: The purpose of this study was to investigate the relationships between caries experience and dental fluorosis at different fluoride concentrations in drinking water. The impact of other fluoride products also was assessed.

Methods: This study used data from the 1986-87 National Survey of US School-children. Fluoride levels of school water were used as an indicator of the children's water fluoride exposure. The use of fluoride drops, tablets, professional fluoride treatments, and school fluoride rinses were ascertained from caregiver questionnaires. Only children with a single continuous residence (n = 18,755) were included in this analysis.

Results: The sharpest declines in dfs and DMFS were associated with increases in water fluoride levels between 0 and 0.7 ppm F, with little additional decline between 0.7 and 1.2 ppm F. Fluorosis prevalence was 13.5 percent, 21.7 percent, 29.9 percent, and 41.4 percent for children who consumed <0.3, 0.3 to <0.7, 0.7 to 1.2, and >1.2 ppm F water. In addition to fluoridated water, the use of fluoride supplements was associated with both fewer caries and increased fluorosis.

Conclusions: A suitable trade-off between caries and fluorosis appears to occur around 0.7 ppm F. Data from this study suggest that a reconsideration of the policies concerning the most appropriate concentrations for water fluoridation might be appropriate for the United States.

Key words: Caries prevention; Dental caries; Dental fluorosis; Water fluoridation.

Reprints: K E Heller, University of Michigan, School of Public Health, Program of Dental Public Health, Ann Arbor, MI 48109, USA.

FLUORIDE 31(1)  1998, p 54	International Society for Fluoride Research
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