The caries preventive effect on permanent teeth adjusted for number of fissure-sealed teeth and surfaces from 6-year community water fluoridation program in Geoje City

Hyun-Hee Cho; Tae-Young Ok; Se-Yeon Kim; Jung-Ha Lee; Ji-Soo Kim; Hyeon-Cheol Kim; Seung-Hwa Jeong; Jin-Bom Kim

doi:10.11149/jkaoh.2017.41.4.296

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Cho, Ok, Kim, Lee, Kim, Kim, Jeong, and Kim: The caries preventive effect on permanent teeth adjusted for number of fissure-sealed teeth and surfaces from 6-year community water fluoridation program in Geoje City

Original Article

J Korean Acad Oral Health 2017;41(4):296-302.

Published online: 15 December 2017

DOI: https://doi.org/10.11149/jkaoh.2017.41.4.296

The caries preventive effect on permanent teeth adjusted for number of fissure-sealed teeth and surfaces from 6-year community water fluoridation program in Geoje City

Hyun-Hee Cho¹, Tae-Young Ok¹, Se-Yeon Kim^1,², Jung-Ha Lee¹, Ji-Soo Kim^1,², Hyeon-Cheol Kim³, Seung-Hwa Jeong^1,², Jin-Bom Kim^1,^2,

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

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

³Department of Conservative Dentistry, 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 E-mail: jbomkim@pusan.ac.kr

Received 12 December 2017 Revised 12 December 2017 Accepted 12 December 2017

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 water fluoridation program has been implemented since 2008, in a region of Geoje City. This study aimed to evaluate the effectiveness of the water fluoridation program on caries prevention in the permanent dentition.

Methods

Evaluation surveys were conducted on 8-, 10- and 12-year-old children in the fluoridated and non-fluoridated regions of Geoje City, in 2015. The survey included 834 children from the fluoridated regions and 703 from the non-fluoridated regions. The data obtained from the survey were analyzed using the IBM SPSS statistical package version 23.0. The effectiveness of community water fluoridation in caries prevention was estimated by the differences in the decayed, missing, filled teeth (DMFT) and decayed, missing, filled surfaces (DMFS) scores, between the program and control groups. The mean numbers of fissure-sealed teeth and surfaces were adjusted to reduce their confounding effect.

Results

The mean DMFT and DMFS scores (0.69 and 0.91, respectively) of 10-year-olds from the fluoridated regions, after adjusting for the numbers of fissure-sealed teeth and surfaces, were significantly lower than those of the 10 year olds (DMFT: 0.95, DMFS: 1.32) from the non-fluoridated regions. The effectiveness of water fluoridation on caries prevention in the permanent dentition, estimated based on the differences in the mean DMFT and DMFS scores, adjusted for the number of fissure-sealed teeth and surfaces, between the program and control groups of 10-year-old children, was 27.4% and 31.1%, respectively.

Conclusions

These results suggest that the effectiveness of water fluoridation on caries prevention in the permanent dentition, in Geoje City was so high that this program should be implemented in other regions in Korea as well.

Keywords: Dental caries, Fluoride, Permanent teeth, Prevention, Water fluoridation

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Table 1.

Subject numbers of control and water fluoridation program in Geoje city

Age	Control*		Program
Age	N^†	%	N^†	%
Total	703	100.0	834	100.0
8	218	31.0	259	31.1
10	212	30.2	240	28.8
12	273	38.8	335	40.2

*Subjects without water fluoridation program in Geoje City.

^† Numbers of subjects.

Table 2.

Distribution of subjects by age and gender in 2015

Age	Gender	Control*		Program		P^‡
Age	Gender	N^†	%	N^†	%	P^‡
8	Male	118	54.1	121	46.7	0.118
	Female	100	45.9	138	53.3
10	Male	112	52.8	138	57.5	0.344
	Female	100	47.2	102	42.5
12	Male	156	57.1	171	51.0	0.142
	Female	117	42.9	164	49.0

*Subjects without water fluoridation program in Geoje City.

^† Numbers of subjects.

^‡ Chi-square test.

Table 3.

Numbers of fissure-sealed teeth and surfaces in 2015

Variables	Age (yr)	Control*			Program			P^§
Variables	Age (yr)	N^†	Mean	SE^‡	N^†	Mean	SE^‡	P^§
Fissure-sealed teeth	8	218	0.77	0.08	259	0.87	0.08	0.348
	10	212	0.89	0.09	240	0.83	0.08	0.616
	12	273	0.71	0.08	335	1.07	0.10	0.004
Fissure-sealed surfaces	8	218	0.92	0.10	259	1.11	0.11	0.207
	10	212	1.10	0.12	240	1.00	0.11	0.517
	12	273	0.83	0.10	335	1.24	0.11	0.006

*Subjects without water fluoridation program in Geoje City.

^† Numbers of subjects.

^‡ Standard error.

^§ Independent samples t-test.

Table 4.

Percentages of caries experience in 2015 by water fluoridation program

Age	Control*		Program		P^‡
Age	N^†	%	N^†	%	P^‡
8	218	21.1	259	22.8	0.739
10	212	40.1	240	30.4	0.038
12	273	54.9	335	49.3	0.166

*Subjects without water fluoridation program in Geoje City.

^† Numbers of subjects.

^‡ Chi-square test.

Table 5.

Mean numbers of decayed, missing and filled teeth and caries prevention fraction in permanent dentition

Age	Control*			Program			P^∥	Control*		Program		P**	Prevention fraction (%)***
Age	N^†	Mean^‡	SE^§	N^†	Mean^‡	SE^§	P^∥	Mean^¶ (A)	SE^§	Mean^¶ (B)	SE^§	P**	Prevention fraction (%)***
8	218	0.40	0.06	259	0.43	0.06	0.722	0.39	0.06	0.43	0.06	0.625	-
10	212	0.94	0.09	240	0.70	0.08	0.048	0.95	0.09	0.69	0.08	0.032	27.4
12	273	1.62	0.12	335	1.49	0.12	0.458	1.57	0.12	1.53	0.11	0.809	2.5

*Subjects without water fluoridation program in Geoje City.

^† Numbers of subjects.

^‡ Unadjusted mean for the number of fissure-sealed teeth in permanent dentition.

^§ Standard error.

^∥ Independent samples t-test .

^¶ Estimated marginal means by univariate analysis of variance adjusted for the number of fissure-sealed teeth. **ANCOVA (analysis of covariance). ***[(A―B)/A]×100, Bold numbers denote prevention fractions from significant differences between both groups.

Table 6.

Mean numbers of decayed, missing and filled surfaces and caries prevention fraction in permanent dentition

Age	Control*			Program			P^∥	Control*		Program		P**	Prevention fraction (%)***
Age	N^†	Mean^‡	SE^§	N^†	Mean^‡	SE^§	P^∥	Mean^¶ (A)	SE^§	Mean^¶ (B)	SE^§	P**	Prevention fraction (%)***
8	218	0.60	0.11	259	0.60	0.09	0.988	0.59^a	0.10	0.61^a	0.09	0.871	-
10	212	1.31	0.14	240	0.92	0.11	0.030	1.32^b	0.13	0.91^b	0.12	0.019	31.1
12	273	2.14	0.17	335	1.98	0.17	0.494	2.08^c	0.18	2.03^c	0.16	0.825	2.4

*Subjects without water fluoridation program in Geoje City.

^† Numbers of subjects.

^‡ Unadjusted mean for the number of fissure-sealed surfaces in permanent dentition.

^§ Standard error.

^∥ Independent samples t-test.

^¶ Estimated marginal means by univariate analysis of variance adjusted for the number of fissure-sealed surfaces. **ANCOVA (analysis of covariance). ***[(A―B)/A]×100, Bold numbers denote prevention fractions from significant differences between both groups.

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