Oral Health Centre of Expertise in Eastern Norway, Sørkedalsveien 10A, 0369, Oslo, Norway.
Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway.
BMC Oral Health. 2021 May 4;21(1):234. doi: 10.1186/s12903-021-01598-w.
Dental caries is the most prevalent non-communicable health condition globally. The surface-based susceptibility hierarchy indicates that surfaces in the same group have similar susceptibility to caries, where the most susceptible group consists of occlusal surfaces of first molars and buccal surfaces of lower first molars, and the least susceptible surfaces are smooth and proximal surfaces of first premolars, canines and incisors. Therefore, fluoride in the drinking water could impact one group more than the other group. The present study examined the association between fluoride levels in the drinking water and dental caries experience in adults in the context of varying tooth surface susceptibility.
Data from the cross-sectional National Lithuanian Oral Health Survey conducted in 2017-2019 included a stratified random sample of 1398 35-74-year-olds (52% response rate). Dental caries experience in dentine was measured at a surface level. The surfaces were grouped according to their caries susceptibility (group 1 being the most and group 4 the least susceptible), and dental caries experience was calculated separately for each susceptibility group, creating four outcomes. Information about explanatory variable, fluoride levels in the drinking water, was provided by the water suppliers. The questionnaire inquired about potential determinants: sociodemographic characteristics and oral health-related behaviors. Chi-square, Mann-Whitney U and Kruskal Wallis tests were used for descriptive statistics, and linear regression analyses to examine the association between fluoride levels and four outcomes.
The proportions of median decayed, missing, filled surfaces decreased following the surface-based susceptibility hierarchy (group 1-33%, group 2-28%, group 3-24%, group 4-15%). When adjusted for potential determinants, higher-level fluoride (≥ 0.7 ppm vs < 0.7 ppm) in the drinking water associated with lower dental caries experience in all surface-based susceptibility hierarchy groups; Group 1: β = - 0.23 (95 %CI - 0.44; - 0.001), Group 2: β = - 0.44 (95 %CI - 0.82; - 0.07), Group 3: β = - 1.14 (95 %CI - 1.88; - 0.41) and Group 4: β = - 6.28 (95 %CI - 9.29; - 3.30).
The higher-level fluoride in the drinking water associated with lower dental caries experience in adults and this was observed in all surface-based susceptibility groups. However, there is a need to validate the surface-based susceptibility hierarchy in longitudinal adult studies.
龋齿是全球最普遍的非传染性健康问题。基于表面的易感性层级表明，同一组的表面具有相似的龋齿易感性，其中最易感的组由第一磨牙的窝沟和下颌第一磨牙的颊面组成，而最不易感的表面为第一前磨牙、尖牙和切牙的光滑和近中面。因此，饮用水中的氟化物可能对一组的影响大于另一组。本研究在不同的牙齿表面易感性背景下，研究了饮用水中氟化物水平与成年人龋齿经历之间的关系。
本研究的数据来自于 2017-2019 年进行的横断面全国立陶宛口腔健康调查，包括 1398 名 35-74 岁的分层随机抽样人群（应答率为 52%）。在表面水平上测量牙本质的龋齿经历。根据其龋齿易感性对表面进行分组（第 1 组为最易感，第 4 组为最不易感），并分别为每个易感组计算龋齿经历，共产生四个结果。饮用水中氟化物水平的解释变量信息由水供应商提供。调查问卷询问了潜在的决定因素：社会人口特征和口腔健康相关行为。采用卡方检验、Mann-Whitney U 检验和 Kruskal Wallis 检验进行描述性统计，线性回归分析检验氟化物水平与四个结果之间的关系。
根据基于表面的易感性层级，中位数龋齿、缺失、填充表面的比例呈下降趋势（第 1 组-33%，第 2 组-28%，第 3 组-24%，第 4 组-15%）。在调整潜在决定因素后，饮用水中较高水平的氟化物（≥0.7ppm 比<0.7ppm）与所有基于表面的易感性层级组的龋齿经历呈负相关；第 1 组：β=-0.23（95%CI-0.44；-0.001），第 2 组：β=-0.44（95%CI-0.82；-0.07），第 3 组：β=-1.14（95%CI-1.88；-0.41），第 4 组：β=-6.28（95%CI-9.29；-3.30）。
饮用水中较高水平的氟化物与成年人的龋齿经历呈负相关，而且在所有基于表面的易感性组中都观察到了这种相关性。然而，需要在纵向成人研究中验证基于表面的易感性层级。
