The CATFISH study: An evaluation of a water fluoridation program in Cumbria, UK

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2024-05-17 DOI:10.1111/cdoe.12967

Michaela Goodwin, Tanya Walsh, William Whittaker, Richard Emsley, Michael P. Kelly, Matt Sutton, Martin Tickle, Iain A. Pretty

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引用次数: 0

Abstract

Objectives

The objective was to assess the effectiveness of a Water Fluoridation program on a contemporary population of children.

Methods

The study used a longitudinal prospective cohort design.

In Cumbria, England, two groups of children were recruited and observed over a period of 5–6 years. The Birth Cohort consisted of families recruited from two hospitals in Cumbria where children were conceived after water fluoridation was reintroduced. The systemic and topical effects of community water fluoridation were evaluated in the Birth Cohort. The Older Cohort were approximately 5 years old and recruited from primary schools in Cumbria, shortly after water fluoridation was reintroduced. The predominantly topical effects of fluoridated water were evaluated in the Older Cohort.

The primary outcome was the proportion of children with clinical evidence of caries experience in their primary (Birth Cohort) or permanent teeth (Older Cohort). Unadjusted and adjusted regression models were used for analysis.

Results

The final clinical examinations for the Birth Cohort involved 1444 participants (mean age 4.8 years), where 17.4% of children in the intervention group were found to have caries experience, compared to 21.4% in the control group. A beneficial effect of water fluoridation was observed adjusting for deprivation (a socioeconomic measure), sex, and age, (adjusted odds ratio 0.74 95% CI 0.55 to 0.98). The final Older Cohort clinical examinations involved 1192 participants (mean age 10.8 years) where 19.1% of children in the intervention group were found to have caries experience compared to 21.9% in the control group (adjusted odds ratio 0.80, 95% CI 0.58 to 1.09). For both the Birth Cohort and Older Cohort there was evidence of a beneficial effect on dmft/DMFT count (IRR 0.61, 95% CI 0.44, 0.86) and (IRR 0.69, 95% CI 0.52, 0.93) respectively. No conclusive proof was found to indicate that the effectiveness of water fluoridation differed across area deprivation quintiles.

Conclusions

In the contemporary context of lower caries levels and widespread use of fluoride toothpaste, the impact of water fluoridation on the prevalence of caries was smaller than previous studies have reported. It is important to consider the clinical importance of the absolute reduction in caries prevalence against the use of other dental caries preventive measures.

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CATFISH 研究：英国坎布里亚郡氟化水项目评估。

目标目的是评估水氟化计划对当代儿童群体的有效性：研究采用纵向前瞻性队列设计。研究采用纵向前瞻性队列设计，在英格兰坎布里亚招募了两组儿童，并对他们进行了为期 5-6 年的观察。出生队列由坎布里亚两家医院招募的家庭组成，这些家庭的孩子都是在重新实施水氟化之后出生的。出生组群对社区水氟化的全身和局部影响进行了评估。年长组群约 5 岁，在重新实施水氟化后不久从坎布里亚的小学中招募。老年队列主要评估氟化水的局部效果。主要结果是有临床证据表明乳牙（出生队列）或恒牙（老年队列）有龋齿的儿童比例。分析采用未调整和调整回归模型：出生队列中有1444名参与者（平均年龄为4.8岁）接受了最终临床检查，其中干预组有17.4%的儿童被发现患有龋齿，而对照组的这一比例为21.4%。在对贫困程度（一种社会经济衡量标准）、性别和年龄进行调整后，观察到水氟化的有益效果（调整后的几率比 0.74 95% CI 0.55 至 0.98）。最终的老年队列临床检查涉及 1192 名参与者（平均年龄为 10.8 岁），干预组中有 19.1% 的儿童被发现患有龋齿，而对照组中只有 21.9% 的儿童被发现患有龋齿（调整后的几率比为 0.80，95% CI 为 0.58 至 1.09）。有证据表明，出生队列和年长队列的 dmft/DMFT 计数（IRR 分别为 0.61，95% CI 0.44，0.86）和（IRR 分别为 0.69，95% CI 0.52，0.93）均有益处。没有发现确凿证据表明氟化水的效果因地区贫困程度的不同而不同：结论：在龋齿水平较低、含氟牙膏广泛使用的当代背景下，水氟化对龋齿流行率的影响比以往研究报告的要小。在使用其他龋齿预防措施的情况下，考虑龋齿发病率绝对值下降的临床重要性非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.