Caries and fluorosis prevalence in communities with different concentrations of fluoride in the water

The need to defluoridate and fluoridate the water supplies in areas with dr inking water naturally containing above-optimal (greater than or equal to 2 .5 mg/l) and suboptimal (less than or equal to 0.3 mg/l) fluoride concentra tion and caries and fluorosis prevalence of 12-year-old schoolchildren were assessed in Italy. In the low-fluoride area, 48.4% children were caries-fr ee (DMFT = 0) and the DMFT and DMFS were 1.5 and 2.6; in the high-fluoride area, 46.8% had a DMFT = 0 and the values of the indices were 1.4 and 1.6, respectively. Multiple logistic regression analysis showed a significant as sociation in the caries-free status according to parents' employment status (OR = 1.2, 95% CI = 1.1-1.3) and children's sweets consumption, since chil dren who consumed sweets at least once a day had an adjusted odds ratio of 1.8 (95% CI =1.4-2.3) compared to those with a lower consumption. Multiple linear regression analysis showed that DMFT and DMFS were significantly hig her in children with a lower socioeconomic status and in those who consumed sweets at least once a day, with the DMFS significantly associated also wi th the area of residence. DT and FT scores were higher in the high- and low -fluoride areas, respectively. No evidence of fluorosis was reported in 94. 5 and 55.3% of children in the low- and high-fluoride areas, respectively. The Community Fluorosis Index (CFI) for all permanent teeth was significant ly higher in the high-fluoride area, 0.8, than the value, 0.1, found in the low-fluoride community. Our results substantiate the difficulties in defin ing universal guidelines for the fluoridation or defluoridation of drinking water and the need for an epidemiological approach to the decision as to f luoridate and defluoridate the water supply.