Case-control study in young people living in fluoridated and non-fluoridated regions




Epidemiology; Oral Health; Dental Caries; Fluoridation.


The objective of this study was to verify the prevalence and severity of dental caries in 12-year-olds from a municipality that regularly performs fluoridation of public water supply, since 1972, comparing oral health conditions among young people born and unborn at the site. This is a case-control study, carried out on 164 12-year-old schoolchildren enrolled in public schools in a municipality that continuously performs fluoridation of the water in the public water supply system. The control group was composed of young people with DMFT=0 (n=82) and the case group was composed of young people with DMFT>0 (n=82). The fact that he was not always born and lived in the municipality was considered the exposure factor. The evaluation of the dental condition was performed using the DMFT index. It was found that the average DMFT index of 164 students was 1.00±1.24. There was a statistically significant association (p=0.001) between dental caries experience and the exposure factor, with odds ratio=3.0134 (95% CI=1.5944 - 5.6595). The means of the DMFT index (unexposed=0.44±0.67; exposed=1.31±1.32), of the decayed teeth component (unexposed=0.12±0.34; exposed=0.49±0.89) and the filled teeth component (unexposed=0.40±0.73; exposed=0.83±1.05) were significantly lower (p<0.05) in the adolescents who were born and lived always in the municipality that regularly carries out the fluoridation of public water supply, compared to those born in another municipality. It was concluded that there was an association between access to fluoridated water regularly since birth and lower prevalence and severity of dental caries.

Author Biographies

Suzely Adas Saliba Moimaz, Universidade Estadual Paulista

Department of Preventive and Restorative Dentistry

Luís Felipe Pupim dos Santos, Universidade Estadual Paulista

Department of Preventive and Restorative Dentistry

Tânia Adas Saliba, Universidade Estadual Paulista

Department of Preventive and Restorative Dentistry

Nemre Adas Saliba, Universidade Estadual Paulista

Department of Preventive and Restorative Dentistry

Fernando Yamamoto Chiba, Universidade Estadual Paulista

Department of Preventive and Restorative Dentistry

Orlando Saliba, Universidade Estadual Paulista

Department of Preventive and Restorative Dentistry


Abanto, J., Tsakos, G., Paiva, S. M., Carvalho, T. S., Raggio, D. P., & Bönecker, M. (2014). Impact of dental caries and trauma on quality of life among 5- to 6-year-old children: perceptions of parents and children. Community Dentistry and Oral Epidemiology, 42(5), 385-394.

Araújo, P. C., Vettore, M. V., Baker, S. R., Garbin, C. A. S., Moimaz, S. A. S., & Arcieri, R. M. (2018). Oral health knowledge among Brazilian preschoolers and their carers receiving and not receiving healthpromotion. Bioscience Journal, 34(2), 514-524.

Baghlaf, K., Muirhead, V., Moynihan, P., Weston-Price, S., & Pine, C. (2018). Free sugars consumption around bedtime and dental caries in children: a systematic review. JDR Clinical and Translational Research, 3(2), 118-129.

Brasil. (2012). SB Brasil 2010: Pesquisa Nacional de Saúde Bucal: resultados principais. Ministério da Saúde.

Carolino, R. A., Silva, G. G., Silva, M. E. C., Silva, T. A. F., Silva, I. P. A., Paiva, D. F. F., Xerez, M. C., Pinheiro, J. C., Silva, R. U. O., Medeiros, R. F. S. B., Souza, L. C., & Moura, C. (2020). Evaluation of the impact of oral health conditions on the quality of life of schoolchildren: An exploratory study. Research, Society and Development, 9(10), e2849108683.

Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal. (2011). Consenso técnico sobre classificação de águas de abastecimento público segundo o teor de flúor. São Paulo: Faculdade de Saúde Pública da Universidade de São Paulo.

Cesa, K., Abegg, C., & Aerts, D. (2011). A vigilância da fluoretação de águas nas capitais brasileiras. Epidemiologia e Serviços de Saúde, 20, 547-555.

Dye, B. A., Hsu, K. L., & Afful, J. (2015). Prevalence and measurement of dental caries in young children. Pediatric Dentistry, 37(3), 200-216.

Ferreira, M. C., Goursand, D., Bendo, C. B., Ramos-Jorge, M. L., Pordeus, I. A., & Paiva, S. M. (2012). Agreement between adolescents' and their mothers' reports of oral health–related quality of life. Brazilian Oral Research, 26(2), 112-118.

Frazão, P. (2012). Epidemiology of dental caries: when structure and context matter. Brazilian Oral Research, 26(spe1), 108-114.

Garbin, C. A. S., Santos, L. F. P., Garbin, A. J. I., Moimaz, S. A. S., & Saliba, O. (2017). Fluoridation of public water supply: bioethical, legal and political approach. Revista Bioética, 25(2), 328-337.

Gomes, D., & Ros, M. A. D. The etiology of carie: the construction of a thought-style. (2008). Ciência & Saúde Coletiva, 13(3), 1081-1090.

Hall-Scullin, E., Whitehead, H., Milsom, K., Tickle, M., Su, T. L., & Walsh, T. (2017). Longitudinal study of caries development from childhood to adolescence. Journal of Dental Research, 96(7), 762-767.

Iheozor-Ejiofor, Z., Worthington, H. V., Walsh, T., O'Malley, L., Clarkson, J. E., Macey, R., Alam, R., Tugwell, P., Welch, V., & Glenny, A. M. (2015). Water fluoridation for the prevention of dental caries. The Cochrane Database of Systematic Reviews, 2015(6), CD010856.

Instituto Brasileiro de Geografia e Estatística. (2021). Cidades e estados: Araçatuba.

Malta, M., Cardoso, L. O., Bastos, F. I., Magnanini, M. M., & Silva, C. M. F. (2010). STROBE initiative: guidelines on reporting observational studies. Revista de Saúde Pública, 44(3), 559-565.

McDonagh, M. S., Whiting, P. F., Wilson, P. M., Sutton, A. J., Chestnutt, I., Cooper, J., Misso, K., Bradley, M., Treasure, E., & Kleijnen, J. (2000). Systematic review of water fluoridation. British Medical Journal, 321(7265), 855-859.

Moimaz, S. A. S., & Santos, L. F. P. (2015). Estudo longitudinal da fluoretação das águas em município com complexa rede de distribuição: dez anos de estudo. Archives of Health Investigation, 4(5), 11-16.

Moimaz, S. A. S., Garbin, C. A. S., Iglesias, G. F., Chiba, F. Y., Sumida, D. H., & Saliba, O. (2015). Dificuldades enfrentadas no processo de fluoretação das águas de abastecimento público. Revista Brasileira de Pesquisa em Saúde, 17(1), 87–94.

Moimaz, S. A. S., Santos, L. F. P., Saliba, N. A., & Saliba, O. (2017). Eleven years of monitoring fluoride content in public water supplies: methods, products, and importance to public health. Bioscience Journal, 33(3), 799-808.

Moimaz, S. A. S., Santos, L. F. P., Saliba, T. A., Saliba, N. A., & Saliba, O. (2020). Health surveillance: public water supply fluoridation in 40 municipalities of São Paulo, Brazil. Ciência & Saúde Coletiva, 25(7), 2653-2662.

Moimaz, S. A. S., Santos, L. F. P., Saliba, T. A., Saliba, N. A., & Saliba, O. (2018). Heterocontrole do flúor nas águas de abastecimento público: resultados e experiência de 13 anos de vigilância. Archives of Health Investigation, 7(7), 262-268.

Mota, K. R., Oliveira, A. C. N., Heimer, M. V., Moreira, A. R. O., Pugliesi, D. M. C., & Santos Junior, V. E. (2020). Public oral health policies for children: historical perspective, state of the art and future challenges. Research, Society and Development, 9(11), e3529119869.

Rebelo, M. A., Vieira, J. M. R., Pereira, J. V., Quadros, L. N., & Vettore, M. V. (2019). Does oral health influence school performance and school attendance? A systematic review and meta‐analysis. International Journal of Paediatric Dentistry, 29(2), 138–48.

Righolt, A. J., Jevdjevic, M., Marcenes, W., & Listl, S. (2018). Global-, regional-, and country-level economic impacts of dental diseases in 2015. Journal of Dental Research, 97(5), 501–507.

Rosin-Grget, K., Peros, K., Sutej, I., & Bašić, K. (2013). The cariostatic mechanisms of fluoride. Acta Medica Academica, 42(2), 179-188.

Silva, M. H. A., Fernandes, E. C., Monteiro, A. K. A. P., & Santos, P. B. D. (2020). Knowledge of parents, teachers and dentists about fluoride toothpaste in children under 7 years. Research, Society and Development, 9(8), e78985351.

Souza, J. G. S., Souza, S. E., Noronha, M. S., Ferreira, E. F., & Martins, A. M. E. B. L. (2017). Impact of untreated dental caries on the daily activities of children. Journal of Public Health Dentistry, 78(3), 197-202.

World Health Organization. (2003). The World Oral Health Report 2003. Continuous improvement of oral health in the 21st century: the approach of the WHO Global Oral Health Programme. Geneva: WHO.

World Health Organization. (2013). Oral health surveys: basic methods. (5a ed.), WHO.

World Health Organization. (2015). Prevention is better than treatment. Bulletin of the World Health Organization, 93, 594-595.



How to Cite

MOIMAZ, S. A. S.; SANTOS, L. F. P. dos .; SALIBA, T. A.; SALIBA, N. A.; CHIBA, F. Y. .; SALIBA, O. Case-control study in young people living in fluoridated and non-fluoridated regions. Research, Society and Development, [S. l.], v. 10, n. 6, p. e9910615646, 2021. DOI: 10.33448/rsd-v10i6.15646. Disponível em: Acesso em: 24 jun. 2021.



Health Sciences