Public water fluoridation and dental health in New South Wales

Objectives: To evaluate whether access to fluoridated public water in New South Wales (NSW) is related to both a reduction in caries experience within NSW regions and to better dental health for disadvantaged children. Methods: Cross-sectional population data on children attending the School Dental Service in NSW in 2000 were used to calculate and compare the number of decayed, missing and filled teeth (dmft/ DMFT) across areas of differing availability of fluoridated water within NSW Area Health Service (AHS) regions. Analyses were also undertaken looking at differences in caries between optimally fluoridated and non-fluoridated communities across strata of socio-economic disadvantage and by Indigenous status. Results: A total sample of 248,944 children aged 3-15 years was obtained. Caries experience in the deciduous dentition of 5-6 year-olds and the permanent dentition of 11-12 year-olds was significantly lower for children in fluoridated areas than nonfluoridated areas in six of the eight AHSs and six of the 10 AHSs respectively where comparisons could be made. Children living in fluoridated areas had lower caries experience than children living in nonfluoridated areas, regardless of socioeconomic disadvantage. Both Indigenous and non-Indigenous children had reduced caries experience in fluoridated compared with non-fluoridated areas. Conclusions: Water fluoridation was found to be related to significantly reduced caries experience in the majority of AHSs where comparisons could be made, and to benefit all socio-economic strata of the community. Implications: Water fluoridation should be extended to those areas of NSW that are yet to benefit from this successful caries preventive public health initiative.