Fluoridation cessation and oral health equity: a 7-year post-cessation study of Grade 2 schoolchildren in Alberta, Canada.
Dental caries
Fluoridation
Health equity
Public health
Journal
Canadian journal of public health = Revue canadienne de sante publique
ISSN: 1920-7476
Titre abrégé: Can J Public Health
Pays: Switzerland
ID NLM: 0372714
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
21
06
2021
accepted:
16
05
2022
pubmed:
8
7
2022
medline:
18
11
2022
entrez:
7
7
2022
Statut:
ppublish
Résumé
Community water fluoridation, because of its universal scope and passive mechanism of uptake, is one component of a multifaceted approach to promoting equity in dental health. The objective of this study was to examine social inequities in children's dental health in the Canadian cities of Calgary (fluoridation cessation in 2011) and Edmonton (still fluoridated). We analyzed data from surveys of population-based samples of Grade 2 (approx. age 7) children in Calgary in 2009/2010 (pre-cessation; n=557) and in both Calgary and Edmonton in 2013/2014 (Calgary, n=3230; Edmonton, n=2304) and 2018/2019 (Calgary, n=2649; Edmonton, n=2600) (post-cessation). We estimated associations between several socioeconomic indicators and dental caries indicators (i.e., dental caries experience [deft, DMFT] and untreated decay in two or more teeth [untreated decay]) using zero-inflated Poisson, binary logistic regression, and the concentration index of inequality. We compared those associations over time (between survey waves) and between cities at post-cessation. Persistent social inequities in deft and untreated decay were evident; for example, having no dental insurance was significantly associated with higher odds of untreated decay across city and survey wave. In most (but not all) cases, differences between cities and survey waves were consistent with an adverse effect of fluoridation cessation on dental health inequities. For example, the association between no dental insurance and higher odds of untreated decay in Calgary was greater in 2018/2019 (later post-cessation) than in 2009/2010 (pre-cessation; odds ratio [OR] for comparison of coefficients = 1.89 [1.36-2.63], p<0.001) and 2013/2014 (early post-cessation; OR for comparison of coefficients = 1.67 [1.22-2.28], p=0.001); that same association in 2018/2019 was greater in Calgary (fluoridation cessation) than in Edmonton (still fluoridated) (OR for comparison of coefficients = 1.44 [1.03-2.02], p=0.033). Social inequities in dental caries were present in both Calgary and Edmonton. Those inequities tended to be worse in Calgary where fluoridation was ceased. Our findings may be relevant to other settings where income inequality is high, dental services are costly, and dental public health infrastructure is limited. RéSUMé: OBJECTIF: En raison de sa portée universelle et de son mécanisme de réception passif, la fluoration de l’eau des communautés s’inscrit dans une démarche multidimensionnelle de promotion de l’équité en santé dentaire. Notre étude visait à examiner les iniquités sociales en santé dentaire chez les enfants dans les villes canadiennes de Calgary (où la fluoration a cessé en 2011) et d’Edmonton (où l’eau est encore enrichie en fluor). MéTHODE: Nous avons analysé les données d’enquêtes menées auprès d’échantillons populationnels d’élèves de 2
Autres résumés
Type: Publisher
(fre)
RéSUMé: OBJECTIF: En raison de sa portée universelle et de son mécanisme de réception passif, la fluoration de l’eau des communautés s’inscrit dans une démarche multidimensionnelle de promotion de l’équité en santé dentaire. Notre étude visait à examiner les iniquités sociales en santé dentaire chez les enfants dans les villes canadiennes de Calgary (où la fluoration a cessé en 2011) et d’Edmonton (où l’eau est encore enrichie en fluor). MéTHODE: Nous avons analysé les données d’enquêtes menées auprès d’échantillons populationnels d’élèves de 2
Identifiants
pubmed: 35799095
doi: 10.17269/s41997-022-00654-4
pii: 10.17269/s41997-022-00654-4
pmc: PMC9663766
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
955-968Subventions
Organisme : CIHR
ID : PJT-156258
Pays : Canada
Organisme : CIHR
ID : CPP-137907
Pays : Canada
Organisme : CIHR
ID : 403867
Pays : Canada
Informations de copyright
© 2022. The Author(s).
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