December 2015

Volume 32, Issue 4

Long term evaluation of the clinical effectiveness of community milk fluoridation in Bulgaria

Authors: P.E. Petersen S. Kwan H. Ogawa
doi: 10.1922/CDH_3629Petersen05


Objective: To determine the clinical effectiveness of a community milk fluoridation programme. Basic research design: Parallel arm 5-year cohort study, with final cross-sectional comparisons between groups. Participants: 3-year-olds in 8 Bulgarian cities/towns entered the cohort study with random samples (n=1,782) recruited at baseline in 2004. After 5 years in 2009 sub-samples (about 30%) of these now aged 8 were randomly selected in intervention sites for follow-up examination (n=454); 276 controls were examined at the age 8 years. For cross-sectional comparisons, in 2004, 284 3-year-olds from control cities were baseline examined for caries, then 276 children at the age 8 years in 2009. Interventions: In six intervention communities: 1,498 examined children received 0.5mg F in 100 or 200ml school milk or yogurt provided each school day; a further 180 received non-fluoridated milk. In two control communities, fluoride was not added to 284 children’s school milk. Main outcome measures: Dental caries experience of primary, and permanent teeth. Results: For primary teeth, caries increments were 46% (p<0.001) and 30% (p<0.01) lower in the fluoridated milk groups compared with non-fluoridated milk groups in the intervention and control communities, respectively. For permanent teeth those reductions were 61% and 53% (p<0.001). The cross-sectional comparisons of 8-year-olds showed significant changes in dental caries experience over time; in children consuming fluoridated milk the level of dmfs fell by 43% (2004 and 2009) against 11% in the control group. Among children consuming fluoridated milk the DMFS fell 68% against rising 3% in the controls. Conclusions: Fluoridated milk delivered daily in schools in Bulgaria resulted in substantially lower caries development compared with children in schools receiving milk without added fluoride. The nation-wide experiences from milk fluoridation indicate that such a public health scheme can be effective to the global fight against dental caries of children. Key words: dental caries prevention; fluoridated milk; cohort study; children; Bulgaria


Other articles in this issue

Article Pages Access
Editorial - Local Dental Networks: Trendy or Transformational? 194-195 Download
The feasibility of using an alcohol screening tool in a UK dental setting to identify patients’ alcohol consumption 196-198 Download
Long term evaluation of the clinical effectiveness of community milk fluoridation in Bulgaria 199-203 Download
Is the value of oral health related to culture and environment, or function and aesthetics? 204-208 Download
Time trends and determinants of acute odontogenic maxillofacial infections in Lithuania: a retrospective national 2009-2013 treatment data audit 209-215 Download
Patient safety in domiciliary dental care for elderly nursing home residents in Sweden 216-220 Download
Dental anxiety and oral health in 15-year-olds: a repeated cross-sectional study over 30 years 221-225 Download
Development and evaluation of a Dental Patient Feedback on Consultation skills (DPFC) measure to enhance communication 226-230 Download
Listening to older adults: community consultation on a new dental service 231-236 Download
A retrospective audit of population service access trends for cleft lip and cleft palate patients 237-240 Download
Perceived mental stress in relation to oral health over time in middle-aged Swedish women 241-246 Download
Dental utilization disparities in a Jewish context: reasons and potential solutions 247-251 Download
Caregiver financial distress, depressive symptoms and limited social capital as barriers to children’s dental care in a midwestern county in the United States 252-256 Download


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