Evaluation of effectiveness of a regional dental disease prevention program for schoolchildren living in a fluorosis-endemic area

Relevance. In areas where the fluoride concentration in drinking water exceeds 1.5 mg/L, fluorosis is endemic, underscoring the need to develop regional dental disease prevention programs for children and evaluate their effectiveness.

Materials and methods. A clinical study included 300 schoolchildren aged 7, 12, and 15 years who lived in an area of endemic fluorosis, where the fluoride concentration in drinking water was 2.4 mg/L. Within each age group, 50 children were included in the prevention subgroup and 50 in the comparison subgroup. Oral health status was assessed using the decayed, missing, and filled teeth (DMFT) index, the papillary-marginal-alveolar (PMA) index, the Simplified Oral Hygiene Index (OHI-S), and Dean’s fluorosis index (1942). This study reports outcomes after 3 years of program implementation.

Results. Dental fluorosis was present in 68.33% of the children, predominantly in very mild and mild forms. Its prevalence remained unchanged over the 3-year follow-up. During the same period, the prevalence of dental caries increased in all age groups. Meanwhile, the prevention subgroups showed greater improvements in oral hygiene and periodontal status than the comparison subgroups. Caries reduction was 18.2%, 66.7%, and 36% among 7-, 12-, and 15-year-olds, respectively. These findings confirm the effectiveness of the prevention program.

Conclusion. Implementation of the regional dental disease prevention program among schoolchildren living in an area of endemic fluorosis reduces the risk of dental caries and improves oral hygiene and periodontal status.

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