{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:54:11Z","timestamp":1792050851249,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001504","name":"Ministry of Health, New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001504","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To provide contemporary national evidence on the effectiveness of community water fluoridation (CWF) for the prevention of early childhood caries (ECC) among 4\u2010year\u2010old children in Aotearoa New Zealand (NZ), and to examine potential effect modification by ethnicity and other sociodemographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A national repeated cross\u2010sectional study was conducted using routinely collected B4 School Check data (2010\u20132022). Children aged 4\u2009years were linked to a national spatial dataset of water distribution zones and council\u2010reported fluoridation histories to classify exposure over the assessment year and preceding 3\u2009years. ECC was identified via the \u2018lift\u2010the\u2010lip\u2019 screening. Multilevel mixed\u2010effects modified Poisson regression models, with children nested within meshblocks, estimated incidence rate ratios (IRRs), adjusting for ethnicity, area\u2010level deprivation, age, sex, rurality, and assessment year. Two\u2010factor interactions were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 630\u2009926 children, 14.2% had ECC. In crude analyses, ECC appeared more common in fluoridated areas; however, after adjustment for sociodemographic characteristics, CWF was associated with a lower rate of ECC (IRR\u2009=\u20091.13; 95% CI: 1.11\u20131.15 for non\u2010fluoridated vs. fluoridated). A significant interaction between CWF and ethnicity was observed. The protective association was strongest among European\/Other children (IRR\u2009=\u20091.25; 95% CI: 1.21\u20131.29) and attenuated among M\u0101ori and Asian children, with minimal effect among Pacific children. The ethnicity\u2010weighted population attributable fraction was 4.4%, equating to approximately 282 ECC cases annually.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings are consistent with CWF being an effective population\u2010level oral health intervention. However, its association with caries experience varies by ethnicity, highlighting the importance of addressing structural inequities alongside universal preventive strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cdoe.70080","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:39:51Z","timestamp":1781239191000},"page":"622-630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigation Into the Effectiveness of Community Water Fluoridation and Dental Caries Experience in 4\u2010Year\u2010Old Aotearoa New Zealand Children: A National Repeated Cross\u2010Sectional Study From 2010 to 2022"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-5600","authenticated-orcid":false,"given":"Tim","family":"Chambers","sequence":"first","affiliation":[{"name":"Ng\u0101i Tahu Research Centre University of Canterbury  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6799-6779","authenticated-orcid":false,"given":"Philip J.","family":"Schluter","sequence":"additional","affiliation":[{"name":"Te Kaupeka Oranga, Faculty of Health, Te Whare W\u0101nanga o Waitaha University of Canterbury  Christchurch New Zealand"},{"name":"School of Clinical Medicine, Primary Care Clinical Unit The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6869-3508","authenticated-orcid":false,"given":"Frank","family":"Dean","sequence":"additional","affiliation":[{"name":"Ng\u0101i Tahu Research Centre University of Canterbury  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8398-7485","authenticated-orcid":false,"given":"Matt","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Te Kaupeka Oranga, Faculty of Health, Te Whare W\u0101nanga o Waitaha University of Canterbury  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8905-398X","authenticated-orcid":false,"given":"Jonathan","family":"Broadbent","sequence":"additional","affiliation":[{"name":"Department of Oral Sciences University of Otago  Dunedin Otago New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Age 5 Oral Health Data From Community Oral Health Services","author":"Health New Zealand \u2010 Te Whatu Ora","year":"2024"},{"key":"e_1_2_11_3_1","unstructured":"D.Graham Potentially Preventable Admissions to New Zealand Public Hospitals for Treatment of Dental Disease(2025)."},{"key":"e_1_2_11_4_1","unstructured":"Health (Fluoridation of Drinking Water) Amendment Act(2021) https:\/\/www.legislation.govt.nz\/act\/public\/2021\/0044\/latest\/whole.html."},{"key":"e_1_2_11_5_1","unstructured":"R.Kelly Bloomfield Will Order Some Water Supplies to Be Fluoridated From Mid\u20102022(2022) https:\/\/www.stuff.co.nz\/national\/127705746\/bloomfield\u2010will\u2010order\u2010some\u2010water\u2010supplies\u2010to\u2010be\u2010fluoridated\u2010from\u2010mid2022."},{"issue":"1","key":"e_1_2_11_6_1","first-page":"12","article-title":"The Health Equity Implications of the Health (Fluoridation of Drinking Water) Amendment Act 2021 on Access to and Performance of Community Water Fluoridation in New Zealand","volume":"121","author":"Chambers T. B.","year":"2025","journal-title":"New Zealand Dental Journal"},{"key":"e_1_2_11_7_1","volume-title":"New Health New Zealand Inc v Director\u2010General of Health","author":"High Court of New Zealand","year":"2023"},{"key":"e_1_2_11_8_1","unstructured":"New Zealand First NZ First Introduces Fluoridation Referendum Bill(2025) https:\/\/www.nzfirst.nz\/nzf\u2010introduces\u2010fluoridation\u2010referendum\u2010bill."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010856.pub2"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12930"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12967"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12384"},{"key":"e_1_2_11_13_1","volume-title":"Our Oral Health \u2013 Key Findings of the 2009 NZ Oral Health Survey","author":"Ministry of Health","year":"2010"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa043"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.2201"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010016\u20100180\u20105"},{"key":"e_1_2_11_17_1","first-page":"15","article-title":"Fluoridation and Dental Caries Severity in Young Children Treated Under General Anaesthesia: An Analysis of Treatment","volume":"30","author":"Kamel M. S.","year":"2013","journal-title":"Community Dental Health"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dib.2023.109349"},{"key":"e_1_2_11_20_1","volume-title":"The B4 School Check: A Handbook for Practitioners","author":"Ministry of Health","year":"2008"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2025.180549"},{"key":"e_1_2_11_22_1","volume-title":"NZDep2013 Index of Deprivation","author":"Atkinson J.","year":"2014"},{"key":"e_1_2_11_23_1","volume-title":"NZDep2018 Index of Deprivation: Interim Research Report","author":"Atkinson J.","year":"2019"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176344136"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010039706"},{"key":"e_1_2_11_27_1","volume-title":"Growing up in New Zealand: A Longitudinal Study of New Zealand Children and Their Families. Now we Are Four: Describing the Preschool Years","author":"Morton S.","year":"2017"},{"key":"e_1_2_11_28_1","volume-title":"Growing up in New Zealand: A Longitudinal Study of New Zealand Children and Their Families. Residential Mobility Report 1: Moving House in the First 1000\u2009Days","author":"Morton S. M. B.","year":"2014"}],"container-title":["Community Dentistry and Oral Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.70080","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cdoe.70080","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.70080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:26:59Z","timestamp":1792049219000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cdoe.70080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/cdoe.70080"],"URL":"https:\/\/doi.org\/10.1111\/cdoe.70080","archive":["Portico"],"relation":{},"ISSN":["0301-5661","1600-0528"],"issn-type":[{"value":"0301-5661","type":"print"},{"value":"1600-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}