{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:16:00Z","timestamp":1792030560984,"version":"4.4.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T00:00:00Z","timestamp":1528934400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["UH2DE025494"],"award-info":[{"award-number":["UH2DE025494"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:p>Fluoridation of America\u2019s drinking water was among the great public health achievements of the 20th century. Yet there is a paucity of studies from the past 3 decades investigating its dental health benefits in the U.S. population. This cross-sectional study sought to evaluate associations between availability of community water fluoridation (CWF) and dental caries experience in the U.S. child and adolescent population. County-level estimates of the percentage of population served by CWF (% CWF) from the Centers for Disease Control and Prevention\u2019s Water Fluoridation Reporting System were merged with dental examination data from 10 y of National Health and Nutrition Examination Surveys (1999 to 2004 and 2011 to 2014). Dental caries experience in the primary dentition (decayed and filled tooth surfaces [dfs]) was calculated for 7,000 children aged 2 to 8 y and in the permanent dentition (decayed, missing, and filled tooth surfaces [DMFS]) for 12,604 children and adolescents aged 6 to 17 y. Linear regression models estimated associations between % CWF and dental caries experience with adjustment for sociodemographic characteristics: age, sex, race\/ethnicity, rural-urban location, head-of-household education, and period since last dental visit. Sensitivity analysis excluded counties fluoridated after 1998. In unadjusted analysis, caries experience in the primary dentition was lower in counties with \u226575% CWF (mean dfs = 3.3; 95% confidence limit [CL] = 2.8, 3.7) than in counties with &lt;75% CWF (mean dfs = 4.6; 95% CL = 3.9, 5.4), a prevented fraction of 30% (95% CL = 11, 48). The difference was also statistically significant, although less pronounced, in the permanent dentition: mean DMFS (95% CL) was 2.2 (2.0, 2.4) and 1.9 (1.8, 2.1), respectively, representing a prevented fraction of 12% (95% CL = 1, 23). Statistically significant associations likewise were seen when % CWF was modeled as a continuum, and differences tended to increase in covariate-adjusted analysis and in sensitivity analysis. These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth.<\/jats:p>","DOI":"10.1177\/0022034518774331","type":"journal-article","created":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T07:02:12Z","timestamp":1528959732000},"page":"1122-1128","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":83,"title":["Water Fluoridation and Dental Caries in U.S. Children and Adolescents"],"prefix":"10.1177","volume":"97","author":[{"given":"G.D.","family":"Slade","sequence":"first","affiliation":[{"name":"Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.B.","family":"Grider","sequence":"additional","affiliation":[{"name":"US Census Bureau, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.R.","family":"Maas","sequence":"additional","affiliation":[{"name":"Dental Public Health Consultant, North Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.E.","family":"Sanders","sequence":"additional","affiliation":[{"name":"Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,6,14]]},"reference":[{"key":"bibr1-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2017.05.014"},{"issue":"3","key":"bibr2-0022034518774331","first-page":"1","volume":"54","author":"Beltr\u00e1n-Aguilar ED","year":"2005","journal-title":"MMWR Surveill Summ"},{"issue":"1","key":"bibr3-0022034518774331","first-page":"575","volume":"69","author":"Brunelle JA.","year":"1990","journal-title":"J Dent Res"},{"key":"bibr4-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1177\/00220345900690S141"},{"key":"bibr5-0022034518774331","unstructured":"Burt BA, Eklund SA. 2005. Dentistry, dental practice, and the community. 6th ed. St. Louis (MO): Elsevier Health Sciences."},{"key":"bibr6-0022034518774331","unstructured":"California Department of Health. 2009. California statewide fluoridation table. [accessed 2018 April 11]. https:\/\/www.waterboards.ca.gov\/drinking_water\/certlic\/drinkingwater\/documents\/fluoridation\/Tables\/Data2008.pdf."},{"issue":"12","key":"bibr7-0022034518774331","first-page":"241","volume":"48","author":"Centers for Disease Control and Prevention","year":"1999","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr8-0022034518774331","unstructured":"Centers for Disease Control and Prevention. 2017a. My water\u2019s fluoride. [accessed 2018 April 11]. https:\/\/nccd.cdc.gov\/DOH_MWF\/Default\/Default.aspx."},{"key":"bibr9-0022034518774331","unstructured":"Centers for Disease Control and Prevention. 2017b. Rhode Island fluoridation report. [accessed 2018 April 11]. https:\/\/nccd.cdc.gov\/DOH_MWF\/Reports\/Default.aspx."},{"key":"bibr10-0022034518774331","unstructured":"Community Preventive Services Task Force. 2017. Oral health: preventing dental caries, community water fluoridation. [accessed 2018 April 11]. https:\/\/www.thecommunityguide.org\/sites\/default\/files\/assets\/Oral-Health-Caries-Community-Water-Fluoridation_3.pdf."},{"key":"bibr11-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12056"},{"key":"bibr12-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2017.04.013"},{"key":"bibr13-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.2001.tb03385.x"},{"key":"bibr14-0022034518774331","unstructured":"Healthy People 2020. 2018. Oral health interventions. OH-13 Increase the proportion of the U.S. population served by community water systems with optimally fluoridated water. [accessed 2018 April 11]. https:\/\/www.healthypeople.gov\/2020\/topics-objectives\/topic\/oral-health\/objectives."},{"key":"bibr15-0022034518774331","volume":"6","author":"Iheozor-Ejiofor Z","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"bibr16-0022034518774331","first-page":"26","volume":"67","author":"Kumar JV","year":"2001","journal-title":"N Y State Dent J"},{"key":"bibr17-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.23.100901.140546"},{"issue":"2","key":"bibr18-0022034518774331","first-page":"A66","volume":"6","author":"Malvitz DM","year":"2009","journal-title":"Prev Chronic Dis"},{"key":"bibr19-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2009.12.022"},{"key":"bibr20-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2012.00721.x"},{"key":"bibr21-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2016.257"},{"key":"bibr22-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.09.004"},{"key":"bibr23-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12261"},{"key":"bibr24-0022034518774331","doi-asserted-by":"publisher","DOI":"10.1007\/s11205-014-0829-x"},{"key":"bibr25-0022034518774331","unstructured":"US Census Bureau Population Division. 2017. 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