{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T07:05:04Z","timestamp":1772435104247,"version":"3.50.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the impact of explicit fluoride-related language in prefectural dental health ordinance on the dissemination of school-based fluoride mouth-rinse (S-FMR) programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal ecological design was employed to analyze prefectural-level panel data from Japan spanning 2007 to 2018. Ordinances enacted between 2010 and 2014 were categorized by the presence of explicit fluoride-related terms: 1) explicit mention of \u201cfluoride mouth-rinse\u201d (FMR group); 2) explicit mention of \u201cfluoride application\u201d (FA group); and 3) no fluoride-related policy language (NF group). The outcome was the proportion of children aged 4\u201315 years participating in S-FMR programs. Total prefectural income per year, prefectural mean age, and prefectural mean number of decayed, missing, or filled primary teeth (dmft) among 3-year-old children were included as covariates. The Callaway and Sant'Anna Difference-in-Differences (CSDID) method was applied to estimate the average treatment effects on the treated (ATT) for the FMR and FA groups under a conditional parallel trends assumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 39 prefectures were analyzed. The pre\u2013post increase in S-FMR participation was greater in the FMR group than in the FA or NF groups, with comparable differences (FMR: 12%; FA and NF: 5% each). In the CSDID analysis, both the FMR and FA groups showed a significant increase in S-FMR participation compared with the NF group, with a larger effect in the FMR group [FMR: 8% (95% CI: 2%\u201315%); FA: 5% (95% CI: 0%\u20139%)]. The event-study estimates indicated that the effects strengthened over time, particularly in the FMR group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prefectural dental health ordinances explicitly refer to fluoride, particularly FMR, are associated with a greater dissemination of the proportion of children participating in S-FMR programs. These findings suggest that more specific and explicit policy language in dental health ordinances may enhance the dissemination of S-FMR programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/froh.2026.1780911","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T06:42:59Z","timestamp":1772433779000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of explicit fluoride-related language in prefectural dental health ordinance on fluoride mouth-rinse programs dissemination in Japan: a quasi-experimental study"],"prefix":"10.3389","volume":"7","author":[{"given":"Manami","family":"Hoshi-Harada","sequence":"first","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry","place":["Miyagi, 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