The relationship between water fluoridation and socioeconomic deprivation on tooth decay in 5-year-old children

Aim: To examine the relationship between water fluoridation, socioeconomic deprivation and tooth decay in 5-year-olds. Setting: 10,004 children: 1,051 in naturally fluoridated Hartlepool in 1991/92, 3,816 in fluoridated Newcastle & North Tyneside and 5,137 in non-fluoridated Salford & Trafford in 1993/94. Outcome measures: Correlations between mean electoral ward dmft and ward Townsend Scores from the 1991 census. Results: Regardless of the level of water fluoridation significant correlations were found between deprivation and tooth decay. Multiple linear regression models for dmft showed a statistically significant interaction between ward Townsend score, and both types of water fluoridation, confirming the more deprived the area the greater the reduction in tooth decay. At a Townsend score of zero (the English average) there was a predicted 43% reduction in decay in 5-year-olds in fluoridated areas. Conclusions: Tooth decay is strongly associated with social deprivation. The findings confirm that the implementation of water fluoridation has halved tooth decay in 5-year-old children and that the dental caries divide between rich and poor is reduced. © British Dental Journal 1999.