238076 Fluoridation in rural-urban settings in the United States

Monday, October 31, 2011: 1:05 PM

R. Constance Wiener, DMD , Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV
Michael Hendryx, PhD , West Virginia Rural Health Research Center, West Virginia University, Morgantown, WV
A significant reduction in caries is attributed to water fluoridation. Many community water sources actively maintain a fluoride level at 1 ppm to reduce the prevalence of caries. Untreated domestic wells and springs, and public non-fluoridated water systems are more likely in rural areas. The purpose of this study was to determine if there is a difference between urban and rural counties in access of fluoridated water, and determine if inadequate fluoridation is associated with poorer adult dental health outcomes. We conducted a retrospective, cross-sectional study of U.S. counties utilizing the CDC's My Water's Fluoride database, 2006 Behavioral Risk Factor Surveillance System, and the U.S. Census Area Resource File. The percent of the population with fluoridated public drinking water was 67.17% (SD 33.29). In metropolitan areas it was 72.6% compared to 63.3% in nonmetropolitan areas (F=45.93, df=1, 3045, p<.001). The differences among metropolitan, micropolitan, and noncore areas were significant (F=30.41, df=2, 3044, p<.001). Differences among fluoridation rates across the 12 urban-influence codes were significant (F=9.06,df=11, 3035, p<.0001). In urban areas, greater levels of fluoridation were related to lower levels of adult tooth loss. In non-metropolitan or non-core areas, measures of adult tooth loss were not significantly related to fluoridation rates, after controlling for other risks. This outcome was unexpected and may result from data limitations, or the greater use of oral health precautions other than fluoridated water among non-metropolitan populations.

Learning Areas:
Public health or related research

Learning Objectives:
1. Identify the mean U.S. water fluoridation level. 2. Compare metropolitan water fluoridation levels with nonmetropolitan water fluoridation levels. 3. Describe the influence of water fluoridation on tooth loss in metropolitan, micropolitan and rural areas.

Keywords: Community Preventive Services, Water

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because of previous clinical and population research at West Virginia University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.