1. FLUORIDATED COMMUNITY WATER KNOWLEDGE AND OPINION AMONG PARENTS IN SOUTHWEST FLORIDA Courtney Uselton, DDS ; Maria E. Davila, DDS, MPH, DrPH; Scott L. Tomar, DMD, MPH, DrPH Department of Community Dentistry and Behavioral Science. College of Dentistry, University of Florida, Naples, Florida
Introduction
Results
Purpose Of Adding Fluoride to Community Drinking Water, By Race/Ethnicity
Community water fluoridation (CWF) is safe and effective approach to prevent dental caries, reducing incidence by approximately 25% in both children and adults (1).
First introduced in 1945, CWF remains effective public health measure even with the availability of other sources of fluoride (2)
CWF currently reaches 74.6% of U.S. residents (3, 4). By 2020, an estimated 79.6% of US population on public water systems will receive CWF.
In Florida, 78.0% of population receives fluoridated drinking water.
Estimated 2014 population of Collier County, in southwest Florida was 348,777. About 5% were children < 5 years old. Population primarily white or Hispanic (5).
CWF reaches 78.5% of Collier County population (6).
In the last 30 years, the oral health of the United States has improved, but substantial disparities remain. Approximately 37% of the children have experienced dental caries in the primary dentition and 21.3% in the permanent dentition (7).
Recent conversations with parents of the children who visit our Naples clinic suggest that families do not drink fluoridated community water, which led us to question the reasons for that behavior.
Selected characteristics of the study participants (n=246)
Characteristics
Number
Percentage
Age of parent (y)
<=25
26–32
33–39
40+ 31 87 67 61
12.6
35.4
27.2
24.8
Mean = (±7.81)
Age of child
<=5
6–9
10–13
103
104 39
41.9
42.3
15.9
Mean = 6.41 (±2.78)
Sex
Male
Female
112
134
45.5
54.5
Race/ethnicity
White
Hispanic/Latino
Other
190 25
77.2
10.2
Level of education of parent
Less than high school
High school
More than high school
105 73 68
42.7
29.7
27.6
Caries experience in child’s primary dentition
Yes No
198 48
80.5
19.5
Mean dft = 4.98 (±4.29)
Caries experience in child’s permanent dentition 81
165
32.9
67.1
Mean DFT = 0.83 (±1.45)
Knowledge of Parents Regarding Drinking Water
Table 1. Selected characteristics of the study participants (n=246)
Objectives
Conclusions
General:
To determine the knowledge and opinions of parents in Collier County, Florida regarding community water fluoridation (CWF)
Specific:
To determine the knowledge regarding the purpose of adding fluoride to drinking water, by age, race/ethnicity
To determine the opinion of parents regarding CWF, by race/ethnicity
Participants’ inadequate fluoride exposure from drinking water may be partly responsible for the high prevalence of dental caries in this community
Significant difference in knowledge of CWF by race/ethnicity
Need education of families in Collier County about the benefits of CFW
Need CWF educational campaign to increase awareness of its benefits in Southwest Florida
Need to promote benefits of drinking tap water.
Methods
Participants’ knowledge of Community Water Fluoridation, by Race/Ethnicity
Race/Ethnicity
Question
What is the purpose of adding fluoride to drinking water? (n=238)
To prevent tooth decay
Number Percent
Other response
Number Percent
Do not know
Hispanic/Latino
White
Other/unknown
x2=20.20;
p=0.005
Should fluoride be added to the drinking water? (n=241)
Yes No
Number Percent
3 1.22
x2=16.35;
p=0.0026
References
Developed a 32-item structured self-completed survey instrument to assess parents’ knowledge and opinion on a variety of oral health topics, including fluoridation of drinking water. The instrument included items that have used in prior studies as well as newly created questions. English and Spanish versions of the survey instrument were created, both of which were pretested.
We sought to recruit parents of all children who attended dental clinic for an initial patient visit or six- month recall between November 2014 and February The study was described to parents and they were asked to provide written informed consent for participation. Any questions participants had about the questionnaire were addressed by the investigators. Those parents who did not know how to read nor write were interviewed by one of the bilingual investigators.
dft index (decay or filled primary teeth) and DFT index (decay or filled permanent teeth) were determined by one of the previously calibrated investigators, using a dental chair with artificial light, explorer, and mirror.
Data analysis was conducted by using IBM SPSS version 21 statistical software package (IBM Corp, Armonk, NY). We conducted descriptive and bivariate analyses, and used the chi-square test to test the bivariate association between categorical variables.
1. Centers for Disease Control and Prevention. Community Water Fluoridation. [On line] Available at:
2. U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the 2. Prevention of Dental Caries. Public Health Reports. 2015; 30:1-13. Available at:
3. Centers for Disease Control and Prevention, Community Water Fluoridation Fluoride statistics. [On line] Available in:
4. Center for Disease Control and Prevention, Division of Oral Health. My Water’s Fluoride. [On line] Available at:
5. States and counties facts. Collier County, Florida. [On line] Available at:
6. Percent of population served with fluoridated drinking water by County (2012). [On line]. Available at:
7. Dye B, Thornton-Evans G, Li X, Iafolla T. Dental caries and sealant prevalence in children and adolescents in the United States, 2011– NCHS data brief, no 191. Centers for Disease Control and Prevention, National Center for Health Statistics; [On line] Available at:
Supported by grant from Naples Children and Education Foundation