C Albert Yeung1. 1. Department of Public Health, NHS Lanarkshire, Hamilton, Scotland, UK.
Abstract
DATA SOURCES: Biomed Central, Cochrane Oral Health Group Trials Register, CENTRAL, Directory of Open Access Journals, Expanded Academic ASAP Plus, Metaregister of Controlled Trials, PubMed, ScienceDirect, Research Findings Electronic Register, BBO and LILACS. STUDY SELECTION: Studies reporting in English, Spanish or Portuguese were included if they reported on the caries preventive effect of salt fluoridation and provided mean DMFT scores with standard deviations or 95% confidence intervals. Randomised or quasi-randomised studies together with cross-sectional studies where historical control data were available for relevant cohorts were included. Studies were assessed for quality. DATA EXTRACTION AND SYNTHESIS: Data were extracted independently by two reviewers, with disagreements being resolved by discussion. Nine studies were included in a meta-analysis. RESULTS: Two studies included 6-8 year-old children and showed a pooled reduction in DMFT scores of -0.98 (95%CI -1.68 to -0.29). The eight studies involving 9-12 year-old children showed a significant pooled DMFT reduction of -2.13 (95%CI -2.55 to -1.70, p<0.0001), while the four studies with cohorts of 13-15 year-old children exhibited a great reduction in DMFT scores of -4.22 (95%CI -6.84 to -1.59, p<0.001). In one study that compared salt fluoridation with water fluoridation there was no statistical difference between the two groups. CONCLUSIONS: The pooled estimates for each of the age cohort favoured salt fluoridation versus no exposure. However, due to the poor quality of the studies the contribution of fluoridated salt to the declines in DMFT could not be quantified. Thus, while this meta-analysis favours salt fluoridation, further high quality studies are needed to confirm its efficacy.
DATA SOURCES: Biomed Central, Cochrane Oral Health Group Trials Register, CENTRAL, Directory of Open Access Journals, Expanded Academic ASAP Plus, Metaregister of Controlled Trials, PubMed, ScienceDirect, Research Findings Electronic Register, BBO and LILACS. STUDY SELECTION: Studies reporting in English, Spanish or Portuguese were included if they reported on the caries preventive effect of salt fluoridation and provided mean DMFT scores with standard deviations or 95% confidence intervals. Randomised or quasi-randomised studies together with cross-sectional studies where historical control data were available for relevant cohorts were included. Studies were assessed for quality. DATA EXTRACTION AND SYNTHESIS: Data were extracted independently by two reviewers, with disagreements being resolved by discussion. Nine studies were included in a meta-analysis. RESULTS: Two studies included 6-8 year-old children and showed a pooled reduction in DMFT scores of -0.98 (95%CI -1.68 to -0.29). The eight studies involving 9-12 year-old children showed a significant pooled DMFT reduction of -2.13 (95%CI -2.55 to -1.70, p<0.0001), while the four studies with cohorts of 13-15 year-old children exhibited a great reduction in DMFT scores of -4.22 (95%CI -6.84 to -1.59, p<0.001). In one study that compared salt fluoridation with water fluoridation there was no statistical difference between the two groups. CONCLUSIONS: The pooled estimates for each of the age cohort favoured salt fluoridation versus no exposure. However, due to the poor quality of the studies the contribution of fluoridated salt to the declines in DMFT could not be quantified. Thus, while this meta-analysis favours salt fluoridation, further high quality studies are needed to confirm its efficacy.