The effect of fluoridation and social class on caries experience in 5-year-old Newcastle children in 1994 compared with results over the previous 18 years.

In 1994, the dental health of 327 5-year-old children who had lived in continuously fluoridated (at 1.0 mg/IF-) Newcastle was compared with the dental health of 335 children of the same age in non-fluoridated (less than 0.1 mg/IF-) south east Northumberland. The caries prevalance in social class groups I + II, III, IV + V children was compared both within and between the two areas. The prevalence of dental caries in the three social groupings I + II, III, and IV + V (and the mean dmft) respectively, was 23 percent (0.59), 39 percent (1.21) and 31 percent (1.17) in the fluoridated area, and 38 percent (1.46), 47 percent (2.04) and 62 percent (2.74) in the non-fluoridated area. Differences between the fluoridated and non-fluoridated areas were observed in all social class groupings but the greatest difference in the percentage of children with decay experience occurred in social groups IV + V. There has been a fall in caries experience in all social groups in both the fluoridated and non-fluoridated areas since a previous survey in 1987. However, this reduction was not enough to obviate the disadvantage of social background. Reduction in caries experience especially amongst social classes I and II has meant that the power of water fluoridation to reduce caries experience has diminished. Refinement of the instruments for classifying socio-economic position has the potential to demonstrate greater degrees of inequality than the crude measures such as occupational class as used in this study.