Caries and fluorosis in 6‐ and 9‐year‐old children residing in three communities in Iran

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Abstract
Abstract –  Objectives:  The aim of this study was to investigate the caries and fluorosis prevalence among 6‐ and 9‐year‐old students in three communities in Iran with varying urbanization and fluoride in piped water.Methods:  Data were obtained from 523 dental examinations of 6‐ and 9‐year olds in an upper middle class district in Teheran (T) (0.3 mg F/l), the city of Semnan (S) (1.3 mg F/l), and the village Dibaj (D) (0.2 mg F/l).Results:  Children in the naturally fluoridated town showed slightly higher dmfs/dfs (SD) values for both 6‐year olds [S: 9.1 (9.2), T: 7.2 (7.4), D: 7.1 (6.1)] and 9‐year olds [S: 6.0 (6.2), T: 4.4 (4.2), D: 5.0 (4.7)], whereas the mean dmft/dft values as well as the numbers of caries‐free children were comparable. A lower prevalence of dental restorations was reported for both Semnan and Dibaj compared with Teheran. A higher prevalence of fluorosis [Tooth Surface Index of Dental Fluorosis (TSIF) 3–7] was observed in the naturally fluoridated town compared with the low‐fluoridated communities.Conclusions:  The ingestion of naturally fluoridated water (1.3 mg F/l) seemed to have a negligible effect on caries prevalence, but resulted in higher prevalence of dental fluorosis. It is emphasized that the study population was not adjusted for socioeconomic status, availability of dental care nor for exposures to other sources of fluoride. Nevertheless, it can be concluded that caries prevalence in Iran is quite low compared with that in other countries in the Middle East and that the elevated fluoride levels in the drinking water in Semnan may contribute to the development of mild to severe fluorosis.