Journal of Public Health

, Volume 26, Issue 5, pp 501–507 | Cite as

Dental caries and dental fluorosis according to water fluoridation among 12-year-old Brazilian schoolchildren: a nation-wide study comparing different municipalities

  • Ramon Targino FirminoEmail author
  • André Xavier Bueno
  • Carolina Castro Martins
  • Fernanda Morais Ferreira
  • Ana Flávia Granville-Garcia
  • Saul Martins Paiva
Original Article



To test the correlation among dental caries, dental fluorosis, and the percentage of municipalities with optimal fluoridated water among Brazilian 12-year-old schoolchildren.

Subjects and methods

An ecological study was performed using primary data from the latest Brazilian Oral Health Survey. The units of analysis were the 26 states plus the Federal District of Brazil (n = 7328 schoolchildren). Dental caries was diagnosed according to the DMFT criteria and dental fluorosis according to Dean’s Index. Descriptive and analytical statistics (p < 0.05) were performed. Google My Maps® was used to display data by state.


Mean DMFT ranged from 1.06 to 4.81 between states, whereas the prevalence rates of dental caries and dental fluorosis ranged from 37.3 to 78.2% and from 0 to 45.8% between states, respectively. In Brazil, 60.25% of the municipalities have an optimal fluoridated water supply. The percentage of municipalities with an optimal fluoridated water supply in each state ranged from 0 to 97.4%. Dental fluorosis was negatively correlated with mean DMFT (r = − 0.645; p < 0.001) and with dental caries (r = − 0.678; p < 0.001). The percentage of municipalities with optimal fluoridated water was negatively correlated with dental caries (r = − 0.678; p < 0.001) and positively correlated with dental fluorosis (r = 0.668; p < 0.001).


Lower prevalence of dental caries was found with the increasing percentage of municipalities with optimal fluoridated water and with the increasing prevalence of dental fluorosis.


Dental caries Dental fluorosis Epidemiology Fluoridation Fluorides 



This study was supported by the Brazilian Ministry of Health, the Brazilian Coordination of Higher Education, Ministry of Education (CAPES), the Research Foundation of the State of Minas Gerais (FAPEMIG), and the National Council for Scientific and Technological Development (CNPQ), Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Paediatric Dentistry and Orthodontics, School of DentistryFederal University of Minas GeraisBelo HorizonteBrazil
  2. 2.Department of Dentistry, School of DentistryState University of ParaíbaCampina GrandeBrazil

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