ArticleBrazilian oral research2024
Municipality-level characteristics associated with very good quality water fluoridation in Brazil in 2018.
Article in Brazilian oral research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Water fluoridation, functional dentition and tooth loss in Brazilian adults: a multilevel analysis of SB Brasil 2023.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2026Article
- Surveillance of public water supply fluoridation from the perspective of municipal health department technicians: a cross-sectional study, Goiás, 2022-2023.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2026Article
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Authors and funding
3 authors.
Funding
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Abstract
The aim of this study was to analyze factors associated with the quality of fluoridation in water supply systems in Brazil in 2018. An ecological study was conducted using official data sources on fluoridation provision and fluoride concentration surveillance in 2018. Inclusion criteria were municipalities with a water supply system and accurate data. Municipalities meeting the quality standard, defined as having 80% or more of water samples within the optimal level for caries prevention were classified as "very good" fluoridation quality. Independent variables encompassed structural aspects, socioeconomic factors, and indicators of managerial and technical capabilities in water surveillance. Prevalence ratios were estimated using Poisson regression with robust variance. A total of 58.9% of municipalities with water supply systems had fluoride-adjusted water, with 65.3% adequately contributing to the surveillance data system. Among these, 42.2% exhibited "very good" fluoridation quality. Quality was higher in larger municipalities with elevated socioeconomic indexes and per capita expenditure on sanitary surveillance above the median. Additionally, municipalities with a conformity rate of free residual chlorine concentration of 75% or higher had better fluoridation quality. After adjusting for all variables, fluoridation quality was lower in municipalities with above-median per capita gross domestic product, higher socioeconomic inequality, and below-median monthly household per capita income. Fluoridation quality was linked to municipality-level characteristics concerning structural aspects, socioeconomic factors, and managerial and technical factors in water surveillance. The information generated regarding the coverage features of surveillance and fluoridation strategies can be highly valuable for redirecting inter-sectoral public policy management.
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