NHS dental activity: a population marker for the effectiveness of community water fluoridation in children in England.

Aim To understand the possible beneficiary effects of artificial and naturally occurring water fluoridation on dental health of children, using routinely collected NHS Dental Statistics.Method A secondary analysis of the NHS Dental Statistics for England 2018-2019 dataset. The proportion of Band 1 courses of treatments are compared with Band 2, Band 3 and urgent treatments collectively, for children attending dental practices in naturally and artificially fluoridated local authorities compared with non-fluoridated authorities who are their statistical peers. Proportions of dental treatments are described by the levels of Index of Multiple Deprivation for the area in which the practice is located.Results The dataset had, 2,001,921 banded paediatric courses of treatment; 1,227,282 provided by dental practices in fluoridated local authorities and 774,639 in non-fluoridated local authorities. Water fluoridation was associated with a significant reduction in dental interventions in the most deprived populations. The proportions of active interventional treatments in the 10% most deprived decile (decile 1) are 0.243 (Cl 0.239-0.247) and 0.188 (Cl 0.184-0.191), in non-fluoridated and fluoridated local authorities, respectively.Conclusion Analysis of routinely collected NHS dental statistics shows potential utility as a tool for demonstrating the effects of community water fluoridation schemes in reducing oral health inequalities among the most deprived socioeconomic populations. The pattern of dental need and intervention is not as expected and therefore, further research is required to control for systematic confounding factors.