Non-Cochrane · prevalence · PM34412623
External control of fluoridation in the public water supplies of Brazilian cities as a strategy against caries: a systematic review and meta-analysis.
Rosário Bárbara Souza Martins, Rosário Henrique Damian, de Andrade Vieira Walbert, et al. · BMC oral health · 2021 · PubMed · doi:10.1186/s12903-021-01754-2
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
15
current version
GRADE rated
0
No studies
0
Included studies
20
linked below
No studies 0 · 0%Ungraded 15 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Artificially fluoridated public water supply of Brazilian cities (water samples under external control) | 42 cities across three Brazilian regions (Northeast, Southeast, South); 449 collection sites; samples collected 1995-2013 (n=14 studies) |
| Intervention | Artificial water fluoridation; fluoride concentration measured by the electrometric (ion-selective electrode) method | Artificial fluoridation; mean fluoride concentration 0.17-0.89 ppmF; acceptable range mostly 0.6-0.8 ppmF |
| Comparison | None (proportion/prevalence review; no comparator) | None |
| Outcomes | Frequency (prevalence) of water samples with fluoride levels outside the acceptable range (primary); also exclusively below and above the acceptable range | Pooled prevalence outside acceptable range 56.6% (95% CI 45.5-67.3), I2=99.5% (n=12 studies in quantitative synthesis) |
| Study designs | Cross-sectional (observational) studies analyzing at least one water sample per month for 12 months using the electrometric method; no restriction of year or language | 14 cross-sectional studies included (12 in meta-analysis; 2 excluded from quantitative synthesis because results were reported by collection sites, not samples) |
| Timing | Not specified (no year restriction) | External control length 1-10 years; samples collected 1995-2013 |
Search date: Until 10 August 2020. Databases: Embase; LILACS; MedLine (via PubMed); SciELO; Scopus; Web of Science (primary sources); OpenThesis; OpenGrey; OATD (gray literature); manual search of reference lists
Questions and results
Fluoride concentration relative to the acceptable range (electrometric ion-selective electrode measurement; acceptable range mostly 0.6-0.8 ppmF) vs None (descriptive proportion meta-analysis)
Population: Artificially fluoridated public water supply in Brazilian cities (water samples under external control)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Water samples with fluoride concentration outside the acceptable range In Brazilian cities using external control, more than half of artificially fluoridated public water supply samples (pooled 56.6%, 95% CI 45.5 to 67.3) had fluoride concentrations outside the acceptable range, with very high heterogeneity (I2=99.5%); ungraded. Source: Abstract; Results (Meta-regression and analyses) para; Fig. 2 · same question in other reviews | Prevalence 56.6 [45.5, 67.3] | 12 studies | Ungraded |
Water samples with fluoride concentration below the acceptable range Region: Northeast Brazil In the Northeast Brazilian region, a pooled 79.7% of water samples had fluoride below the acceptable range; ungraded. Source: Results (Meta-regression and analyses); Fig. 3B · same question in other reviews | Prevalence 79.7 | NR | Ungraded |
Samples with fluoride concentration outside the acceptable range 1995-2013 · Sensitivity analysis excluding Silva et al. Population: Brazilian cities with artificially fluoridated public water supplies After excluding Silva et al., the pooled prevalence outside the acceptable range was 47.1%. Source: Meta-regression and analyses · same question in other reviews | Prevalence 47.1 [39.6, 54.7] | 11 studies | Ungraded |
Water samples with fluoride concentration above the acceptable range Region: Southeast Brazil In the Southeast Brazilian region, a pooled 11.5% of water samples had fluoride above the acceptable range; ungraded. Source: Results (Meta-regression and analyses) · same question in other reviews | Prevalence 11.5 | NR | Ungraded |
Water samples with fluoride concentration outside the acceptable range Region: Southeast Brazil In the Southeast Brazilian region, a pooled 42.4% (95% CI 30.9 to 54.4) of water samples had fluoride outside the acceptable range; ungraded. Source: Results (Meta-regression and analyses) · same question in other reviews | Prevalence 42.4 [30.9, 54.4] | NR | Ungraded |
Water samples with fluoride concentration above the acceptable range Region: Northeast Brazil In the Northeast Brazilian region, a pooled 0.2% of water samples had fluoride above the acceptable range; ungraded. Source: Results (Meta-regression and analyses); Fig. 3C · same question in other reviews | Prevalence 0.2 | NR | Ungraded |
Water samples with fluoride concentration outside the acceptable range Region: Northeast Brazil In the Northeast Brazilian region, a pooled 81.1% (95% CI 65.3 to 92.9) of water samples had fluoride outside the acceptable range; ungraded. Source: Results (Meta-regression and analyses); Fig. 3A · same question in other reviews | Prevalence 81.1 [65.3, 92.9] | NR | Ungraded |
Water samples with fluoride concentration below the acceptable range Region: Southeast Brazil In the Southeast Brazilian region, a pooled 24.6% of water samples had fluoride below the acceptable range; ungraded. Source: Results (Meta-regression and analyses) · same question in other reviews | Prevalence 24.6 | NR | Ungraded |
External control of fluoride concentration vs Not applicable
Population: Brazilian cities in the Northeast region with artificially fluoridated public water supplies
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Samples with fluoride concentration above the acceptable range 1995-2013 · Northeast region In the Northeast region, 0.2% of samples were above the acceptable range. Source: Meta-regression and analyses; Fig. 3C · same question in other reviews | Prevalence 0.2 | NR | Ungraded |
External control of fluoride concentration vs Not applicable
Population: Brazilian cities in the Southeast region with artificially fluoridated public water supplies
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Samples with fluoride concentration below the acceptable range 1995-2013 · Southeast region In the Southeast region, 24.6% of samples were below the acceptable range. Source: Meta-regression and analyses; Fig. 3B · same question in other reviews | Prevalence 24.6 | NR | Ungraded |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Water samples with fluoride concentration below the acceptable range Region: South Brazil | Prevalence 32.4 [7.1, 65.3] | NR | Ungraded |
Water samples with fluoride concentration above the acceptable range Region: South Brazil | Prevalence 12.7 [0.5, 36.6] | NR | Ungraded |
Water samples with fluoride concentration outside the acceptable range Region: South Brazil | Prevalence 50.7 [40.7, 60.6] | NR | Ungraded |
Water samples with fluoride concentration above the acceptable range | Prevalence 6.7 | 12 studies | Ungraded |
Water samples with fluoride concentration below the acceptable range | Prevalence 45.0 [26.1, 64.7] | 12 studies | Ungraded |
Included primary studies 20
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Amaral 2007 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Assaf 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Bergamo (2015) Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis. PMID:25760066 | this review only | not stated | not extracted yet | not extracted yet |
| Bergamo 2015 Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis DOI:10.1590/1807-3107bor-2015.vol29.0047 | this review only | not stated | not extracted yet | not extracted yet |
| Brito 2016 Vigilância da concentração de flúor nas águas de abastecimento público na cidade de Passo Fundo - RS DOI:10.1590/1414-462x201600040240 | this review only | not stated | not extracted yet | not extracted yet |
| Kuhnen 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Lima (2004) [Twenty-four months of external control of fluoride levels in the public water supply in Pelotas, Rio Grande do Sul, Brazil]. PMID:15073621 | this review only | not stated | not extracted yet | not extracted yet |
| Lima 2004 Vinte e quatro meses de heterocontrole da fluoretação das águas de abastecimento público de Pelotas, Rio Grande do Sul, Brasil DOI:10.1590/s0102-311x2004000200009 | this review only | not stated | not extracted yet | not extracted yet |
| Maia (2003) [Operational control of water fluoridation in Niterói, Rio de Janeiro, Brazil]. PMID:12700784 | this review only | not stated | not extracted yet | not extracted yet |
| Maia 2003 Controle operacional da fluoretação da água de Niterói, Rio de Janeiro, Brasil DOI:10.1590/s0102-311x2003000100007 | this review only | not stated | not extracted yet | not extracted yet |
| Moimaz (2012) External control of the public water supply in 29 Brazilian cities. PMID:22344332 | this review only | not stated | not extracted yet | not extracted yet |
| Moimaz 2012 External control of the public water supply in 29 Brazilian cities DOI:10.1590/s1806-83242012000100003 | this review only | not stated | not extracted yet | not extracted yet |
| Moura 2005 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Panizzi (2008) [Ten years of external control over water fluoridation in Chapecó, Santa Catarina State, Brazil]. PMID:18813678 | this review only | not stated | not extracted yet | not extracted yet |
| Panizzi 2008 Dez anos de heterocontrole da fluoretação de águas em Chapecó, Estado de Santa Catarina, Brasil DOI:10.1590/s0102-311x2008000900008 | this review only | not stated | not extracted yet | not extracted yet |
| Peixoto 2012 Heterocontrole da fluoretação da água de abastecimento público do município de Jaguaribara, Ceará, Brasil DOI:10.5020/18061230.2012.p271 | this review only | not stated | not extracted yet | not extracted yet |
| Piva 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Saliba 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Silva (2007) [Monitoring water fluoridation in three cities in Piauí State, Brazil]. PMID:17486231 | this review only | not stated | not extracted yet | not extracted yet |
| Silva 2007 Heterocontrole da fluoretação das águas em três cidades no Piauí, Brasil DOI:10.1590/s0102-311x2007000500010 | this review only | not stated | not extracted yet | not extracted yet |