Harding 2005.
| Methods |
FLUOROSIS STUDY Country of study: Ireland Geographic location: Cork city (F); Cork county (non‐F) Year of study: not stated Year of change in fluoridation status: NA Study design: cross‐sectional |
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| Participants | Inclusion criteria: age 5 years; location of the school attended and fluoridation status of water supply Exclusion criteria: absence on the day of examination; too apprehensive to participate or < 5 years; incorrectly received a form; incomplete form; existing medical condition Other sources of fluoride: fluoride prevalence of children with different nutritional and brushing habits were reported: breast‐fed = 30 (28%) vs not breast‐fed = 38 (21%); brushing before 12 months: F = 47 (22.6%) vs non‐F = 19 (22.1%); started brushing with toothpaste between 12 and 18 months: F = 79 (38%) vs non‐F = 25 (29.1%); started brushing with toothpaste between 19 and 24 months: F = 37 (17.8%) vs non‐F = 21 (24.4%); started brushing with toothpaste after 24 months: F = 41 (19.7%) vs non‐F = 18 (20.9%) Social class: schools were chosen to provide a socioeconomic spread; 7 urban and 10 rural schools Ethnicity: not stated Residential history: lifetime residents Other confounding factors: food sources of fluoride |
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| Interventions | Group 1: 0.8‐1 ppm (artificial fluoridation) Group 2: 'low' level ‐ ppm not stated (natural fluoridation) | |
| Outcomes | Dental fluorosis (TSIF) Age at assessment: 5 years |
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| Funding | Not stated | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Sampling | Low risk | A stratified sample for 5‐year olds was drawn from study areas on the basis of age, location, school attended and fluoridation status. Schools were chosen to provide a socioeconomic spread |
| Confounding | Low risk | SES range (by school) was sampled. There were similar levels of toothpaste use across the groups |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Insufficient information |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Of the 311 participants examined, outcome data were not presented for 17 participants due to partial fluoride history; unlikely to influence the results |
| Selective reporting (reporting bias) | High risk | Data not in suitable format for analysis |
| Other bias | High risk | Clinical examination was carried out by one examiner trained extensively by a gold standard but no report of calibration nor intra‐examiner reliability tests |