Kunzel 1997.
| Methods |
CARIES STUDY Country of study: Germany Geographic location: Chemnitz (F); Plauen (non‐F) Year study started: 1959 Year study ended: 1971 Year of change in fluoridation status: 1959 Study design: CBA |
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| Participants | Inclusion criteria: children born in study areas Exclusion criteria: children who had moved into the 2 study areas; disabled children Other sources of fluoride: number of topical applications of fluoride toothpastes; solutions and gel was low ‐ water fluoridation was the only preventive measure Social class: not stated Ethnicity: not stated Residential history: lifetime residents Other confounding factors: increasing annual sugar consumption in both areas |
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| Interventions |
Initiation of water fluoridation Group 1 baseline: 0.2 ppm (natural fluoridation) Group 1 post intervention: 1 ppm (artificial fluoridation) Group 2: 0.2 ppm (natural fluoridation) |
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| Outcomes | dmft, DMFT, % caries free (deciduous dentition), % caries free (permanent dentition) Age at baseline measure: 6‐15 years Age at final measure: 6‐15 years |
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| Funding | Supported by the German Federal Ministry of Education, Science, Research and Technology, grant 01 ZZ 9502 | |
| Notes | Data extracted from Kunzel 1997 differs from that presented in CRD review (additional data extracted) Study presents data on both initiation and cessation of water fluoridation, but cessation data excluded from this review due to unsuitable control group |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Sampling | Unclear risk | Sampling details had previously been published (Kunzel 1980), however, the exclusion of disabled children as stated in this study, puts the representativeness of the sample in doubt |
| Confounding | High risk | Did not account for SES |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Insufficient information |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Data appear to be presented for all participants |
| Selective reporting (reporting bias) | Low risk | Standard deviation was not reported |
| Other bias | Low risk | No other biases apparent |