Saravanan 2008.
| Methods |
FLUOROSIS STUDY Country of study: India Geographic location: Tamil Nadu Year of study: not stated Year of change of fluoridation status: NA Study design: cross‐sectional |
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| Participants | Inclusion criteria: the coverage of children was confined only to primary schools as each village had a primary school and 99% of the children of primary school age group in the study area were attending schools Exclusion criteria: high school children were not included as only 85% of the children of high school age group (11‐16 years) in the study area were attending schools Other sources of fluoride: not stated Ethnicity: not stated Social class: the majority of people in the study setting were of lower socioeconomic class Residential history: lifetime residents Other confounding factors: not stated |
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| Interventions | All natural fluoridation Group 1: < 0.1 ppm Group 2: < 0.1 ppm Group 3: 0.25 ppm Group 4: 0.56 ppm Group 5: 0.66 ppm Group 6: 0.67 ppm | |
| Outcomes | Dental fluorosis (Dean's Index) Age at assessment: 5‐10 years |
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| Funding | Not stated | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Sampling | Low risk | All eligible children were invited to participate |
| Confounding | High risk | No details were reported on the use of fluoride from other sources |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Insufficient information |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Around 1.1% of the school children were eventually excluded because of absenteeism. It is not clear which fluoride areas they belonged to, however, these participants are unlikely to have been systematically different from those that completed the study |
| Selective reporting (reporting bias) | Low risk | Outcome of interest reported |
| Other bias | Unclear risk | High school children were not included as only 85% of the children of high school age group (11‐16 years) in the study area were attending schools; examiners were calibrated and intra‐and inter‐examiner reliability assessed, however, Kappa scores not reported |