External Control of Fluoridation in the Public Water Supplies of Brazilian
Rosário et al. BMC Oral Health (2021) 21:410 https://doi.org/10.1186/s12903-021-01754-2 RESEARCH ARTICLE Open Access External control of fuoridation in the public water supplies of Brazilian cities as a strategy against caries: a systematic review and meta-analysis Bárbara Souza Martins Rosário1, Henrique Damian Rosário2, Walbert de Andrade Vieira3, Graziela Oro Cericato4, Diego Figueiredo Nóbrega5, Cauane Blumenberg6, Fernando Neves Hugo7, Márcio Magno Costa8 and Luiz Renato Paranhos9* Abstract Background: Among the methods currently available to provide fuoride in population levels, fuoridated water is the most successful for presenting high efcacy, safety and good cost–beneft. However, recent studies on external control have shown great variability of fuoride concentrations in the water from treatment stations in Brazilian cities, which must present concentration between 0.6 and 0.8 mg/L to be considered acceptable in most cities. Thus, this study aimed to perform a systematic review of the literature to assess the adequacy of fuoride concentration in the water in Brazilian cities using external control. Methods: The protocol was registered in PROSPERO. Six databases were used as primary search sources and three databases were used to partially capture the "gray literature". Only observational studies that assessed the fuoride concentration of artifcially fuoridated water from the public supply network were included. The JBI Critical Appraisal Tools for Systematic Reviews was used to assess the risk of bias of the studies. A proportion meta-analyses using random-efect models were performed. The heterogeneity between studies was determined by I2 statistic. Meta- regressions were conducted to identify relevant moderators to be used in stratifed meta-analyses.
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