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Research Letter
January 28, 2019

Association Between Water Fluoridation and Income-Related Dental Caries of US Children and Adolescents

Author Affiliations
  • 1Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill
  • 2US Census Bureau, Durham, North Carolina
  • 3Dental Public Health Consultant, North Bethesda, Maryland
  • 4Odum Institute for Research in Social Science, Department of Political Science, University of North Carolina at Chapel Hill
JAMA Pediatr. 2019;173(3):288-290. doi:10.1001/jamapediatrics.2018.5086

By age 11 years, an American child living in poverty has twice the level of dental caries (tooth decay) as one living at 3 times the poverty threshold.1 To achieve the Healthy People 2020 overarching goal of health equity, interventions must preferentially prevent disease at the lower end of the income distribution. Research conducted in Canada2 suggests that water fluoridation might reduce inequality, but that possibility has not been investigated in the United States. We used 2 nationally representative data sets to investigate whether water fluoridation attenuated income-related inequality in dental caries among US children and adolescents.