Objectives: To assess the effects of an 11-month break in water fluoridation on fluorosis prevalence. Methods: The interruption to water fluoridation in Durham, NC, occurred between Sept. 1990 and Aug. 1991. A total of 1896 children were examined between Jan. 1996 and Feb. 2001. The children were 7-10 years old (mean=8.8) at the time of examination and were born between March 1985 and March 1992. Parents or guardians completed a questionnaire on demographics and fluoride history. Cohorts, defined by their age at the time of the break, ranged from those born 5 years beforehand (cohort 5), to those born 1 year after (cohort -1). Fluorosis was defined as a TF score of 1 or higher in at least one of the maxillary incisors. Results: Fluorosis prevalence for cohorts 5, 4, 3, 2, 1, 0, and -1 was 57.1, 62.3, 33.0, 32.3, 39.8, 30.2, and 36.8%, respectively. Logistic regression analysis showed that fluorosis prevalence in cohorts 4 and 5 was significantly higher than prevalence in the other cohorts. Toothbrushing twice or more per day and use of fluoride supplements were also significantly associated with fluorosis, though race, educational level, gender, and use of fluoride rinses, fluoride gels, and bottled water were not. Conclusions: Toothbrushing frequency, fluoride supplement use, and cohort effects were significantly associated with fluorosis. The 11-month non-exposure to fluoridated water seemed to reduce fluorosis in children aged from birth 3 years at the break, and in those born 1 year after it, when compared to those aged 4-5 years at the break. Supported by NIDCR grant DE-11240.

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