Blog

Patrice James, a Clinical Research Support Officer at University College Cork, talks about her study protocol on fluoride and oral health. In this guest blog, Patrice talks about evaluating the impact of policy changes regarding water fluoridation in Ireland on children’s teeth and the benefits of open peer review.

Community water fluoridation in Ireland

The Republic of Ireland (RoI) is one of several countries with community water fluoridation programmes where the level of fluoride in water was adjusted downwards in response to a trend of decreasing prevalence of dental caries (tooth decay), increasing prevalence of dental fluorosis (white lines or marks on teeth caused by excess fluoride ingestion when teeth are forming) and the availability of fluoride from other sources such as fluoride toothpaste.

Approximately three-quarters of the population of RoI receive fluoridated water supplies. In 2007, the level of fluoride in water was adjusted downwards from 0.8-1.0 mg/l fluoride to the current level of 0.6-0.8 mg/l fluoride. In 2002, recommendations were issued to the public regarding the use of fluoride toothpaste in young children.

Our main focus in the Fluoride And Caring for Children’s Teeth (FACCT) study is to find out the impact of these policy changes on dental caries and dental fluorosis levels in Irish children.

Importance of FACCT

Dental caries (tooth decay) is the most common chronic disease of childhood. In the national study of children’s oral health in RoI 2002, more than half of 5-year-olds living in areas without water fluoridation and approximately one-third in areas with water fluoridation were found to have experienced dental caries.

Therefore, it is crucial that the effectiveness of the policy of community water fluoridation for preventing dental caries in Ireland is regularly monitored and evaluated. The findings of this study will contribute to oral health policy development in RoI, and therefore will be important for the health and wellbeing of all children living in RoI. The findings may also contribute to policy decisions around the use of fluorides for dental caries prevention in other countries.

The benefits of open peer review

We wanted to comprehensively report our study protocol, to facilitate critical review of our methods and to share our methods with other research groups undertaking similar research. We considered the restrictions on the word count permitted by traditional peer-reviewed journals as a significant barrier to comprehensively describing the methods in our study protocol. In addition, there is a lack of traditional peer-reviewed journals that accept study protocols for publication.

The launch of HRB Open Research provided us with the opportunity to publish our clinical fieldwork protocol comprehensively and within a short time frame. The opportunity to upload supporting documents such as our parent questionnaires and clinical fieldwork manuals, which we believe can be invaluable tools for other researchers was also of great value.

The peer review process was refreshingly transparent. The peer reviewers’ comments were constructive and timely and contributed to our analysis plan for the study data. The process was very efficient and with open access, we were immediately able to share our study protocol with our wide network of stakeholders who have each contributed within their own area of expertise to the design of the study.