Association between Drinking Water Source and Dental Caries Experience among Young Children
DOI:
https://doi.org/10.54361/LJMR.20.2.54Keywords:
Early childhood caries, Bottled water, Bap water, FluorideAbstract
Background: Early childhood caries remains a major public health concern influenced by multiple behavioral and environmental factors, particularly fluoride exposure through drinking water. This study investigated the association between primary drinking water source and dental caries experience among young children in Al-Zawia, Libya. Methods: A cross-sectional study was conducted among 136 children aged 3–13 years. Dental caries experience was assessed using the deft index for primary dentition and the DMFT index for permanent teeth. Participants were divided into two groups according to their primary drinking water source: the study group (children consuming municipal tap water) and the control group (children consuming bottled water). Fluoride exposure was estimated based on the reported water source. Statistical analysis included independent-samples t-tests and non-parametric tests where appropriate, with statistical significance set at p < 0.05. Results: The mean caries experience score was significantly higher among bottled water consumers (3.29 ± 2.89) compared to tap water consumers (2.00 ± 2.67). The difference was statistically significant (t = −2.18, p = 0.032). A substantial proportion of children (70.2%) exhibited caries experience greater than zero. Increasing caries severity was observed with age, particularly among children aged 5–6 years. Bottled water samples showed low fluoride concentrations (0.06–0.30 ppm), below levels considered optimal for caries prevention. Conclusion: A significant association was identified between drinking water source and dental caries experience in young children. Consumption of bottled water was associated with higher caries burden, likely due to reduced fluoride exposure compared with municipal tap water. These findings highlight the importance of adequate fluoride exposure in early childhood and support public health strategies promoting optimal fluoride intake to reduce caries risk.
Downloads
References
1. Lydia N, Imran M, Atique S, Bahammam HA, Moothedath M, Habibullah MA, et al. Global policy approaches to combat early childhood caries: a scoping review with evidence map. Front Oral Health. 2025 Oct 31;6. doi:10.3389/froh.2025.1664019
2. Phantumvanit P, Makino Y, Ogawa H, Rugg‐Gunn A, Moynihan P, Petersen PE, et al. WHO Global Consultation on Public Health Intervention against Early Childhood Caries. Community Dent Oral Epidemiol. 2018 Jun;46(3):280–7. doi:10.1111/cdoe.12362
3. Creeth J, Smith G, Franks B, Hara A, Zero D. Remineralisation of enamel erosive lesions by daily-use fluoride treatments: network meta-analysis of an in situ study set. Clin Oral Investig. 2024 Dec 26;29(1):28. doi:10.1007/s00784-024-06107-1
4. Al-Qashouti H, Al-Ansari H, Al-Moadhadi A, Al-Neama R, Philip N, Nazzal H. Children’s drinking water sources in the state of Qatar: parental preferences and knowledge of its fluoride content. Eur Arch Paediatr Dent. 2025 Nov 6. doi:10.1007/s40368-025-01136-0
5. Banerjee I, Chatterjee A, Banerjee A, Jayasinghe RD, Wati SM. Exploring the Link between Problematic Eating Behaviors and Early Childhood Caries in Preschoolers: A Cross-sectional Study in West Bengal, India. Journal of Orofacial Sciences. 2025 Jan 1;17(1):101-8.
6. Sanders AE, Divaris K, Godebo TR, Slade GD. Effect of bottled fluoridated water to prevent dental caries in primary teeth: study protocol for a phase 2 parallel-group 3.5-year randomized controlled clinical trial (waterBEST). Trials. 2024 Mar 5;25(1):167. doi:10.1186/s13063-024-08000-4
7. Hazzazi LW, Soto-Rojas AE, Martinez-Mier EA, Nassar HM, Eckert GJ, Lippert F. Tap water filtration and purification usage and their impact on the concentrations of fluoride and other minerals - A community-based study. J Dent. 2024 Nov;150:105377. doi:10.1016/j.jdent.2024.105377 PubMed PMID: 39349095.
8. Antonijevic S, Sitalo D, Vidakovic B. Bayesian Meta-Analysis with Application in Dental Studies [Internet]. arXiv; 2025 [cited 2026 May 29]. Available from: http://arxiv.org/abs/2511.06200 doi:10.48550/arXiv.2511.06200
9. Nascimento CFD, Gindri LADS, de Oliveira MN, Paranhos LR, Hugo FN. Water Fluoridation and Dental Caries Prevention Globally: A Systematic Review and Meta-Analysis. JDR Clin Transl Res. 2026 Apr 1;11(2):107–16. doi:10.1177/23800844251342804
10. Chemical fact sheets: Fluoride [Internet]. [cited 2026 May 30]. Available from: https://www.who.int/publications/m/item/chemical-fact-sheets--fluoride
11. Yaşar M, Bal C, Aksoy M, Güngörmüş M, Orhan K. In vitro caries-preventive effect of a mineralization-promoting peptide combined with fluoride gel on sound primary teeth. Int J Paediatr Dent. 2024 May;34(3):256–66. doi:10.1111/ipd.13126 PubMed PMID: 37837213.
12. Creeth J, Smith G, Franks B, Hara A, Zero D. Remineralisation of enamel erosive lesions by daily-use fluoride treatments: network meta-analysis of an in situ study set. Clin Oral Investig. 2024 Dec 26;29(1):28. doi:10.1007/s00784-024-06107-1 PubMed PMID: 39724489; PubMed Central PMCID: PMC11671545.
13. Fernández CE, Gatica C, Valdebenito A, Vargas CJ. Fluoride concentration and pH in bottled waters commercialized in Chile: Implications for oral health. J Food Compos Anal. 2024 Sep 1;133:106440. doi:10.1016/j.jfca.2024.106440
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ayah Ramadhan Al Tarhouni (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Open Access Policy
Libyan journal of medical Research (LJMR).is an open journal, therefore there are no fees required for downloading any publication from the journal website by authors, readers, and institution.
The journal applies the license of CC BY (a Creative Commons Attribution 4.0 International license). This license allows authors to keep ownership f the copyright of their papers. But this license permits any user to download , print out, extract, reuse, archive, and distribute the article, so long as appropriate credit is given to the authors and the source of the work.
The license ensures that the article will be available as widely as possible and that the article can be included in any scientific archive.
Editorial Policy
The publication of an article in a peer reviewed journal is an essential model for Libyan journal of medical Research (LJMR). It is necessary to agree upon standards of expected ethical behavior for all parties involved in the act of publishing: the author, the journal editorial, the peer reviewer and the publisher.
Any manuscript or substantial parts of it, submitted to the journal must not be under consideration by any other journal. In general, the manuscript should not have already been published in any journal or other citable form, although it may have been deposited on a preprint server. Authors are required to ensure that no material submitted as part of a manuscript infringes existing copyrights, or the rights of a third party.
Authorship Policy
The manuscript authorship should be limited to those who have made a significant contribution and intellectual input to the research submitted to the journal, including design, performance, interpretation of the reported study, and writing the manuscript. All those who have made significant contributions should be listed as co-authors.
Others who have participated in certain substantive aspects of the manuscript but without intellectual input should only be recognized in the acknowledgements section of the manuscript. Also, one of the authors should be selected as the corresponding author to communicate with the journal and approve the final version of the manuscript for publication in the LJMR.
Peer-review Policy
- All the manuscripts submitted to LJMR will be subjected to the double-blinded peer-review process;
- The manuscript will be reviewed by two suitable experts in the respective subject area.
- Reports of all the reviewers will be considered while deciding on acceptance/revision or rejection of a manuscript.
- Editor-In-Chief will make the final decision, based on the reviewer’s comments.
- Editor-In-Chief can ask one or more advisory board members for their suggestions upon a manuscript, before making the final decision.
- Associate editor and review editors provide administrative support to maintain the integrity of the peer-review process.
- In case, authors challenge the editor’s negative decision with suitable arguments, the manuscript can be sent to one more reviewer and the final decision will be made based upon his recommendations.












https://portal.issn.org/resource/ISSN/2413-6069