New Study Reviews Effectiveness Of Water Fluoridation
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- Published: Thursday, 17 October 2024 18:17
- Written by Guy Tuggle
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The prevalence of fluoride in toothpastes means that the benefits of adding fluoride to the domestic water supply may have been diluted.
This is the conclusion of a group of researchers from Dundee, Aberdeen and Manchester universities who analysed 157 studies which had compared dental health in communities served by a fluoridated water supply with communities that were not.
Their Report states ’Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community Water Fluoridation (CWF) is currently practised in about 25 countries; health authorities consider it to be a key strategy for preventing dental caries.’
An update of a Cochrane Review first published in 2015, the new Report focuses on contemporary evidence about the effects of CWF on dental caries. It objectives were:
1. to find out if water with added fluoride in the local water supply is better than water without added fluoride at:
‐ reducing the number of teeth, or tooth surfaces, with signs of decay;
‐ increasing the number of people who have no tooth decay.
2. to find out about unwanted effects.
The researchers found 21 studies that assessed the effects of adding fluoride to a water supply. They also found one study that assessed the effects of stopping artificially‐added fluoride in a water supply. Studies only measured tooth decay in children.
In the last version of the Cochrane review, which was not updated on this occasion, 135 studies had assessed the association of fluoridated water with dental fluorosis.
Quoted in The Guardian (4th October) Anne-Marie Glenny, a Professor of Health Sciences Research at the University of Manchester and a co-author of the review said " When interpreting the evidence, it is important to think about the wider context and how society and health have changed over time.
“Most of the studies on water fluoridation are over 50 years old, before the availability of fluoride toothpaste. Contemporary studies give us a more relevant picture of what the benefits are now.”
Adding fluoride to the water supply has long been mired in controversy, thereby polarising opinion.
Those in favour of adding fluoride to water cite its role in reducing oral health inequalities. The Report, The Guardian says ’sought to examine this but did not find enough evidence to support the claim, although the researchers said that did not necessarily mean there was no effect.’
“Whilst water fluoridation can lead to small improvements in oral health, it does not address the underlying issues such as high sugar consumption and inadequate oral health behaviours,” said Janet Clarkson, a co-author and Professor of Clinical Effectiveness at the University of Dundee. “It is likely that any oral health preventive programme needs to take a multifaceted, multi agency approach.”
The Report’s Key Conclusions:
Studies conducted after 1975 showed that adding fluoride to water may lead to slightly less tooth decay in children’s baby teeth. We could not be sure whether adding fluoride to water reduced tooth decay in children’s permanent teeth or decay on the surfaces of permanent teeth.
Adding fluoride to water may slightly increase the number of children who have no tooth decay in either their baby teeth or permanent teeth. However, these results also included the possibility of little or no difference in tooth decay.
Studies conducted in 1975 or earlier showed a clear and important effect on prevention of tooth decay in children. However, due to the increased availability of fluoride in toothpaste since 1975, it is unlikely that we will see this effect in all populations today.
We were unsure whether there were any effects on tooth decay when fluoride is removed from a water supply.
We were unsure if fluoride reduces differences in tooth decay between richer and poorer people.
In the last version of the review, we found that adding fluoride to water supplies increases the number of people with dental fluorosis. If water contains 0.7 mg/L of fluoride, about 12% of people may have dental fluorosis that causes them to be bothered about how their teeth look, and about 40% of people may have dental fluorosis of any level. We were unsure whether fluoride in water leads to other unwanted effects.
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