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An update on community water fluoridation, part 1 Mechanism of action, effectiveness, and cost savings.
| Journal of the American Dental Association (JADA) | Warren JJ, Levy SM, Kumar JV. | 157(4):334-343.
Community water fluoridation F-proponents Review

Abstract

Original abstract online at
https://jada.ada.org/article/S0002-8177(26)00062-0/abstract?dgcid=PromoSpots_ADAorg_ADANews_AprilJADA

Background

Water fluoridation has been an effective means of caries prevention for more than 80 years. The authors reviewed evidence on the benefits of community water fluoridation (CWF) in preventing caries, its cost-effectiveness, and the impact of discontinuing CWF.

Types of Studies Reviewed

The authors focused on observational studies identified in the dental literature from January 1, 2014, through December 31, 2025. The review was facilitated by means of an assessment of several national reports and independent panels’ reports on the benefits of CWF in preventing caries.

Results

Researchers found water fluoridation to be associated with substantially less caries, with most finding that water fluoridation reduced caries by approximately 25%. In addition, fluoridation has been found to be a cost-saving measure, as its cost is consistently a small fraction of the increased treatment costs expected in the absence of fluoridation. Moreover, researchers found that cessation of water fluoridation consistently results in higher caries levels and greater restorative needs.

Conclusions and Practical Implications

There is overwhelming evidence that, along with other fluoride agents, water fluoridation is effective in preventing caries. Dentists should advise policy makers and their patients not to abandon water fluoridation for the prevention of caries.

Key Words

  1. Water fluoridation
  2. caries
  3. cost savings

Abbreviation Key

  1. Ca (Calcium)
  2. CO3 (Carbonate)
  3. CWF (Community water fluoridation)
  4. dmfs (Decayed, missing, and filled surfaces index for primary dentition)
  5. DMFS (Decayed, missing, and filled surfaces index for permanent dentition)
  6. dmft (Decayed, missing, and filled teeth index for primary dentition)
  7. DMFT (Decayed, missing, and filled teeth index for permanent dentition)
  8. F (Fluoride)
  9. KNHANES (Korea National Health and Nutrition Examination Survey)
  10. NHANES (National Health and Nutrition Examination Survey)
  11. PO4 (Phosphate)

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