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Fluoride – is it fake news? Water fluoridation for the prevention of dental caries.
| British Dental Journal | O | 238:241–242
Fluoridation UK Other

Abstract

Key points

  • Early studies of community water fluoridation showed an important effect on prevention of tooth decay in children. Recent studies show smaller effects.
  • Any potential oral health benefits should be comprehensively considered alongside potential harms and costs (taking contemporary effect estimates into account).
  • There is inconsistent evidence with regards to the impact of water fluoridation on oral health inequalities.
  • Where community water fluoridation is implemented, monitoring of water fluoride concentrations is critical to ensure schemes consistently provide optimal potential benefits in terms of caries prevention.

Perspective by

• Lucy O’Malley, Senior Lecturer in Health Services Research, University of Manchester, UK

• Jan Clarkson, Professor of Clinical Effectiveness, University of Dundee, UK; Professor of Dental Research, University of Manchester, UK

• Sharon Lewis, Senior Systematic Reviewer, University of Manchester, UK

• Tanya Walsh, Professor of Healthcare Evaluation, University of Manchester, UK

• Anne-Marie Glenny, Professor of Health Sciences, University of Manchester, UK

References

  1. Iheozor-Ejiofor Z, Walsh T, Lewis S R et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2024; DOI: 10.1002/14651858.CD010856.pub2.

  2. Griffin S O, Regnier E, Griffin P M, Huntley V. Effectiveness of fluoride in preventing caries in adults. J Dent Res 2007; 86: 410-415.

  3. McDonagh M, Whiting P, Bradley M et al. A systematic review of public water fluoridation. York: NHS Centre for Reviews and Dissemination, University of York, 2000.

  4. Rugg-Gunn A J, Do L. Effectiveness of water fluoridation in caries prevention. Community Dent Oral Epidemiol 2012; 40: 55-64.

  5. Australian Government. Information paper – water fluoridation: dental and other human health outcomes. 2017. Available at www.nhmrc.gov.au/sites/default/files/documents/reports/fluoridation-info-paper.pdf (accessed January 2025).

  6. Canadian Agency for Drugs and Technologies in Health. Community water fluoridation programs: a health technology assessment — review of dental caries and other health outcomes. Ottawa: Canadian Agency for Drugs and Technologies in Health, 2019.

  7. Lambe K, Farragher A, Moloney T, Sunday S, Long J. Impact of community water fluoridation on systemic health excluding oral health: an evidence review. 2022. Available at https://www.hrb.ie/publication/impact-of-community-water-fluoridation-on-systemic-health-excluding-oral-health-an-evidence-review/ (accessed January 2025)

  8. Moore D, Goodwin M, Pretty I A. Long-term variability in artificially and naturally fluoridated water supplies in England. Community Dent Oral Epidemiol 2020; 48: 49-55.

  9. Goodwin M, Emsley R, Kelly M P et al. Evaluation of water fluoridation scheme in Cumbria: the CATFISH prospective longitudinal cohort study. Southampton: National Institute for Health and Care Research, 2022.

ONLINE AT https://www.nature.com/articles/s41415-025-8412-1#Bib1