News Release

Water fluoridation: benefits should be considered alongside risks

Peer-Reviewed Publication

BMJ

Systematic review of water fluoridation

Editorial: Fluoridation, fractures, and teeth

Adding fluoride to the public water supply is associated with a reduction in tooth decay, but this reduction comes at the expense of an increased level of fluorosis (mottled teeth), finds a study in this week's BMJ.

McDonagh and colleagues reviewed over 200 studies on the health effects of water fluoridation. Although these studies were generally of poor quality, the authors found a median 15% reduction in tooth decay - or a median 2.25 fewer decayed, missing, and filled primary/permanent teeth - amongst children living in fluoridated areas compared to non-fluoridated areas.

The prevalence of fluorosis was also highly associated with water fluoride concentration. At a fluoride level of 1 part per million, an estimated 12.5% of exposed people would have fluorosis that they would find aesthetically concerning, say the authors, although the effects of fluoride from other sources may also be playing a part, they add. No clear evidence of other potential adverse effects was found.

The evidence of a beneficial reduction in tooth decay should be considered together with the increased level of fluorosis, say the authors, and they stress the need for future research to improve the quality of the existing evidence base.

These views are reiterated in an accompanying editorial by Professor Hannu Hausen at the University of Oulu, Finland. Research among 13-15 year olds in Finland has shown that the effect of fluoridation can vary strongly depending on different circumstances. The benefits and potential risks of fluoridation require careful and continuous monitoring, he says.

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Contacts:

[Paper] Paul Wilson or Rachel Richardson, NHS Centre for Reviews and Dissemination, University of York, UK
[Editorial] Professor Hannu Hausen, Institute of Dentistry, University of Oulu, Finland
E-mail: hannu.hausen@oulu.fi


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