A new review into the effectiveness of water fluoridation has found that the benefits of fluoridated water to our oral health may actually be smaller than previously thought. The American Dental Association have announced that they will continue to support the practice of water fluoridation. Other organizations have also commented on the findings.
A new review into Water Fluoridation has suggested that the benefits of fluoridated water to our oral health are actually smaller than previously thought [1].
This review has led to some concern about whether or not water fluoridation is worthwhile, especially with some health and economic concerns existing.
However, the American Dental Association (ADA) has released a statement in support of water fluoridation, suggesting that the practice should continue [2].
What is Water Fluoridation?
Water fluoridation is the process of adding small amounts of the natural mineral fluoride to the public water supply. This is a practice used in approximately 25 countries around the world [1].
The main reason for water fluoridation is due to its impact on oral health. In the past, research has shown that water fluoridation has a positive impact on tooth decay reduction [3].
Research has largely supported this link in the past. Those that benefit the most, according to the research, are children [3].
However, water fluoridation has proven to be a controversial subject matter. In fact, the practice has been banned in some countries.
Some have argued the benefits are too small to justify its use, whereas concerns over an overexposure to fluoride and ethical reasons are other reasons cited by those who oppose water fluoridation.
The Review: “Smaller Benefits”
A new review published in the Cochrane Database of Systematic Reviews has cast doubt over the true effectiveness of water fluoridation [1].
The research involved an analysis of 157 existing studies into water fluoridation from the past. The findings of the studies were grouped together and analyzed [1].
The authors concluded that the “benefits of fluoride in water supplies may be smaller than they were before the widespread addition of fluoride to toothpaste” [1].
Therefore, the authors pointed out that pre-1975 studies – before fluoride was added to toothpaste – produced better results [1]. The implication of this is that fluoride being added to toothpaste has lessened the impact of water fluoridation.
However, the review did still conclude that water fluoridation was beneficial to children [1]. This is a finding which has been consistent over several decades.
How have the ADA responded?
The ADA continue to champion strong oral health. Advocacy and support for water fluoridation has been a big part of their activities over the last few decades. Therefore, this review has proven concerning [2].
President of the ADA – Linda J. Edgar – has commented. Edgar has said “optimally fluoridated water is accessible to communities regardless of socioeconomic status, education, or other social variables” [2].
Continuing, Edgar said that “even in an era with widespread availability of fluoride from various sources, other studies show that community water fluoridation prevents at least 25% of tooth decay”, before going on to say “the scientific weight of sound evidence of water fluoridation is clear and compelling” [2].
Therefore, the ADA remain steadfast in their support of water fluoridation. They have underlined the consistent findings in past research to advocate for its use.
Furthermore, the ADA have also said that many recent studies into water fluoridation were excluded from this review. Therefore, they have suggested that the new review may not provide an accurate depiction of the true situation [2].
National Fluoridation Advisory Committee’s reactions
The National Fluoridation Advisory Committee (NFAC), who support the use of fluoridated water, also commented on the review [2].
NFAC member Catherine Hayes has said that “the study’s exclusion criteria meant that highly relevant research from the past decade showing significant increases in tooth decay in communities like Juneau, Alaska, Calgary, Canada, and other areas after their decision to remove fluoride from water supplies were not included” [2].
Moreover, the NFAC also stated that the review did not use “enough high-quality studies” [2]. This resulted, according to Hayes, in “an important oversight that cannot be ignored” [2].
Additionally, Hayes pointed out that another benefit of water fluoridation which was not considered is cost savings [2]. Therefore, the NFAC believes that crucial details were omitted.
This reaction is shared by the U.S. Centers for Disease Control and Prevention (CDC), who have mentioned that water fluoridation and fluoride toothpaste work together – rather than alone – to shield against tooth decay [2].
Summary
It is important to state that the recent review has not concluded that water fluoridation is not beneficial. They have concluded that water fluoridation does help the public, just not to the same extent as previously thought.
The overall stance of the ADA is that they will continue to endorse “optimal levels” of water fluoridation in the public water supply. This approach is also backed by the CDC and the NFAC.
Water fluoridation has proven to be a contentious issue in recent years. This review is likely to keep the debate into the practice of fluoridated water alive.
Thinking points…
[1] Whether you live in an area with fluoridated water or not, it is important to look after your oral health. One of the best ways of helping this is attending regular dental check-ups. At these check-ups, a dentist can take a look at your oral health, provide advice and offer treatment if needed. We recommend booking an appointment soon!
[2] Some good news from this review is that the findings reaffirmed that water fluoridation has a positive impact on children. If you have children – remember to try and get them to drink water rather than other drinks! Water has a strong effect on the teeth of children. Remember that juice and soft drinks often contain sugar!
What we offer at Taradale Dental
Taradale Dental is a dental clinic based in Calgary, Alberta, Canada. At our Calgary dental clinic, we provide a range of services for our patients.
We advise our patients to attend our Calgary dental clinic at least twice per year for a regular dental check-up. At these check-ups, we provide a comprehensive review of a patient’s oral health. If any problems are detected, we have many treatments available. For example, these include cavity fillings and root canals. To strengthen your oral health, we recommend brushing your teeth at least twice a day and flossing regularly.
Here at Taradale Dental, we also have some cosmetic treatments available! These include dental implants, teeth whitening and Invisalign™! Our patients find that these treatments have a positive impact on their appearance, confidence and self-esteem.
Moreover, the fees of our treatments at our Calgary dental clinic Taradale Dental are set in line with the Alberta Dental Fee Guide. This ensures transparent and fair pricing, with no hidden costs.
We hope to see you soon at our Taradale Dental clinic in Calgary! You can find out more about us by visiting our website https://taradaledental.ca/!
References
[1] Iheozor-Ejiofor, Z., Walsh, T., Lewis, S. R., Riley, P., Boyers, D., Clarkson, J. E., Worthington, H. V., Glenny, A-M., & O’Malley, L. (2024). Water fluoridation for the prevention of dental caries. Cochrane Database of Systematic Reviews. 10. p1465-1858. DOI: https://doi.org/10.1002/14651858.CD010856.pub3.
[2] Oral Health. (2024). ADA continues backing water fluoridation at ‘optimal levels’ despite review claiming ‘smaller benefits’. Available: https://www.oralhealthgroup.com/oral-health/ada-continues-backing-water-fluoridation-at-optimal-levels-despite-review-claiming-smaller-benefits-1003981733/. Last accessed: 26th October 2024.
[3] Harding, M. A., & O’Mullane, D. M. (2013). Water fluoridation and oral health. Acta Medica Academica. 42 (2): p131-139. DOI: https://doi.org/10.5644/ama2006-124.81.
