The American Dental Association (ADA) examined a recent review released by the Cochrane Collaboration designed to study the effects of water fluoridation on the prevention of tooth decay and dental fluorosis.
The key findings from the review, titled “Water Fluoridation for the Prevention of Dental Caries,” were:
- Data from studies conducted prior to 1975 show that water fluoridation is effective in reducing tooth decay in children.
- There is insufficient information to determine whether water fluoridation results in a change in tooth decay across socioeconomic status (SES) levels.
- There is insufficient information to determine the effect of stopping water fluoridation on tooth decay levels.
- No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review’s inclusion criteria.
- The authors’ confidence in the evidence relating to the association between dental fluorosis and the fluoride level is limited due to the high risk of bias and variation in the studies’ results.
The authors noted that there is much debate regarding the approach used to assess the quality of evidence within this review when applied to public health interventions, particularly for research questions where evidence from randomized controlled trials will never be available. Community water fluoridation is one such area.
The US Community Services Task Force conducts systematic reviews of interventions in many public health topics to find which program and policy interventions have proven to be effective, their benefits or harms, return on investment, and other factors. The Task Force recommended community water fluoridation based on strong evidence of effectiveness in reducing dental caries across populations.
The American Dental Association strongly endorses the Task Force’s recommendation and supports ongoing research on the safety and effectiveness of community water fluoridation.
