Cochrane publishes lukewarm report on fluoridation
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- Published: Monday, 22 June 2015 07:31
- Written by News Editor
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Cochrane has carried out a review to assess the effects of water fluoridation (artificial or natural) for the prevention of tooth decay. The authors conclude that ‘there is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.’
See review at: http://tinyurl.com/q6dewu5
The review also evaluated the effects of fluoride in water on dental fluorosis.
The authors conclude that ‘the available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles.
‘The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.
There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.
There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation.’
Commenting on the review, the BDA’s Scientific Adviser, Professor Damien Walmsley, said: “Despite the huge improvements we have seen in people’s dental health since the 1970s, too many communities still experience unacceptably high levels of tooth decay. One in eight three-year olds in England have tooth decay, and poor communities are disproportionately affected. Treating extensive tooth decay remains the main reason why children are admitted to hospital – more than 60,000 children had to have rotten teeth removed under a general anaesthetic in 2012/13.
“As children’s ability to learn, eat and speak is affected by dental disease, a preventable condition, we need a range of strategies to reduce this burden on youngsters, their families and the NHS. We believe that targeted fluoridation has an important role to play, along with the need to reduce sugar consumption and the promotion of a good oral hygiene routine.”
The British Association of Dental Therapists (BADT) has welcomed the findings of the Cochrane Oral Health Review on water fluoridation published today (18 June). Commenting on the review, BADT president, Fiona Sandom, said: “I have also seen first-hand the benefit of water fluoridation as I grew up on Anglesey, which was itself fluoridated until 1990 and seen the decay levels subsequently rise in the population. Dental therapists can help child patients out of pain, but fluoride is key to prevention in many cases.”
Image credit - Petras Gagilas under CC licence - not modified.
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