Water Fluoridation’s Declining Impact: Is It Still Worth It?
A recent Cochrane review shows that water fluoridation’s benefits in preventing tooth decay have lessened since fluoride toothpaste became widely available. While it may still reduce decay slightly in children’s teeth, the review raises questions about whether it remains a cost-effective public health strategy today.
A new Cochrane review suggests that the benefits of water fluoridation in reducing tooth decay are less pronounced today than they were before the widespread availability of fluoride toothpaste. Researchers from the Universities of Manchester, Dundee, and Aberdeen analyzed 157 studies comparing communities with and without fluoridated water, revealing that the impact of fluoridation has declined since the 1970s. The review primarily focused on high-income countries and found that in more recent studies, fluoridation led to only a modest reduction in tooth decay among children’s baby teeth — approximately 0.24 fewer decayed teeth per child. By contrast, studies conducted before 1975 showed a more significant reduction of 2.1 decayed teeth per child.
Though fluoridation still offers some benefits, particularly for children, the review highlighted uncertainty around its effectiveness in recent years. Additionally, there was no clear evidence that water fluoridation helps reduce oral health inequalities, a key argument often made by advocates. The review also pointed out that current evidence only pertains to children’s teeth, as no studies involving adults met the review’s criteria.
Experts suggest that the diminished impact of water fluoridation calls for careful consideration of its costs, feasibility, and ongoing monitoring before implementing new plans. While water fluoridation may contribute to small improvements in oral health, it does not address broader factors like sugar consumption and poor oral health habits. Click here to read more.
