Fluoride May Not Prevent Cavities, Study Shows

Fluoride May Not Prevent Cavities, Study Shows
If you’re like two-thirds of Americans, fluoride is added to your tap water for the purpose of reducing cavities. But the scientific rationale for putting it there may be outdated, and no longer as clear-cut as was once thought.

Water fluoridation, which first began in 1945 in Grand Rapids, Michigan, and expanded nationwide over the years, has always been controversial. Those opposed to the process have argued—and a growing number of studies have suggested—that the chemical may present a number of health risks, for example interfering with the endocrine system and increasing the risk ofimpaired brain function; two studies in the last few months, for example, have linked fluoridation to ADHD and underactive thyroid. Others argue against water fluoridation on ethical grounds, saying the process forces people to consume a substance they may not know is there—or that they’d rather avoid.

Despite concerns about safety and ethics, many are content to continue fluoridation because of its purported benefit: that it reduces tooth decay. The Centers for Disease Control and Prevention’s Division of Oral Health, the main government body responsible for the process, says it’s “safe and effective.”

Authors’ Conclusions:
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. 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. 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. – Cochrane Collaboration, 2015

You might think, then, that fluoridated water’s efficacy as a cavity preventer would be proven beyond a reasonable doubt. But new research suggests that assumption is dramatically misguided; while using fluoridated toothpaste has been proven to be good for oral health, consuming fluoridated water may have no positive impact...............