Water fluoridation for the prevention of dental caries

Abstract

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. 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.

A randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services: the Northern Ireland Caries Prevention In Practice (NIC-PIP) trial

“…38 More recently, a Cochrane review of water fluoridation has been published. 39 The included studies suggest that water fluoridation results in a 35% reduction in decayed, missing or filled primary teeth and a 26% reduction in decayed, missing or filled permanent teeth. However, the review team queried the applicability of these findings to current populations, as the majority of the studies included in the review were conducted before fluoride toothpastes and other preventative measures were widely introduced.…”

“…However, the review team queried the applicability of these findings to current populations, as the majority of the studies included in the review were conducted before fluoride toothpastes and other preventative measures were widely introduced. Iheozor-Ejiofor et al 39 reported that over 97% of the 155 studies included in the review were at a considerable risk of bias and concluded that the evidence for the effectiveness of water fluoridation is limited because of the considerable risk of bias within the studies and substantial between-study variation. In the UK, the NIHR has commissioned an evaluation of the cost, and effects, of water fluoridation in the contemporary context.…”

Heterocontrole do flúor nas águas de abastecimento público: resultados e experiência de 13 anos de vigilância

“…A eficácia da fluoretação já foi há muito comprovada, e revisões sistemáticas confirmam este fato: a pesquisa de McDonalgh et al 15 evidenciou que em regiões fluoretadas havia um número maior de crianças sem cárie em comparação com áreas não fluoretadas; a revisão sistemática de IheozorEjiofor, que objetivou foi analisar os efeitos da fluoretação na prevenção da cárie e também nos riscos de se desenvolver de fluorose dentária, comprovou que a medida é eficaz na redução dos níveis de cárie na dentição decídua e permanente em crianças 16 .…”

Ratovi cjepiva: Što možemo naučiti iz kalifornijskog iskustva s obveznim cijepljenjem školske djece?

“…More recently data from case reporting has become the cornerstone of monitoring and evaluating national and worldwide progress to elimination of HIV (WHO, 2015a). A second group of mandatory public health activities is mass screening, treatment or preventive supplementation, the latter including the addition of fl uoride to drinking water (Iheozor-Ejiofor et al, 2015), iodide to salt or vitamins to cereal grains (Raitiainen et al, 2016); a prominent example is the decision to supplement cereal grains consumed by pregnant women with folic acid to prevent neural tube defects in foetuses (Ray et al, 2002). Mass drug administration may also be done at the individual level, such as administration of topical antibiotics to all newborns to presumptively treat gonococcal ophthalmia and parenteral vitamin K to prevent neonatal haemorrhage (Zi-pursky, 1999).…”