Water fluoridation benefits and risks – a systematic review

Water fluoridation has become a fairly common public health practice, as communities across the world accepted the evidence that fluoridated water is relatively safe and reduces cavities (known properly as dental caries). Several decades ago, it became a part of the public health strategy in many communities.

However, as fluoride became more available, especially in the forms in toothpaste and various mouthwashes, it has become time to review water fluoridation benefits and risks – especially as it becomes one of those “things” that cause concerns with the public.

As I’ve mentioned literally a few hundred times in this blog, the very highest level of research is a meta (or systematic) review, which tries to identify, appraise, select and synthesize all high quality research evidence relevant to a particular question or hypothesis in medicine. Systematic reviews of high-quality randomized controlled trials are critical pieces of evidence that forms the basis of science-based healthcare.

Systematic reviews are best when they select hundreds or even thousands of research studies over decades of clinical studies, eliminating studies with bias (or pointing out the bias), and combining data from the best of the best. Now it’s time to look at one of the newer meta-reviews regarding water fluoridation benefits and risks from the Cochrane Collaboration, probably the premiere group that produce systematic reviews.

Using data from a wide variety of resources (from clinical trials to peer-reviewed studies to recommendations from public health organizations), the Cochrane Collaboration attempts to find the best and least biased data to answer a question. In case you’re wondering who is this “Cochrane,” they are either a group of brilliant scientists trying to provide better data for medicine or dentistry. Or they’re a cabal of evil wizards, hiding from the world in a dungeon in one of Big Pharma’s creepy castles in New Jersey. My guess it’s the former. Continue reading “Water fluoridation benefits and risks – a systematic review”

Water fluoridation myths – just another blog article

When I was a kid (probably 6 or 7), there was a big controversy in our community whether the water would be fluoridated or not. Now, I was just becoming fascinated by science, medicine, health, and sports at that time, so I tried to figure out what was happening.

To my ears and adolescent brain, the argument boiled down to no fluoridation (which meant cavities and visits to the dentist) vs. fluoridation (which was a communist conspiracy). Scary choices. Though Nazi dentists were also plenty scary.

But I grew up, and fluoridation became more common, as communities accepted the evidence that fluoridate water was safe, and improved the health of the community’s teeth. Water systems are mostly fluoridated (unless you drink bottled water).

And fluoride is in toothpaste and various mouthwashes. I thought the fluoridation controversy had passed into history with rotary phones, the Soviet Union, and the slide rule. My younger readers probably have never seen any of those three in their native states.

Now it’s time to look at those water fluoridation myths that can be found in many corners of the internet. Continue reading “Water fluoridation myths – just another blog article”

Water fluoridation-an update

fluoride smile

This is an update of an article from 30 January 2013 to include recent studies about the efficacy of fluoridation. 

Water fluoridation is a controversy that just doesn’t seem to go away, despite the overwhelming evidence of successfully reducing the rate of cavities in children (and adults), while also having little or weak evidence that there are any risks. When I was a kid, I remember controversies about fluoridating water. But I just hated dentists, so to my young, immature scientific mind, if fluoridation kept me from the dentist, that was a good thing!

Today, fluoridated water has become ubiquitous in the USA and many other countries. Unless you drink bottled or filtered water, or avoid fluoride toothpastes (or mouthwashes), most children and adults get an adequate level of fluoride to maintain good dental health. I actually thought that the fluoridation controversy had passed into history with rotary phones, the Soviet Union, and the slide rule. 

Yes, there are groups that still fight against water fluoridation, and there are many people who think that fluoridation is bad.

The John Birch Society, a right wing conspiracy group that I thought had passed into history, still considers water fluoridation to be mass medicine and once thought of it as a communist plot to poison Americans (see Schneider & Lilienfeld, 2011). Ironically, on the opposed side of the political spectrum, leftists, like the UK’s Green Party, are opposed to fluoridation because of the mass medicine idea, a concern occasionally expressed by antivaccine proponents. So it’s really not a right or left political issue. It seems to be, like many medical issues (for example, vaccinations), a matter of good science versus bad science (or even no science). Continue reading “Water fluoridation-an update”