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”