Dental experts respond to Cochrane Review on fluoridation
18 June 2015
The British Dental Association’s scientific and public health experts have responded to the publication of the Cochrane Oral Health Review on water fluoridation, which is received by around 10 per cent of the population in the UK.
Fluoridated water can reduce the incidence of decayed, missing or filled teeth by up to 35 per cent, according to the Cochrane Oral Health Group’s review of studies on this measure, whereas tooth decay is associated with pain, infection, tooth loss and reduced quality of life.
The Cochrane review reinforces previous findings that adding fluoride to water at the optimal level for dental health substantially reduces decay in children’s ‘baby’ and permanent teeth. It also increases the proportion of children who have no tooth decay, even after the widespread introduction of fluoride toothpaste.
The BDA supports the authors' call for more contemporary, high quality studies on water fluoridation.
Commenting on the review, the BDA’s Scientific Adviser, Professor Damien Walmsley, said:
“Despite the huge improvements we have seen in people’s dental health since the 1970s, too many communities still experience unacceptably high levels of tooth decay.
“One in eight three-year olds in England have tooth decay, and poor communities are disproportionately affected. Treating extensive tooth decay remains the main reason why children are admitted to hospital – more than 60,000 children had to have rotten teeth removed under a general anaesthetic in 2012/13.
“As children’s ability to learn, eat and speak is affected by dental disease, a preventable condition, we need a range of strategies to reduce this burden on youngsters, their families and the NHS.
“We believe that targeted fluoridation has an important role to play, along with the need to reduce sugar consumption and the promotion of a good oral hygiene routine.”
1. Although the Cochrane Review focuses mainly on studies published before 1975, the BDA notes that a report by the European Commissions’ Scientific Committee on Health and Environmental Risks (SCHER) in 2010 found that water fluoridation has a beneficial impact on reducing oral health inequalities.
2. The Cochrane report highlights that cross-sectional studies, which form the majority of fluoridation studies, were not included in their review.
3. Fluoride is a naturally occurring mineral which can protect teeth in a number of ways. It makes developing enamel more resistant to acid, it helps to repair teeth during the early stages of decay, and it prevents tooth decay by reducing the ability of plaque bacteria to produce acid. In some areas in the UK the ideal level of fluoride occurs naturally; other areas have chosen to add it to the water for public health reasons.
4. Only 10 per cent of the UK population receives fluoridated water compared with 67 per cent in the USA in 2002[i]. Major schemes are in operation in Birmingham, throughout the West Midlands and also in Tyneside. About 500,000 people receive water which naturally contains fluoride at or about the level of 1ppm, while a further one million people receive water which naturally contains fluoride at a lower level, but which is still considered to confer some dental benefits.
About the BDA
The British Dental Association (BDA) is the professional association and trade union for dentists in the UK. It represents dentists working in general practice, in community and hospital settings, in academia and research, and in the armed forces, and includes dental students. The BDA promotes members’ interests, advances the science, arts and ethics of dentistry, and contributes towards improving the nation's oral health.
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