Link between High Fluoride in Drinking Water and Dental Caries Prevalence

Abstract

Introduction:

Numerous community trials have revealed a negative correlation between higher fluoride levels in drinking water and reduced dental caries incidence. However, the debate over its effectiveness and safety persists, necessitating more research. While some evidence supports the safety and efficacy of water fluoridation in decreasing dental caries, other studies caution against the health risks of excessive fluoride exposure. This review evaluates the evidence regarding fluoride addition to drinking water as a measure to curb dental caries.

Methods:

We searched medical databases, including PubMed and Embase, for community trials examining the effect of water fluoridation on dental caries rates. Two reviewers independently screened the studies for relevance based on predetermined eligibility criteria. Initially, 35 studies were deemed relevant and included in the analysis. Eligible studies encompassed randomized controlled trials, cohort, case-control, cross-sectional studies, and systematic reviews that investigated fluoride's impact in drinking water on dental caries, covering various populations and settings worldwide.

Results:

Water fluoridation, initiated as a public health policy in the US in 1951, has seen varying global adoption, with about 69.2% of Americans accessing fluoridated water by 2006. Adoption rates differ internationally, with countries like New Zealand, Brazil, and Ireland implementing fluoridation programs. Nonetheless, some areas have ceased fluoridation due to alternative dental health strategies and health risk concerns. Evidence indicates that while higher fluoride levels in drinking water can decrease dental caries, they may increase dental fluorosis rates. The occurrence of dental caries and fluorosis varies by region, with limited research on fluoride levels in water and their effects on dental health in certain regions, including Arab countries.

Conclusions:

Research confirms that elevated fluoride levels in drinking water can reduce dental caries but may heighten dental fluorosis risk. The incidence of both conditions differs across regions, with a noted research gap in the study of water fluoride concentration and its dual impact on dental caries and fluorosis in various areas.