Estimates of fluorosis prevalence  in the Australian National Health & Medical Research Council review (2016)

The 2016 NHMRC Evidence Evaluation (1) included a critical assessment of the 2000 York review, the 2007 Australian NHMRC review and the 2015 Cochrane review.

Their main finding on dental fluorosis was that these earlier reviews were of limited relevance to the Australian setting because:

  • Many of the studies had fluoride levels much higher (up to 5ppm) than used in Australia (around 1ppm)

  • They did not consider other sources of fluoride (e.g. toothpaste), and

  • There is evidence that some of the dental fluorosis included in “fluorosis of aesthetic concern” reviews may not actually be of any concern to Australians.

The Evidence Evaluation therefore concentrated on recent Australian studies which show:

  • Dental fluorosis is found in 1 in 4 children, slightly higher in fluoridated (25%) compared to non-fluoridated (17%) areas

  • The vast majority is mild or very mild

  • Moderate fluorosis is uncommon and may, or may not, be of concern to people who have it

  • Severe fluorosis is rare

Click here to view the NHMRC’s draft information paper on this 2016 systematic review.


  1. Jack, B., Ayson, M., Lewis, S., Irving, A., Agresta, B., Ko, H., Stoklosa, A. 2016, Health Effects of Water Fluoridation: Evidence Evaluation Report, report to the National Health and Medical Research Council, Canberra.

Key Findings

York and Cochrane review findings on dental fluorosis of “limited relevance” to fluoridation at levels in Australia (i.e. around 1ppm)

The vast majority of fluorosis is mild or very mild.

Moderate fluorosis is uncommon and may not be of concern to people who have it

Severe fluorosis is rare