International group of experts points to contemporary evidence of fluoridation’s dental benefits

Writing in the British Dental Journal, experts from the United States, Canada, Ireland, the UK, Israel, Australia and New Zealand called for future systematic reviews of the benefits of water fluoridation to look at a wider range of studies than those included in the Cochrane Oral Health Group review published in 2015.

International group of experts point to contemporary evidence of fluoridation’s dental benefits
The 2015 Cochrane review confirmed that water fluoridation is effective in reducing tooth decay in children; however, a criticism made by the authors was that there was very little “contemporary” evidence. This is almost certainly a result of the restrictive inclusion criteria used (Cochrane excluded studies which compared tooth decay rates in fluoridated and non-fluoridated areas at a single point in time – referred to as cross-sectional observational studies). BFS and others have argued (1, 2) that well-designed cross-sectional observational studies can be appropriate for evaluating public health interventions such as water fluoridation, and that their exclusion from the Cochrane review meant valid information was lost. Indeed, a more recent review by the Australian NHMRC, with broader inclusion criteria, identified 25 studies published between 2006 and 2015 which were judged mostly to be of acceptable quality but had been excluded by the Cochrane review.

1. Lennon MA (2015). Editorial: The Cochrane review of water fluoridation; a commentary. Community Dental Health 32: 130-131. Available at:

2. Rugg-Gunn et al (2016). Critique of the review of “Water fluoridation for the prevention of dental caries’ published by the Cochrane Collaboration in 2015. British Dental Journal;220(7):335-340