Medical Research Council review (2002)

In 2000, the Department of Health asked the Medical Research Council (MRC) to set up a working group to assess the findings of the York review of water fluoridation.  Its report was published in 2002. (1)

Dental benefits over and above those considered in the York review

The MRC working group noted that, in considering the effects of water fluoridation on tooth decay, the York review had looked only at those studies presenting baseline and follow up data for both fluoridated and non-fluoridated communities, and that outcome measures were limited to the prevalence of tooth decay and average levels of decayed, missing and filled teeth.  Further, the MRC group noted that York had not included studies of outcome measures such as:

• the percentage of children with high levels of decayed, missing and filled teeth;

• the number of extracted teeth;

• experience of general anaesthesia for dental extraction;

• toothache;

• the prevalence of dental abscesses;

• the long term dental effects in communities with naturally fluoridated water; and

• ‘cross sectional’ studies that examine and compare levels of tooth decay in communities at a particular moment in time.

The MRC group therefore broadened the scope of its review beyond the narrower range of studies included in the York analysis.  From this additional work, the group highlighted other studies suggesting that fluoridation:

• reduces the amount of toothache suffered by children, and thereby improves the quality of their lives;

• reduces the need for dental treatment involving general anaesthesia;

• reduces tooth decay in children as young as 3 years old and in adults aged up to 75;

• has an important post-eruptive, topical effect on teeth, which means it can potentially benefit older children and adults as well as individuals born after fluoridation starts;

• benefits people living in non-fluoridated areas who consume foods and drinks made with fluoridated water, which may narrow what would otherwise be a wider gap in dental health between fluoridated and non-fluoridated communities.

1. Medical Research Council (2002): Working group report: Water fluoridation and health.