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Fluoridation beneficial, studies say
The first systematic review of water fluoridation reveals that the quality of evidence surrounding the topic is low, but the only adverse effect from adding fluoride to drinking water appears to be fluorosis, and this depends on the concentration of the chemical in drinking water. On the benefit side, the authors found a median 15% reduction in tooth decay, which meant a median 2.25 fewer decayed, missing and filled primary and permanent teeth. The review, which looked at 214 studies and was published in the BMJ (2000;321:855-9), concluded that "the evidence of reduction in caries should be considered together with the increased prevalence of dental fluorosis. No clear evidence of other potential negative effects was found." Another study in the same issue determined that long-term exposure to fluoridation may reduce the risk of hip and other fractures. Earlier this year Canada's main dental body, the Canadian Dental Association (www.cda-adc.ca), reaffirmed "its support for fluoridation of municipal water supplies as a safe, economical and effective means of preventing dental caries in all age groups." However, it noted that water supplies have to be monitored to ensure that fluctuations in fluoride concentrations are avoided. Fluoride was first added to Canadian drinking water in Brantford, Ont., in 1945, and hundreds of communities have since followed its lead. Several major cities, including Montreal, Vancouver and Victoria have not followed suit. The subject remains controversial. The STOP Fluoridation USA Web site (www.rvi.net/~fluoride/) says "the evidence against the safety of this public health policy keeps mounting." Patrick Sullivan, CMAJ
Copyright 2000 Canadian Medical Association or its licensors |