A new report examines whether water fluoridation is an effective measure to reduce oral health inequalities and whether concerns about negative side effects are well-founded.
Published by the Academy of Medical Sciences, the report found that water fluoridation has a beneficial effect on reducing tooth decay when used at an optimal concentration between 0.7 and 1.2 mg/L. It has also been found to reduce the number of invasive dental treatments required, such as fillings and extractions.
Water fluoridation was linked to a reduction in the number of children admitted to hospital for tooth extractions related to tooth decay. However, the report said it was “unclear” whether it reduced dental inequalities. The evidence showed no consistent effect in three-year-olds and a reduction in caries prevalence that was consistent across deprivation levels in five-year-olds.
In adults, the greatest reduction in invasive dental treatments was seen in the most deprived group. On the other hand, the effect of water fluoridation on the number of decayed, filled, and missing teeth was inconsistent across deprivation levels.
Are there any negative effects of water fluoridation?
Higher levels of water fluoridation were associated with a higher prevalence of dental fluoridation, according to the report. The authors emphasize that this is generally considered an “adverse effect” rather than a “harm” as it is a purely cosmetic problem.
In 2025, a study found “significant inverse associations” between water fluoridation and children’s IQ, calling into question its safety. However, the Academy of Medical Sciences report said there was “no evidence of an effect on neurodevelopment or cognitive function as measured by IQ.”
Other potential harms previously reported include an increased risk of being born with Down syndrome, kidney stones, hip fractures, and bladder or bone cancer (osteosarcoma). At the meeting discussed in the report, he concluded that there was no evidence of a link between water fluoridation and these concerns. The authors acknowledged that most of these impairments have not been specifically investigated in children.
Barry Cockcroft, chairman of the British Fluoridation Society, said: “Once again, water fluoridation is being given a clean bill of health by a leading independent expert body. This latest review reinforces the role of fluoridation as an evidence-based and effective basis for improving oral health inequalities across the UK.
Is fluoridation cost effective?
The report also looked at whether fluoridation systems are cost-effective. It found that they are “economic or net beneficial” overall. The authors emphasized that this “must be taken into account in the context in which the program is implemented”, for example the size of the population and its oral health status and the cost of implementing the program.
Public support for water fluoridation was described as “consistently high” over the past 15 years. Several public surveys showed that about two-thirds of the population were in favor of adding fluoride to water.
Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.
