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The American Dental Association Responds to Cochrane Review of Water Fluoridation

July 07, 2015

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CHICAGO — The American Dental Association (ADA) examined a recent review released by the Cochrane Collaboration designed to study the effects of water fluoridation on the prevention of tooth decay and dental fluorosis.

The key findings from the review, titled, “Water fluoridation for the prevention of dental caries,” were:

  • Data from studies conducted prior to 1975 show that water fluoridation is effective in reducing tooth decay in children.
  • There is insufficient information to determine whether water fluoridation results in a change in tooth decay across socioeconomic status (SES) levels.
  • There is insufficient information to determine the effect of stopping water fluoridation on tooth decay levels.
  • No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review’s inclusion criteria.
  • The authors’ confidence in the evidence relating to the association between dental fluorosis and the fluoride level is limited due to the high risk of bias and variation in the studies’ results.

The authors noted that there is much debate around the approach used to assess the quality of evidence within this review when applied to public health interventions, particularly for research questions where evidence from randomized controlled trials will never be available. Community water fluoridation is one such area.

The U.S. Community Services Task Force conducts systematic reviews of interventions in many public health topics to find which program and policy interventions have proven to be effective, their benefits or harms, return on investment and other factors. The Task Force recommended community water fluoridation based on strong evidence of effectiveness in reducing dental caries across populations.

The American Dental Association strongly endorses the Task Force’s recommendation and supports ongoing research on the safety and effectiveness of community water fluoridation.

For more information about fluoride and water fluoridation visit

Editor’s Note: Reporters are invited to follow the ADA on Twitter @AmerDentalAssn

About the ADA

The not-for-profit ADA is the nation's largest dental association, representing 162,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA's consumer website