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Water fluoridation linked to reduced risk of severe dental caries in children’s first set of teeth

New Zealand researchers studied preschoolers both exposed to fluoridated water and those without

August 12, 2020

By David Burger

A study out of New Zealand suggests that community water fluoridation is a worthwhile intervention associated with reduced severe caries rates among preschool children.

The pediatric publication of The Journal of the American Medical Association, JAMA Pediatrics, published the study July 27.

In a national study of 275,843 children with a median age of 4.3 years, those living in areas without community water fluoridation had significantly higher odds of severe caries compared with children living in areas with water fluoridation after adjustment for age, sex, ethnicity, area-level deprivation and residual location, the New Zealand researchers found.

image of research logoThe children studied had undergone a health and developmental assessment as a part of the New Zealand’s B4 School Check screening program between July 2010 and June 2016.

Dr. Leon Stanislav, chair of the ADA’s National Fluoridation Advisory Committee, said that primary dentition is critical to the proper function of the permanent dentition.

“Premature loss of ‘baby teeth’ can cause serious mal-alignment of the permanent teeth,” Dr. Stanislav said. “This is aside from pain and suffering of tooth decay, abscessed baby teeth, and the cost of dental care treating such preventable conditions. Also, the unnecessary trauma of treating childhood decay comes into play.”

Primary teeth are very important for several reasons, added Dr. E. Angeles Martinez Mier, a professor at the Indiana University School of Dentistry and member of the National Fluoridation Advisory Committee.

“Baby teeth play a fundamental role in the development of the stomatognathic system, an anatomic system comprising teeth, jaws and associated soft tissues,” she said. “They are essential for an adequate nutrition process (chewing, biting) and proper speech development. Besides, deciduous teeth are key to maintain space and guide the later eruption of the permanent successors. The early loss of a primary tooth can impact negatively the quality of life of children.”

“Healthy teeth and healthy habits lead to successful aging, good general health and quality of life,” said Dr. Karin Arsenault of the Tufts University School of Dental Medicine and member of the committee.

Dr. Howard Pollick, a health sciences clinical professor at the University of California, San Francisco, School of Dentistry and member of the National Fluoridation Advisory Committee, echoed Dr. Stanislav’s comments that the study showed welcome results.

“Studies like this with contemporary large national data sets are important to show that, in spite of fluoridated toothpaste being widely available, community water fluoridation continues to be a benefit in reducing tooth decay for children as well as reducing hospitalization for dental treatment, particularly for those living in the most deprived areas,” Dr. Pollick said. “Community water fluoridation is the most effective tool to reduce disparities in oral health and is especially important at a time during the COVID-19 pandemic, when access to preventive dental services is reduced.”

For more information on fluoride and ADA advocacy of community water fluoridation, visit