A new report weighs up whether water fluoridation is an effective measure for reducing oral health inequalities and if concerns around negative side effects are well-founded.
Released by the Academy of Medical Sciences, the report found that water fluoridation does have a beneficial effect on reducing dental caries when utilised at an optimal concentration of between 0.7 and 1.2mg/L. It was also 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 decay-related dental extractions. However, the report said it is ‘unclear’ whether it reduces dental inequalities. The evidence showed no consistent effect in three-year-olds and a reduction in caries prevalence that was consistent across all deprivation levels in five-year-olds.
In adults, the greatest reduction in invasive dental treatments was observed 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 all levels of deprivation.
Are there any negative effects of water fluoridation?
Higher levels of water fluoridation were associated with a greater prevalence of dental fluorosis, according to the report. The authors stress that this is generally considered an ‘unwanted effect’ rather than ‘harm’, as it is a purely cosmetic problem.
In 2025, a study found ‘significant inverse associations’ between water fluoridation and children’s IQ scores, calling its safety into question. However, the Academy of Medical Sciences’ report said there is ‘no evidence of an effect on neurodevelopment or cognition, as measured by intelligence quotient’.
Other potential harms that have been raised previously include increased risks of being born with Down’s syndrome, having kidney stones, hip fractures, and bladder or bone cancer (osteosarcoma). At the concentration discussed in the report, it concluded that there was no evidence of a link between water fluoridation and these concerns. The authors acknowledged that most of these harms have not explicitly been investigated in children.
Barry Cockcroft, chair of the British Fluoridation Society, said: ‘Once again, water fluoridation receives a clean bill of health from a leading independent expert body. This latest review reinforces fluoridation’s role as a proven and effective foundation for improving oral health inequalities across the UK.’
Is fluoridation cost-effective?
The report also considered whether fluoridation schemes are effective from a cost versus benefit standpoint. It found that they are ‘cost-effective or net beneficial’ overall. The authors highlighted that this ‘should be considered within the context that the scheme is being implemented’, for example the population size and its oral health status, and the cost of implementing the scheme.
Public support of water fluoridation was described as ‘consistently high’ in the last 15 years. Several public surveys showed around two thirds of the population were in favour of adding fluoride to water.
Follow Dentistry.co.uk on Instagram to keep up with all the latest dental news and trends.
