Fluoridation helps protect adult teeth as well as children’s

Photo credit: Seniors Benefit From Drinking Water Together

Recent research reveals that community water fluoridation benefits adults as well as children.

While research into the effects of fluoridation in adults started earlier than for children, early studies suffered from a lack of information on effects of socioeconomic status and other confounding factors.  Recent studies with adults have been more robust but there is still some confusion – especially since the often cited recent Cochrane systematic survey of the scientific literature on fluoridation was unable to draw conclusions on this because of the strict inclusion criteria used was not suitable.

This new study checked the effects of lifetime access to fluoridation on the dental health of adults from a city in southern Brazil.  It concluded that lifetime access to community water fluoridation is associated with lower tooth decay in adults.

The study is:

Peres, M. A., Peres, K. G., Barbato, P. R., & Hofelmann, D. A. (2016). Access to Fluoridated Water and Adult Dental Caries: A Natural Experiment. Journal of Dental Research, 95(8): 1-7.

The full text of the paper is available here.

The researchers adjusted their data for well-known confounders such as socioeconomic status, the pattern of dental visiting, smoking, educational attainment, income, and age. Use of fluoridated toothpaste was common for all subjects so could not explain the results.

The final data, adjusted fo confounders, showed a greater protection with a longer exposure to fluoridated water. The figure below shows this data for  DMFT (decayed, missing and filled teeth) and DFT (decayed and filled teeth). The use of both measures helps to accommodate the fact that some teeth are missing for reasons other than decay.

The data is present as ratios of DMFT and DFT for the shorter exposure periods ( <50% and 50%-75%) to the values of DMFT and DFT for exposures of >75%.

So, once again a study showing the benefits of community water fluoridation. this time for adults with long time exposure to fluoridation.

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New research confirms adults benefit from community water fluoridation as well as children

Community water fluoridation is beneficial to adults as well as children.

A new Australian study confirms that lifetime access to community water fluoridation (CWF) is associated with reduced tooth decay for adults – at least in the age groups 15 – 34 years and 35 – 44 years.

The study is reported in the paper:

Do et al., (2017). Effectiveness of water fluoridation in the prevention of dental caries across adult age groups. Community Dentistry and Oral Epidemiology.

Other workers reported similar results. But Do et al., (2017) had a closer look at the data, because of the difficulties in assessing both access to CWF, and tooth decay, in adults. In particular, they carried out a secondary analysis which looked at lifetime access to CWF and tooth decay within defined age groups as well as across age groups of adults aged between 15 – 91 years.

They found the association of access to CWF with reduced tooth decay was strongest for the youngest adult age group, 15 – 34-year-olds.  The association was weaker, but still significant, for the 35 – 44 years age group. However, they did not see a significant association for the remaining age groups, 45 – 54 years and 55+ years.

The authors discuss possible reasons for what they call the “fading” of apparent benefits from CWF with age.

1: Lack of exposure to CWF during childhood for the older age groups. This is because CWF was not present when they were young. The authors say:

“there is some evidence among children at least of the importance of a critical period of exposure, where either the incorporation of fluoride into the developing tooth may be crucial or the establishment of a positive mouth ecology may set a child on a lifelong trajectory.”

This would be in line with research showing a systemic effect of fluoride for developing teeth in children. There is also that those older adults were exposed to risks of tooth decay before later being exposed to CWF.

2: A limit to the measurement of tooth decay in adults because the measures of tooth decay:

“increasingly shows saturation of all susceptible surfaces, whereby more members of an age group approach a ceiling in the sum of the surfaces with past or present caries experience. . . .  It should be emphasized that, for the older age groups, this saturation might have occurred before access to FW had become available in Australia.”

So, yet another confirmation of the benefits of CWF for adults as well as children.

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