PREVENTING DENTAL CARIES WITH FLUORIDE: THE RISKS AND BENEFITS SUMMARY: A recent Cochrane review on water fluoridation found that the initiation of water fluoridation resulted in reductions in dmft

A recent Cochrane review on water fluoridation found that the initiation of water fluoridation resulted in reductions in dmft of 1.81 (35%) and in DMFT of 1.16 (26%). There were also increases in the percentage of caries-free children (deciduous dentition: 15%, permanent dentition: 14%). However, the majority of the studies were conducted prior to 1975, and the widespread use of fluoride toothpaste, and the authors found very little contemporary evidence on the efficacy of water fluoridation. They estimated that for a fluoride level of 0.7 ppm the percentage of participants with some degree of fluorosis was 40% and that in 12.5% this was of aesthetic concern. In the following editorial in Fluoride, this editor noted that the ability of fluoride to adversely cellular metabolism in cariogenic bacteria was its Achilles’ heel for being a useful systemic therapeutic agent as it could also disrupt the ultrastructure of mitochondria and endoplasmic reticulum, and alter enzyme and gene expression levels in humans. The Fluoride editorial noted that, as well as contributing to dental fluorosis, systemic fluoride intake may be a possible aetiological factor in a number of significant health problems and concluded that an objective assessment of the risks and benefits of water fluoridation, together with taking account of the precautionary principle, indicated that systemic fluoride ingestion for preventing dental caries was a flawed concept.