September 2015

Community Dental Health (2015) 32, 130–131 Editorial The Cochrane review of water fluoridation; a commentary Professor Michael A Lennon OBE The recently published systematic review of water fluoridation by the Cochrane Oral Health Group (Iheozor-Ejiofor et al., 2015) concludes that “the initiation of water fluoridation results in a 35% reduction in dmft and a 26% reduction in DMFT compared to the median control group value” and that “there were also increases in the percentage of caries-free children of 15% in deciduous dentition and 14% in permanent dentition” - oral health improvements which led the COHG authors to the view that “fluoridation is effective at reducing caries levels in children”. Looking at broadly the same literature, the York Report (McDonagh et al., 2000) made similar findings and concluded that the evidence was of “moderate quality” and that “the best available evidence suggests that fluoridation of drinking water supplies does reduce caries prevalence”. The Australian National Health and Medical Research Council (2007) concluded that “the existing body of evidence strongly suggests that water fluoridation is beneficial at reducing dental caries”. In two American reviews the authors concluded that there is “strong evidence that community water fluoridation is effective in reducing the cumulative experience of dental caries within communities” (Truman et al., 2002) and that there was “strong evidence of effectiveness in reducing dental caries across populations” (Community Preventive Services Task Force, 2013). All five systematic reviews between 2000 and 2015 reached the conclusion that fluoridation reduces dental caries in children. Three of them called the evidence ‘strong’. McDonagh et al. called it ‘moderate’.