{"id":291,"date":"2021-07-11T19:15:02","date_gmt":"2021-07-11T19:15:02","guid":{"rendered":"https:\/\/fluorideexposed.org\/fluoridescience\/?page_id=291"},"modified":"2022-04-26T06:34:50","modified_gmt":"2022-04-26T06:34:50","slug":"fluoride-and-dental-caries","status":"publish","type":"page","link":"https:\/\/fluorideexposed.org\/fluoridescience\/fluoride-and-dental-caries","title":{"rendered":"Fluoride and Dental Caries"},"content":{"rendered":"\n

Topic Summary<\/em><\/h2>\n\n\n\n
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By Center for Fluoride Research Analysis \/ Fluoride Science Editorial Board<\/span><\/a><\/h5>\n\n\n\n
Last updated: September 16, 2016<\/h5>\n\n\n\n
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OVERVIEW OF FLUORIDE AND DENTAL CARIES (TOOTH DECAY)<\/h5>\n\n\n\n

Dental caries, or tooth decay, is one of the most common chronic diseases experienced by children and adults in the United States. It is a multifactorial disease process driven by cariogenic bacteria in the mouth resulting in the dissolution of tooth structure. Cariogenic bacteria and inadequate oral hygiene, in addition to a diet consisting of an increased amount of sugar and carbohydrates, promote the decay process ultimately leading to pulpal necrosis and acute systemic infection if proper intervention is not provided in a timely manner to reverse or halt the disease process.<\/p>\n\n\n\n

The beneficial effect of fluoride in the prevention and control of dental caries was discovered as a result of extensive epidemiological studies of people living in communities with varying levels of natural fluoride in drinking water, which showed a strong inverse relationship between levels of fluoride and dental caries.1,2<\/sup> An observed natural breakpoint between the level of fluoride associated with decreasing prevalence of dental caries and increasing prevalence of objectionable enamel fluorosis was the basis of the U.S. Public Health Service\u2019s recommendation in 1962 regarding optimal fluoride level in drinking water at the concentration of 1 mg\/L (or ppm). An optimal range from 0.7 to 1.2 mg\/L was recommended for the prevention and control of dental caries in the community taking account of differing levels of water consumption associated with regional air temperature.2,3<\/sup> With fluoride in drinking water recognized as a public health measure to control dental caries, many ways of incorporating fluoride into daily use have been implemented since. The most widespread of these has been the introduction of fluoride into toothpaste, while fluoride was also made available via dental rinses, gels, foams, varnishes, tablets and drops. Although it is possible to reduce the incidence of dental caries by promoting proper oral hygiene and the avoidance of excessive intake of dietary sugars, the outcome depends on the individual\u2019s behavior and the quality of that behavior. While many countries in Europe, Latin America, and the Caribbean have chosen to add fluoride to milk and\/or table salt, the most practical and cost-effective approach to prevent dental caries at the community level in the U.S. is through fluoridation of drinking water.<\/p>\n\n\n\n

On April 25, 2015, the U.S. Department of Health and Human Services announced the final recommendation for optimal fluoride level in drinking water at the concentration of 0.7 mg\/L based on the contemporary landscape surrounding community water fluoridation that indicates 1) the pattern of water consumption is no longer different across different temperature zones, 2) the sources of fluoride has increased, and 3) national surveillance data show an increasing trend in the rate of mild-enamel fluorosis in recent years.4<\/sup>  This standardized level of fluoride in drinking water maintains the public health benefit of caries prevention while reducing the occurrence of enamel fluorosis.<\/p>\n\n\n\n

Over the past seventy years with large reductions in tooth decay in many industrialized countries which utilize water fluoridation, including the U.S., its effectiveness, safety, and return on investment of this initiative have been proven.5-8<\/sup> The following section summarizes the findings from the most recent systematic reviews on this topic.<\/p>\n\n\n\n

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SYSTEMATIC REVIEWS ON FLUORIDE AND DENTAL CARIES: WATER FLUORIDATION<\/h4>\n\n\n\n

MCDONAGH ET AL. (2000)5<\/sup><\/strong><\/h5>\n\n\n\n

Twenty-six studies on the effect of water fluoridation on dental caries, published before February 2000, met the inclusion criteria. The effect of water fluoridation was systematically examined as the difference in change in the prevalence of dental caries from baseline to final observation in fluoridated areas compared with non-fluoridated areas using the following two outcome measures: 1) decayed, missing, and filled primary\/permanent teeth; 2) proportion of children without dental caries. They found<\/p>\n\n\n\n