Water fluoridation and your health

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Your health

Water fluoridation is a safe way to help protect teeth against decay and is supported by many organisations worldwide including:

• The World Health Organization
• The World Dental Federation
• National Health and Medical Research Council
• The Australian Dental Association
• The Australian Medical Association
• The Public Health Association of Australia

Some people worry that water fluoridation may cause serious problems such as cancer, bone fractures, birth defects, Alzheimer’s disease or allergy. The safety of water fluoridation has been frequently re-evaluated, and the best evidence does not link water fluoridation with any of these medical conditions.

• There have been many studies about water fluoridation. Any scientific study must be carefully reviewed to see if the results are likely to be accurate. A review is one way to consider the overall weight of evidence. One review (National Health Service Centre for Reviews and Dissemination, 2000) looked at 214 of the highest quality studies to assess the benefits and possible side effects of water fluoridation. It found that water fluoridation helps protect against tooth decay without causing any unwanted effects apart from dental fluorosis in some people (see page 12). Other reviews from Europe, North America and Australia also support the safety of water fluoridation. Some of these reviews are listed in the reference section.
• In areas with extremely high levels of natural fluoride in the water, skeletal fluorosis (bone pain and joint stiffness) may occur. Skeletal fluorosis is common in several parts of the world including India, China, parts of the Middle East and Africa, in areas where water supplies have fluoride levels naturally higher than those recommended by the World Health Organization. Skeletal fluorosis is extremely rare in the developed world.

Dental fluorosis

Mottling of tooth enamel (dental fluorosis) can occur if young children get too much fluoride. The use of fluoride tablets, drops or standard fluoride toothpaste by young children, adds to the chance of developing dental fluorosis. The amount of fluoride in standard fluoride toothpaste is about a thousand times higher than the amount in drinking water. For this reason, whether you have water fluoridation or not, it is important to:

• Discourage children from swallowing toothpaste.
• Clean children’s teeth with water and no toothpaste before the age of 18 months, unless otherwise recommended by a health professional.
• Use only a pea-sized amount of low-fluoride children’s toothpaste, smeared over the toothbrush, for children between the ages of 18 months and five years of age (inclusive), unless otherwise recommended by a health professional.
• Stop using fluoride drops and tablets.
• Only use fluoride mouthrinses from the age of 6 years.

Most dental fluorosis that does occur is barely noticeable and appears as very fine pearly white lines or flecks on the tooth enamel. It cannot develop after teeth are fully formed, and does not affect the function of teeth.

Mottling of tooth enamel is not always caused by too much fluoride. Other causes include medications, injury to the teeth or childhood infections––if fluoride is not the cause, then it should not be called dental fluorosis.

Dental fluorosis also occurs in areas without water fluoridation. This is why careful use of toothpaste described above is important for children in areas both with or without water fluoridation.

By using fluoridated toothpaste carefully it is possible to reduce the chances of dental fluorosis without denying anybody the benefits of water fluoridation.

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