Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Research
  • Published:

A review of water fluoridation studies and the effect on dental caries and treatment costs, undertaken in Scotland

British Dental Journal (2024)Cite this article

Abstract

Objectives This review aimed to investigate the effect of water fluoridation on the dental health of Scottish people by comparing results of starting and discontinuing fluoridation in Scotland.

Data sources Data sources were retrieved from electronic databases. The grey literature was also searched. Articles were selected if the population of interest was Scottish. The objective was to evaluate the influence of water fluoridation on dental caries using the dmft/s, DMFT/S (decayed, missing and filled teeth/surfaces) or deft/s indices (decayed, extraction needed, filled teeth/surfaces).

Data extraction Name of the authors, publication years, location of the study, sample size, type of study design, age of participants, method of assessing the outcome, data related to the exposure and the outcome, and the overall result of each study were extracted. The data were collected based on the effect of water fluoridation and its cessation on dental caries and the type of dentition.

Results Nine studies were included in the review. The findings revealed that the introduction of water fluoridation led to reductions in caries. Moreover, after the cessation of fluoridation, caries levels continued to remain lower in the fluoridated groups. Additionally, fluoridation had the effect of reducing the cost of dental treatment.

Conclusion Water fluoridation was effective in improving dental caries among the Scottish child population. New studies are required to provide contemporary evidence for water fluoridation in Scotland.

Key points

  • Water fluoridation is effective in reducing dental caries in the deciduous and permanent dentition of children.

  • Water fluoridation should be introduced across the UK to reduce dental caries.

  • The costs of dental treatment in children are reduced by water fluoridation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

References

  1. Vasantavada P V, Hearnshaw S, Do L, Vernazza C R, Zohoori F. Editorial - Community Water fluoridation. Community Dent Health 2021; 38: 158-160.

  2. Tobias G, Mordechai F, Tali C et al. The effect of community water fluoridation cessation on children's dental health: a national experience. Isr J Health Policy Res 2022; 11: 4.

  3. Mariño R, Zaror C. Economic evaluations in water-fluoridation: a scoping review. BMC Oral Health 2020; 20: 115.

  4. Iheozor-Ejiofor Z, Worthington H V, Walsh T et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015; DOI: 10.1002/14651858.CD010856.pub2.

  5. Methley A M, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res 2014; 14: 579.

  6. Blinkhorn A S, Brown M D, Attwood D, Downer M C. The effect of fluoridation on the dental health of urban Scottish Schoolchildren. J Epidemiol Community Health 1981; 35: 98-101.

  7. Stephen K W, Macpherson L M, Gilmour W H, Stuart R A, Merrett M C. A blind caries and fluorosis prevalence study of school-children in naturally fluoridated and nonfluoridated townships of Morayshire, Scotland. Community Dent Oral Epidemiol 2002; 30: 70-79.

  8. Stephen K W. A four-year fissure sealing study in fluoridated and non-fluoridated Galloway. Health Bull (Edinb) 1978; 36: 138-145.

  9. Attwood D, Blinkhorn A S. A reassessment of the dental health of urban Scottish schoolchildren following the cessation of water fluoridation. Community Dent Health 1989; 6: 207-214.

  10. Stephen K W, McCall D R, Tullis J I. Caries prevalence in northern Scotland before, and 5 years after, water defluoridation. Br Dent J 1987; 163: 324-326.

  11. Attwood D, Blinkhorn A S. Dental health in schoolchildren 5 years after water fluoridation ceased in south-west Scotland. Int Dent J 1991; 41: 43-48.

  12. Department of Health and Social Security. The Fluoridation Studies in the United Kingdom and the Results Achieved After Eleven Years. Reports on Public Health and Medical Subjects, no. 122. London: Her Majesty's Stationery Office, 1969.

  13. Downer M C, Blinkhorn A S, Attwood D. Effect of fluoridation on the cost of dental treatment among urban Scottish schoolchildren. Community Dent Oral Epidemiol 1981; 9: 112-116.

  14. Attwood D, Blinkhorn A S. Reassessment of the effect of fluoridation on cost of dental treatment among Scottish schoolchildren. Community Dent Oral Epidemiol 1989; 17: 79-82.

  15. UK Government. Statement on water fluoridation from the UK Chief Medical Officers. 2021. Available at https://www.gov.uk/government/publications/water-fluoridation-statement-from-the-uk-chief-medical-officers/statement-on-water-fluoridation-from-the-uk-chief-medical-officers (accessed July 2022).

  16. Seppä L, Kärkkäinen S, Hausen H. Caries in the primary dentition, after discontinuation of water fluoridation, among children receiving comprehensive dental care. Community Dent Oral Epidemiol 2000; 28: 281-288.

  17. Maupomé G, Clark D C, Levy S M, Berkowitz J. Patterns of dental caries following the cessation of water fluoridation. Community Dent Oral Epidemiol 2001; 29: 37-47.

  18. Gu X S, Shen Y M. Effects of stopping water fluoridation on prevalence of dental caries in children. Zhonghua Yu Fang Yi Xue Za Zhi 1989; 23: 346-348.

  19. Lemke C W, Doherty J M, Arra M C. Controlled fluoridation: the dental effects of discontinuation in Antigo, Wisconsin. J Am Dent Assoc 1970; 80: 782-786.

  20. Macpherson L M, Anopa Y, Conway D I, McMahon A D. National supervised toothbrushing programme and dental decay in Scotland. J Dent Res 2013; 92: 109-113.

  21. Kalsbeek H, Kwant G W, Groeneveld A, Backer Dirks O, van Eck A A, Theuns H M. Cessation of fluoridation of drinking water; results of caries research in Tiel and Culemborg in the period of 1968-1988. Ned Tijdschr Tandheelkd 1992; 99: 24-28.

  22. Seppä L, Kärkkäinen S, Hausen H. Caries frequency in permanent teeth before and after discontinuation of water fluoridation in Kuopio, Finland. Community Dent Oral Epidemiol 1998; 26: 256-262.

  23. McDonagh M, Whiting P, Bradley M et al. A systematic review of public water fluoridation. York: University of York, 2000.

  24. Centres for Disease Control and Prevention. Water fluoridation and costs of Medicaid treatment for dental decay - Louisiana, 1995-1996. MMWR Morb Mortal Wkly Rep 1999; 48: 753-757.

Download references

Acknowledgements

This study was carried out as part of a Master's Degree in Dental Public Health at the University of Dundee. We would also like to thank Scott McGregor for his help with the literature search process.

Author information

Authors and Affiliations

  1. School of Dentistry, Park Place, University of Dundee, DD1 4HN, UK

    Ahmed Al Rasheed

  2. Edinburgh Dental Institute, Lauriston Place, University of Edinburgh, EH3 9HA, UK

    Colwyn Jones

Authors
  1. Ahmed Al Rasheed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Colwyn Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Ahmed Al Rasheed initiated the review, undertook paper selection and writing of the review. Colwyn Jones developed the review question, undertook paper selection and writing of the review.

Corresponding author

Correspondence to Ahmed Al Rasheed.

Ethics declarations

The authors declare no conflicts of interest.

As this research methodology was a review of results from existing articles, essentially secondary analysis of outcomes from the publications found during the review literature search, university policy specified that ethical approval was not required.

Data availability

The research data associated with our paper are available within the reference list and can be accessed through online databases.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al Rasheed, A., Jones, C. A review of water fluoridation studies and the effect on dental caries and treatment costs, undertaken in Scotland. Br Dent J (2024). https://doi.org/10.1038/s41415-023-6719-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41415-023-6719-3

Search

Advanced search

Quick links