SynthesisJournal of epidemiology and community health2016
Does cessation of community water fluoridation lead to an increase in tooth decay? A systematic review of published studies.
Synthesis in Journal of epidemiology and community health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review on the Association Between Water Fluoride Levels and Dental Fluorosis: Exploring the 'Halo Effect' and Confounding Environmental Factors.International journal of molecular sciences · 2026Pooled it
- The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis.Environmental health : a global access science source · 2025Pooled it
- From Evidence to Engagement: Understanding Online Resistance to Community Water Fluoridation for Public Health Communication-A Qualitative Study.Journal of public health dentistry · 2026Article
- Analysis of Water Fluoridation Debates on Meta Platforms Using Advanced Machine Learning Approaches.JDR clinical and translational research · 2026Article
- Upstream Interventions to Promote Oral Health and Reduce Oral Health Inequalities: A Scoping Review.Community dentistry and oral epidemiology · 2026Article
- Community water fluoride cessation and rate of caries-related pediatric dental treatments under general anesthesia in Alberta, Canada.Canadian journal of public health = Revue canadienne de sante publique · 2024Article
- Distribution of Dental Fluorosis in the Southern Zone of Ecuador: An Epidemiological Study.Dentistry journal · 2023Article
- Fluoridation cessation and children's dental caries: A 7-year follow-up evaluation of Grade 2 schoolchildren in Calgary and Edmonton, Canada.Community dentistry and oral epidemiology · 2022Article
- The Impact of Water Fluoridation on Medicaid-Eligible Children and Adolescents in Alaska.Journal of prevention (2022) · 2022Article
- The effect of community water fluoridation cessation on children's dental health: a national experience.Israel journal of health policy research · 2022Article
- Impact of water fluoridation on dental caries decline across racial and income subgroups of Brazilian adolescents.Epidemiology and health · 2022Article
- Strengthening the approach to oral health policy and practice in Canada.Paediatrics & child health · 2020Article
- Dental caries experience in children of a remote Australian Indigenous community following passive and active preventive interventions.Community dentistry and oral epidemiology · 2019Article
- Consequences of community water fluoridation cessation for Medicaid-eligible children and adolescents in Juneau, Alaska.BMC oral health · 2018Article
- Making the most of natural experiments: What can studies of the withdrawal of public health interventions offer?Preventive medicine · 2018Review
- A Radiographic Evaluation of Missing of Permanent First Molars in a Group of Iranian Children and Adults: A Retrospective Study.International journal of dentistry · 2018Article
- Fluoridation cessation: More science from Alberta.Community dentistry and oral epidemiology · 2017Article
- Maintaining Good Oral Health With Fluoridated Water.American journal of lifestyle medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
backgroundCessation of community water fluoridation (CWF) appears to be occurring with increasing frequency in some regions. Our objective was to comprehensively review published research on the impact of CWF cessation on dental caries.
methodsWe searched 13 multidisciplinary databases. Results were synthesised qualitatively and quantitatively.
resultsWe identified 15 instances of CWF cessation ('intervention') in 13 countries, which covered a broad time frame (1956-2003) and diverse geographical and political/economic contexts. Overall, results were mixed, but pointed more to an increase in caries postcessation than otherwise. For example, of the 9 studies with at least moderate methodological quality based on criteria we developed for this review, 5 showed an increase in caries postcessation. 3 studies did not show an increase in caries postcessation; however, important postcessation changes (eg, implementation of alternative fluoride delivery programmes) and/or large-scale social change may have contributed to those effects. Of the 3 study groupings that permitted quantitative synthesis, 2 showed statistically significant mean overall increase in caries postcessation; however, quantitative synthesis results must be interpreted cautiously.
conclusionsOverall, the published research points more to an increase in dental caries post-CWF cessation than otherwise. However, the literature is highly diverse and variable in methodological quality. To build this literature, it is important to exploit research opportunities presented by CWF cessation. Remaining knowledge gaps include the impact of CWF cessation on the distribution of dental caries (ie, equitable or not) and understanding the decision-making circumstances around CWF cessation.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.