A literature review of the risk of possible harmful effects from water fluoridation was commissioned from ESR. The ESR review concludes that there was no persuasive evidence of harmful effects from optimal water fluoridation (between 0.7 and 1.0 ppm), and the evidence has strengthened that there are no serious health risks associated with water fluoridation.
Fluoride tends to accumulate in bone with age and this may affect the strength of bone. Osteoporosis (the loss of bone mass while maintaining a normal composition) occurs naturally with increasing age and is influenced by a variety of genetic, environmental and lifestyle factors, including nutrition, use of medicines, alcohol and tobacco use, and amount of physical activity. The ESR review considers the eight recent studies that addressed the question of whether there could be some association between fluoridation and bone fracture risk. While all the studies had some limitations, the results were reassuring and strengthened the evidence that there is no increased risk of bone fracture associated with optimal levels of fluoridation of water supplies.
The ESR review found that, of the four studies examining cancer in relation to fluoridation published since 1995, no meaningful evidence has been published that there is an association between fluoridation and cancer.