Community Water Fluoridation: An evidence review

The 2014 report from the Royal Society of New Zealand (RSNZ) and the 2021 report from the Office of the Prime Minister’s Chief Science Advisor (OPMCSA) on the risks and benefits of community water fluoridation (CWF) concluded that CWF is a safe and effective public health intervention to prevent dental caries.

This current review updates the evidence regarding CWF published since the OPMCSA report of 2021.

The current review supports that conclusion on the basis that;

• the evidence that has been published since 2021 indicates ongoing clear benefits from CWF even during the period when alternative forms of fluoride (such as fluoride toothpaste) are available and 
• CWF promotes equity by decreasing the incidence and severity of dental caries in individuals in areas of high socioeconomic deprivation as much as, or more than individuals in areas of less deprivation and 
• there has been no high-quality evidence published since those 2014 and 2021 reports to suggest a causal link between fluoride exposure at the levels used in Aotearoa New Zealand for CWF and significant harm to health.

Individuals living in countries with high naturally occurring fluoride in drinking water are at greater risk of dental fluorosis. However, the risk and severity of this complication in the setting of CWF is very low. Aotearoa New Zealand does not have high naturally occurring fluoride levels in drinking water.