Water Fluoridation (Report‪)‬

Introduction Rationale for this review. The use of fluoride (F) has been the cornerstone of caries preventive strategies since the middle of the 20th century. The painstaking epidemiological research in the early part of the 20th century led to the identification of naturally occurring F in drinking water as an agent with both beneficial and detrimental effects on the human dentition. Subsequent determination of the water F level that achieved an acceptable balance between the benefits (caries control) and detrimental effects (fluorosis) has been well documented [Murray et al., 1991; Burt and Eklund, 2006; Ellwood et al., 2008]. The first experimental trials of water fluoridation, i.e. the controlled addition of a F compound to a public water supply to bring its F concentration up to an optimal level to prevent dental caries, were conducted in the USA and Canada in the mid 1940s, [Murray et al., 1991] and established water fluoridation as an effective public health measure to control dental caries. Globally, it is estimated that 350 million people drink F-water. In Europe, water fluoridation operates in the UK and Spain, and reaches approximately 10% of the population of each country [British Fluoridation Society, 2004]. The Republic of Ireland has had mandatory water fluoridation since the 1960s, and currently 71% of the Irish population receives fluoridated water [Department of Health and Children, 2002].