US researchers have found that banning fluoride would substantially increase dental decay and costs, particularly for publicly insured and uninsured children.
The research team at Mass General Brigham in Boston, Massachusetts, focused on children for the study—published in JAMA Health Forum—because fluoride strengthens teeth during development, and more robust data links fluoridated water to oral health in this age group.
The study used detailed oral health and water fluoridation data collected from 8484 children (ages 0–19, 49 per cent girls) in the nationally representative National Health and Nutrition Examination Survey (NHANES).
Using this dataset, the researchers developed a microsimulation model to see how banning fluoride from drinking water would impact oral health, quality of life and dental care costs.
The researchers simulated two scenarios over five- and 10-year periods, which align with policy planning horizons. First, maintaining current fluoride levels, and second, eliminating the addition of fluoride to public water.
The researchers found that eliminating fluoride increased the total number of decayed teeth by 7.5 percentage points, or 25.4 million more teeth with tooth decay over five years (equivalent to a tooth for one out of every three American children). The number of fluorosis cases—a discolouring of tooth enamel due to excessive fluoride intake—decreased by 0.2 million.
They also estimated a cost of $9.8 billion in additional dental care costs over five years, which rose to $19.4 billion after 10 years.
“We know fluoride works. We’re able to show just how much it works for most communities and how much people stand to lose if we get rid of it,” Dr Lisa Simon said.
