After a successful call for papers, BMC Oral Health is delighted to announce the publication of a Collection of articles on water fluoridation and oral health. Professor Maha El Tantawi and Professor Morenike Oluwatoyin Folayan, two senior members of the editorial board, launched the Collection to support the United Nation’s Sustainable Development Goals (SDGs).
The topic of water fluoridation and oral health addresses both Maha’s and Morenike’s research interests. Maha El Tantawi, a Professor of Dental Public Health at Alexandria University, Egypt, and Morenike, a Professor of Paediatric Dentistry at Obafemi Awolowo University, Nigeria, often collaborate to investigate the social determinants associated with early childhood caries and oral health status in Nigeria. Maha also researches the impact of public health measures, such as sugar tax and tobacco cessation counselling, on dental health. As well as investigating the risk factors associated with childhood caries, Morenike researches dental anxiety management and the determinants of oral health in marginalised communities. Morenike focuses on community engagement in research and supports the prompt translation of evidence-based research to policies and programs to reduce inequality and improve health and well-being for all. In this blog, Maha and Morenike discuss the articles included in the Collection and how they support the SDGs.
BMC Oral Health Collection – Something in the Water: Fluoridation and Caries
Fluoride is well known to have beneficial effects on dental health by helping to prevent cavities. Therefore, as a public health measure, fluoride is often added to community water supplies. However, when present in drinking water above the World Health Organisation’s (WHO’s) recommended concentration, long term exposure can lead to a disease called fluorosis. Fluorosis is characterised by staining and pitting of the teeth but can cause painful damage to bones and joints in severe cases. Therefore, communities must have access to drinking water containing safe levels of fluoride. As a result, water fluoridation is an important discussion topic among dentists, public health practitioners, policymakers and stakeholders interested in oral health and well-being. The review on water fluoridation strategy in England included in the Collection by Wordley and Bedi is an excellent example of such discussion.
The Collection aligns with multiple SDGs, including SDG#3, SDG#6, SDG#8, and SDG#10. For example, the Collection supports SDG#3 by further demonstrating the well-known anti-caries effect of fluorides; this information helps to ensure good health and well-being for all. Stangvaltaite-Mouhat et al. examined the association between fluoride levels in the drinking water and the susceptibility of different tooth surfaces to caries in Lithuanian adults. The researchers found that higher levels of fluoride (≥ 0.7 ppm) in the drinking water was associated with lower levels of dental caries in all tooth surface groups.
Research within the Collection also aligns with SDG #6 to “achieve universal and equitable access to safe and affordable drinking water for all” and SDG #10, which aims for reduced inequalities. The process of water fluoridation includes adjusting the concentration of fluoride in community water to predetermined levels to ensure access to safe drinking water. However, many communities are exposed to high fluoride levels in groundwater, leading to fluorosis. In this Collection, Rojanaworar et al. investigate the prevalence of dental fluorosis within agricultural communities in Thailand exposed to high levels of natural fluoride in groundwater used for household consumption. The researchers demonstrate that the occurrence of dental fluorosis among children exposed to fluoride concentrations in water sources greater than the WHO guideline value of 1.5mg/L is 1.62 times greater than those with drinking water containing the recommended concentration. This research highlights the need for access to safe drinking water in these areas. Furthermore, the Collection features an article by Rosário et al. that describes significant variability of fluoride concentrations in the water from treatment stations in Brazilian cities. Importantly, the group finds that over half of the public water supplies analysed had fluoride concentration levels outside the acceptable range, affecting the Brazilian population’s risk of developing oral diseases.
Articles within the Collection also support SDG #8 to “promote sustained, inclusive and sustainable economic growth”. The Collection features a scoping review by Mariño and Zaror of cost-effectiveness analyses of community water fluoridation (CWF), concluding that CWF represents an appropriate use of communities’ resources. In addition, a research article by Cronin et al. demonstrates that despite a reported increase in the prevalence of mild enamel fluorosis remains, CWF remains a cost-effective public health intervention for Irish schoolchildren.
To read these papers on water fluoridation and oral health, please visit <https://bmcoralhealth.biomedcentral.com/articles/collections>.