Dental caries is a common cause of acute preventable hospital admissions in Australia, and the addition of fluoride to water systems …show more content…
(Rugg-Gunn et al, 2016) The Cochrane fluoride review, specifically the York review on water fluoridation evaluated the efficacy of fluoride population wide in the prevention of caries. Despite the fact that the main findings established that the “median difference in percentage of caries free was 14.6% (-5% to +64%), and the median difference in dmft/DMFT was 2.25 (0.5-4.4)” (Treasure et al., 2017), different levels of evidence quality were employed. The evidence suggests that fluoridation of drinking water leads to reduced caries prevalence, both as measured by the proportion of children who are caries free and by the mean dmft/DMFT score. They obtained their results for the effectiveness of fluoride from moderate levelled quality of evidence; using before and after studies and cohort studies. Anecdotally, the evaluation of safety and adverse effects of fluoride such as fluorosis were with low quality research methods. The differing quality of evidence used with the points in this review questions its reliability, however since it has been approved as a Cochrane review, this evidence must be valid because Cochrane …show more content…
(Armfield, 2017) Water fluoridation is important for its remineralising properties, therefore water consumption is the most effective method to prevent dental caries. Fluoride has been known to have remineralising properties since the 1980s, and the most recent Cochrane review states that it “reduces the proportion of people with any decay and the average severity of decay”. (Weintraub, 2002) The Australian Dental Association agrees with this statement, summarising, “Fluoride is crucial to combatting decay” (ADA, 2017).” Further to this, ADA concludes that fluoride is effective because it decreases the acid solubility of enamel and enhances remineralisation. When the oral cavity reaches the critical pH of 5.5, the condition in which demineralisation is favourable, the fluoride “allows for the attraction of calcium and phosphate ions”. (Goldstep, 2012) Systemic fluoride consumption is a viable preventative strategy because fluoride is available in the plaque fluid as a reservoir and during the remineralisation process, diffusion of fluoride ions into the enamel builds up as fluorapatite. “To receive the benefit of the remineralising process, fluoride must be present in a person's saliva…therefore drinking fluoridated tap water throughout the day would be a better choice than unfluoridated water”. (Salvo, 2017) Fluorapatite creates a more acid resistant surface, to reduce the ability