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Expert Evaluation by Tim Wright DDS, MS <br /> Community water fluoridation is one of the few preventive therapies ever evaluated at the <br /> community level and there are over 100 years of science evaluating the beneficial effects of fluoride <br /> related to caries reduction. Systematic reviews evaluating the community based intervention trial on <br /> community water fluoridation and its beneficial effects on caries provide the highest level of scientific <br /> evidence achievable.'2 Reviews also show that removing fluoride from the drinking water results in an <br /> increase in dental caries.3 Anti-fluoridation advocates may refer to the 2015 Cochrane Review that there <br /> is little contemporary evidence meeting inclusion criteria ... to determine effectiveness of water <br /> fluoridation in preventing caries in adults.4 Cochrane reviews are based on randomized control trials and <br /> water fluoridation has been tested as a community based intervention as it does not lend itself to a <br /> randomized controlled trial design. This type of study would be very difficult to implement. <br /> There are multiple guidelines developed using systematic reviews recommending fluorides in a <br /> variety of forms for effective caries prevention. There is a tremendous body of evidence showing that <br /> for 75 years community water fluoridation has provided a safe and effective method of preventing and <br /> arresting dental caries. Community assessment of water fluoridation also shows that it helps reduce the <br /> prevalence of dental caries in populations challenged with social deprivation.5 <br /> Reference: <br /> 1. McDonagh MS, Whiting PF, Wilson PM, et al. Systematic review of water fluoridation. BMJ <br /> 2000;321(7265):855-9. <br /> 2. Yeung CA. A systematic review of the efficacy and safety of fluoridation. Evid Based Dent <br /> 2008;9(2):39-43. <br /> 50 <br />