Some detractors of water fluoridation support concentrated topical methods to deliver fluoride, as seen in these fluoride trays often used in dentistry.Discoloration of teeth as seen in dental fluorosis caused by excessive fluoride.
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Water fluoridation opposition refers to activism against the addition of fluoridation chemicals to public water supplies. more...

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Opposition to water fluoridation arises from concern over the lack of quality research demonstrating its efficacy and safety, evidence that it may cause serious health problems, and a general resistance to the idea of compulsory 'mass medication' which takes away an individual's right to choose.
Despite the University of York's conclusion that the "evidence about reducing inequalities in dental health (using water fluoridation) was of poor quality, contradictory and unreliable" (though they noted that overall the studies they reviewed did support a decrease in dental decay from fluoridated water) , and members of the U.S. Environmental Protection Agency (EPA) calling for a ban on water fluoridation , most major medical and dental research associations maintain that water fluoridation is a safe and effective way to prevent tooth decay and improve oral health.
Many industrialized countries have since dispensed with water fluoridation having found other means to prevent dental decay.

Efficacy of water fluoridation

In order to test the efficacy of water fluoridation, studies tend to look at the incidence of decayed, missing and filled teeth (DMFT) between fluoridated and non-fluoridated areas.
A recent review of the evidence from the University of York, published in 2000, examined 30 studies. The researchers concluded that the quality of evidence in most studies was poor, also expressing concern over the "continuing misinterpretations of the evidence." Of the studies examined, there were mixed conclusions on the effectiveness of water fluoridation - the majority found some improvement, some showed no difference, some actually showed an increase in decay. The study did find an increase in cosmetic fluorosis, but no evidence of any link between fluoride and cancer, Down syndrome, or bone fractures. It reserved caution however. A BBC story reviewing the review article, suggested that because of the poor evidence it said no firm conclusions should be drawn, and more evidence is needed.

Those that question the effectiveness of water fluoridation point out that dental decay continues to exist in water fluoridated communities. They reason that if fluoride is effective, then there would be no more tooth decay, and suggest that the continued prevalence of tooth decay among low-income groups demonstrates the ineffectiveness of fluoridation. One study by the National Institute of Dental Research showed little difference in tooth decay rates among children in fluoridated and non-fluoridated communities. In the study's results, the difference between the children exposed to water fluoridation, and those who were not exposed, was very small, between 0.12 and 0.30 DMFS (Decayed Missing and Filled Surfaces).

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