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Water fluoridation, bone mass and fracture: a quantitative overview of the literature

journal contribution
posted on 2023-05-16, 11:58 authored by Graeme JonesGraeme Jones, Riley, MD, Couper, DJ, Terry DwyerTerry Dwyer
Objective: To use the technique of meta-analysis to address the following research questions: Is water fluoridation associated with altered fracture risk at a population level and are the differences between studies consistent with confounding or chance variation between studies? Method: The data sources utilised were Medline 1966-97, reviews and bibliographies. The search terms were fluoridation, bone mass and/or fracture. We included all observational studies published in English relating water fluoridation to bone mass and/or fracture in the initial assessment. Results: Water fluoridation had no evident effect on fracture risk (RR 1.02, 95% CI 0.96-1.09, n = 18 studies). There was marked heterogeneity between studies which could be explained, in part, by the combination of gender, urbanicity and study quality (R 2 0.25, p = 0.05, weighted analysis). Conclusions: Water fluoridation both at levels aimed at preventing dental caries and, possibly, at higher naturally occurring levels appears to have little effect on fracture risk, either protective or deleterious, at a population level. The small effect on bone mass seen in studies performed at the individual level is consistent with this finding. Variation between studies is also likely to be due to differences in the distribution of other recognised fracture risk factors between different populations. Confirmation of these findings is required in large studies performed at the individual level.


Publication title

Australian and New Zealand Journal of Public Health








Menzies Institute for Medical Research


Public Health Association Australian Inc.

Place of publication

Curtin, Australia

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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