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latest information

(05/01/16) A summary of 'Cochrane Collaboration systematic review of water fluoridation 2015' has been posted in Reports.
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(16/04/14) A critique of 'One in a Million: The Facts' has been posted in Reports.
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(16/04/14) 'Fluoridation: Popularity' has been posted in the Archive.
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(18/04/10) New fluoridation scheme for Southampton

(18/04/10) The Reports and Archive sections have been updated with further documents and links

(11/07/09) A critique of Prof. Newton's report to South Central SHA has been posted in Reports.
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(28/09/08) A critique of the South Central Strategic Health Authority Consultation Paper on Water Fluoridation in Southampton, has been posted in Reports.
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(07/09/08) A response to the Chief Dental Officer's 'Dear Colleague' letter of guidance for new schemes, endorsed by scientists from the York review, has been posted in Reports.
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(23/06/08) Isle of Man has announced on 12th June that it will not be fluoridating its water supply
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4 York scientists' open letter

11th December 2002

Dear Minister,

We are scientists involved in the systematic review of evidence on the effects of water fluoridation, carried out by the NHS Centre for Reviews and Dissemination at the University of York. As far as we are aware, no other review of this topic is of comparable scientific standard, and we are concerned about some continuing misinterpretations of the evidence which could have implications for public policy. It is not for us to say whether the standard of evidence should be judged sufficient for a public health measure affecting whole populations, but we think it is important that decision makers are aware of what the review really found:

  • Effectiveness of fluoridation in reducing caries

    We could discover no reliable, good-quality evidence in the fluoridation literature world-wide. What we found suggested that fluoridation was likely to have a beneficial effect, but in fact the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.

  • Effectiveness of fluoridation in reducing inequalities in dental health across social groups

    This evidence is weak, contradictory and unreliable.

  • Safety of fluoridation

    Apart from an increase in dental fluorosis (mottled teeth) we found no clear pattern among the possible negative effects we examined, and we felt that not enough was known because the quality of the evidence is poor.

We append relevant extracts from the report of the review from which the conclusions under 1. and 2. can be substantiated. 3. covers too broad an area to summarise easily.

Since the report was published in September 2000 there has been no other scientifically defensible review that would alter the findings of the York review. As emphasised in the report, only high-quality studies can fill in the gaps in knowledge about these and other aspects of fluoridation. Recourse to other evidence of a similar or lower level than that included in the York review, no matter how copious, cannot do this.

We think these matters are important enough to bring directly to your attention, as well as to the notice of others who have a stake in public health policy.

Yours sincerely,

(SIGNED) Professor Jos Kleijnen
Director, NHS Centre for Reviews and Dissemination

(SIGNED) Sir Iain Chalmers
UK Cochrane Centre

(SIGNED) Professor Trevor Sheldon
Head of Department
Department of Health Sciences, University of York

(SIGNED) Professor George Davey-Smith
Department of Social Medicine
University of Bristol

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