title: Critique of the review of 'Water fluoridation for the prevention of dental caries' published by the Cochrane Collaboration in 2015.
abstract: The Cochrane Review on water fluoridation for the prevention of dental caries was published in 2015 and attracted considerable interest and comment, especially in countries with extensive water fluoridation programmes. The Review had two objectives: (i) to evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries, and (ii) to evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis. The authors concluded, inter alia, that there was very little contemporary evidence, meeting the Review's inclusion criteria, that evaluated the effectiveness of water fluoridation for the prevention of dental caries. The purpose of this critique is to examine the conduct of the above Review, and to put it into context in the wider body of evidence regarding the effectiveness of water fluoridation. While the overall conclusion that water fluoridation is effective in caries prevention agrees with previous reviews, many important public health questions could not be answered by the Review because of the restrictive criteria used to judge adequacy of study design and risk of bias. The potential benefits of using wider criteria in order to achieve a fuller understanding of the effectiveness of water fluoridation are discussed.
authors.affiliation: Newcastle University.
authors.forename: A J
authors.initials: AJ
authors.lastname: Rugg-Gunn
authors.affiliation: University of Adelaide.
authors.forename: A J
authors.initials: AJ
authors.lastname: Spencer
authors.affiliation: School of Dentistry, University of Leeds.
authors.forename: H P
authors.initials: HP
authors.lastname: Whelton
authors.affiliation: NHS Health Scotland, Edinburgh.
authors.forename: C
authors.initials: C
authors.lastname: Jones
authors.affiliation: Dental Public Health, University of Leeds.
authors.forename: J F
authors.initials: JF
authors.lastname: Beal
authors.forename: P
authors.initials: P
authors.lastname: Castle
authors.affiliation: Faculty of Dentistry, University of Toronto.
authors.forename: P V
authors.initials: PV
authors.lastname: Cooney
authors.affiliation: American Fluoridation Society.
authors.forename: J
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Institute of Public Health, University of Cambridge.
authors.forename: M P
authors.initials: MP
authors.lastname: Kelly
authors.affiliation: University of Sheffield.
authors.forename: M A
authors.initials: MA
authors.lastname: Lennon
authors.affiliation: American Dental Association, Chicago.
authors.forename: J
authors.initials: J
authors.lastname: McGinley
authors.affiliation: University College Cork.
authors.forename: D
authors.initials: D
authors.lastname: O'Mullane
authors.affiliation: Hebrew University, Hadassah, Jerusalem.
authors.forename: H D
authors.initials: HD
authors.lastname: Sgan-Cohen
authors.affiliation: Ontario Association of Public Health Dentistry.
authors.forename: P P
authors.initials: PP
authors.lastname: Sharma
authors.affiliation: University of Otago.
authors.forename: W M
authors.initials: WM
authors.lastname: Thomson
authors.affiliation: The Borrow Foundation.
authors.forename: S M
authors.initials: SM
authors.lastname: Woodward
authors.affiliation: Ministry of Health, Jerusalem.
authors.forename: S P
authors.initials: SP
authors.lastname: Zusman
mesh_terms: D003731:Dental Caries / Q000517:prevention & control*; D005457:Fluoridation; D009050:Fluorosis, Dental / Q000209:etiology; D006801:Humans; D015397:Program Evaluation; D011785:Quality Assurance, Health Care