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Long-Term Associations between Water Fluoridation and Adult Dental Caries
1Cork University Business School, University College Cork, Cork, Ireland.
Journal of Dental Research
|May 27, 2026
Summary
Community water fluoridation (CWF) significantly reduces adult dental caries. Adults in the Republic of Ireland, with lifelong CWF exposure, showed substantially lower tooth decay compared to those in Northern Ireland.
Area of Science:
- Public Health
- Epidemiology
- Dental Research
Background:
- Dental caries remains a global health challenge, particularly in adults, despite declining childhood rates.
- Community water fluoridation (CWF) is a WHO-recommended strategy for caries prevention.
- Long-term studies on CWF's impact on adult caries experience are needed.
Purpose of the Study:
- To examine the association between lifelong community water fluoridation exposure and dental caries experience in adults.
- To assess if the association between CWF and caries differs across various tooth surfaces.
Main Methods:
- Utilized existing epidemiological, demographic, and sociological data from adults on the island of Ireland.
- Assessed caries experience using decayed, missing, and filled teeth (D3CMFT) and tooth surface (D3CMFS) indices.
- Employed negative binomial regression to analyze associations between region (as a proxy for CWF) and caries experience.
Main Results:
- Adults in the Republic of Ireland (with CWF) demonstrated significantly lower caries experience than those in Northern Ireland (without CWF).
- Adjusted analyses revealed 10.6% lower D3CMFT and 15.6% lower D3CMFS scores in the ROI group.
- The greatest reduction in caries was observed on approximal surfaces (18.6%), followed by smooth (14.9%) and occlusal (11.9%) surfaces.
Conclusions:
- Long-term community water fluoridation exposure is associated with reduced dental caries experience in adulthood.
- Findings provide life-course evidence supporting CWF's effectiveness in reducing caries across different tooth surfaces.
- Results can inform public health policies on the role of CWF in improving adult oral health.
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