{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:07:19Z","timestamp":1792080439711,"version":"4.4.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JDR Clinical &amp; Translational Research"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Fluoridation of community water supplies constitutes one of the most effective public health interventions for preventing dental caries. In recent years, questions have been raised about its effectiveness and safety. This study aims to systematically review and summarize the existing evidence on community water fluoridation (CWF) and dental caries in permanent and deciduous teeth. Five databases and 3 gray databases were searched for relevant studies. Paired reviewers independently screened the studies, extracted data, and assessed their methodological quality. Standard mean differences (SMDs) for dmf(s)\/DMFT(S) (decayed, missing, and filled teeth\/surface) and odds ratios (ORs) for caries prevalence were measured between exposure or not to CFW for deciduous and permanent teeth. Subgroup analysis was performed to explore whether the study design, continent, or decade of publication changed the point estimates. Seventy-four studies were included in the qualitative analysis: 57 cross-sectional, 13 before-and-after, and 4 cohort studies. Thirty-two studies provided sufficient data for meta-analyses. The overall SMD of DMFT and dmf in those exposed to CWF compared with unexposed were \u22120.32 (95% confidence interval [CI]: \u22120.48 to \u22120.17,\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 96%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.01) and \u22120.30 (95% CI: \u22120.39 to \u22120.21,\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 88%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.01), respectively. The prevalence of caries was smaller in those exposed to CWF for both the permanent (OR = 0.52, 95% CI: 0.43 to 0.63) and deciduous (OR = 0.60, 95% CI: 0.48 to 0.76) dentitions. Study design, continent, or decade of publication satisfactorily explained the heterogeneity between studies. Communities where water was fluoridated experienced less caries and differences expressed in terms of SMD and prevalence (OR) where of high magnitude, both in children and in adults. The results of the meta-analyses revealed significant differences in caries experience and prevalence in favor of CWF, which represents an effective and comprehensive public health intervention for caries prevention, especially in the primary dentition.\n                  <\/jats:p>\n                  <jats:sec>\n                    <jats:title>Knowledge Transfer Statement:<\/jats:title>\n                    <jats:p>Based on the published literature, the results of this study show that fluoridation of community water supplies is still an effective public health intervention to prevent dental caries, both in children and adults, despite the widespread availability of fluoride-containing dental products, especially toothpaste. This result adds to the existing evidence to support its incorporation into public oral health policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23800844251342804","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T02:17:13Z","timestamp":1750990633000},"page":"107-116","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Water Fluoridation and Dental Caries Prevention Globally: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8557-0808","authenticated-orcid":false,"given":"C.F.D.","family":"Nascimento","sequence":"first","affiliation":[{"name":"Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.A.D.S.","family":"Gindri","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.N.","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"School of Dentistry, University Center\u2014UNIFAE, S\u00e3o Jo\u00e3o da Boa Vista, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-0120","authenticated-orcid":false,"given":"L.R.","family":"Paranhos","sequence":"additional","affiliation":[{"name":"Department of Preventive and Community Dentistry, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.N.","family":"Hugo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ipd.12928"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Bomfim RA Fraz\u00e3o P. 2022. Impact of water fluoridation on dental caries decline across racial and income subgroups of Brazilian adolescents. Epidemiol Health. 44:e2022007. https:\/\/doi.org\/10.4178\/epih.e2022007.","DOI":"10.4178\/epih.e2022007"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.16427"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.2307\/4584182"},{"key":"e_1_3_2_6_1","unstructured":"Deeks JJ Higgins JPT Altman DG editors. 2023. Chapter 10: analysing data and undertaking meta-analyses. In: Higgins JPT Thomas J Chandler J Cumpston M Li T Page MJ Welch VA editors. Cochrane handbook for systematic reviews of interventions version 6.4. 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