{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:33:21Z","timestamp":1793824401226,"version":"4.6.1"},"reference-count":31,"publisher":"FapUNIFESP (SciELO)","issue":"5","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Braz. Dent. J."],"abstract":"<jats:p>Abstract Since the 1950s, the benefits and risks of fluoridated water use have been debated worldwide. In the past, it was considered that the systemically ingested fluoride would exert its primary preventive effect after being incorporated into the enamel as fluorapatite, making the enamel more resistant to the caries process; however, it is now recognized that the main effect of water fluoridation is local and post eruptive. On the other hand, irrespective of the caries decline reported worldwide, the anticaries benefit of water fluoridation continues to be observed even in developed countries. Regarding the risks, water fluoridation is considered an acceptable community-based method for fluoride delivery, because the risk of developing dental fluorosis lesions due to the ingestion of fluoride during the enamel formation period has been deemed acceptable when contrasted to the anticaries benefits of fluoride. However, the use of fluoride in water to control caries has created a controversy due to data associating water fluoridation as the cause of some systemic diseases. Therefore, the aim of this descriptive review was to discuss the systemic effects (risks) of water fluoridation use.<\/jats:p>","DOI":"10.1590\/0103-6440201903124","type":"journal-article","created":{"date-parts":[[2019,10,5]],"date-time":"2019-10-05T15:26:35Z","timestamp":1570289195000},"page":"421-428","source":"Crossref","is-referenced-by-count":47,"title":["Systemic Effects (Risks) of Water Fluoridation"],"prefix":"10.1590","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-5605","authenticated-orcid":false,"given":"Jaime A","family":"Cury","sequence":"first","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6593-6040","authenticated-orcid":false,"given":"Antonio P","family":"Ricomini-Filho","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6102-7608","authenticated-orcid":false,"given":"Francine L. Perecin","family":"Berti","sequence":"additional","affiliation":[{"name":"Pediatric Dentist,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7660-5685","authenticated-orcid":false,"given":"Cinthia PM","family":"Tabchoury","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2019,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1590\/S1806-83242010000500003","article-title":"Fluoride: its role in dentistry","volume":"24","author":"Tenuta LM","year":"2010","journal-title":"Braz Oral Res"},{"key":"ref2","series-title":"Dental Caries: The Disease and Its Clinical Management","first-page":"245","volume-title":"Fluorides in caries control","author":"Fejerskov O","year":"2015","edition":"ed 3."},{"key":"ref3","first-page":"80","article-title":"Benefits and risks of fluoride supplements of Brazilian Market (In Portuguese)","volume":"2","author":"Rebelo MAB","year":"2014","journal-title":"Vig Sanit Debate"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/154407370802000104","article-title":"How to maintain a cariostatic fluoride concentration in the oral environment","volume":"20","author":"Cury JA","year":"2008","journal-title":"Adv Dent Res"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1159\/000489132","article-title":"Fluoride increase in saliva and dental biofilm due to a meal prepared with fluoridated water or salt: a crossover clinical study","volume":"53","author":"Lima CV","year":"2019","journal-title":"Caries Res"},{"key":"ref6","series-title":"Oral Biochemistry","first-page":"124","volume-title":"Metabolism and toxicity of fluoride","author":"Nobrega FF","year":"2017","edition":"1st ed."},{"key":"ref7","series-title":"Medical emergencies in Dentistry","first-page":"145","volume-title":"Acute intoxication by fluoride ingestion","author":"Cury JA","year":"2011","edition":"3rd ed."},{"key":"ref8","series-title":"Fluoride in dentistry","first-page":"55","volume-title":"Fluoride metabolism","author":"Ekstrand J","year":"1996","edition":"2nd ed."},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1177\/00220345920710051901","article-title":"Acute and chronic fluoride toxicity","volume":"71","author":"Whitford GM","year":"1992","journal-title":"J Dent Res"},{"key":"ref10","first-page":"964","article-title":"Drinking water quality and fluoride concentration.","volume":"45","author":"Fraz\u00e3o P","year":"2011","journal-title":"Rev Saude Publica"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1080\/000163599428652","article-title":"\u201cRisk periods\u201d associated with the development of dental fluorosis in maxillary permanent central incisors: a meta-analysis","volume":"57","author":"B\u00e4rdsen A","year":"1999","journal-title":"Acta Odontol Scand"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/1807-3107BOR-2015.vol29.0047","article-title":"Fluoride concentrations in the water of Maring\u00e1, Brazil, considering the benefit\/risk balance of caries and fluorosis","volume":"29","author":"Bergamo ET","year":"2015","journal-title":"Braz Oral Res"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1600-0528.2009.00507.x","article-title":"A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects\/oral health-related quality of life","volume":"38","author":"Chankanka O","year":"2010","journal-title":"Community Dent Oral Epidemiol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1177\/0022034514548705","article-title":"Effects of enamel fluorosis and dental caries on quality of life","volume":"93","author":"Onoriobe U","year":"2014","journal-title":"J Dent Res"},{"key":"ref15","first-page":"204:225","article-title":"Natural history and long-term impact of dental fluorosis: a prospective cohort study","volume":"18","author":"Do LG","year":"2016","journal-title":"Med J Aust"},{"key":"ref16","series-title":"Ministry of Health. 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