{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:11:01Z","timestamp":1759191061961,"version":"3.44.0"},"reference-count":33,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background\/Objectives: Fluorides play a well-established role in preventing dental caries, primarily by enhancing enamel resistance and inhibiting demineralization. Drinking water is among the most important sources of systemic fluoride intake. In 1993 and 2007, national analyses of Austrian drinking water revealed fluoride levels below 0.5 mg\/L in almost all regions, which is insufficient for effective caries prevention. The present study aimed to re-examine the fluoride concentration in Austrian drinking water. Methods: Drinking water was collected in a total of 1985 Austrian municipalities. Fluoride concentration was measured by a fluoride-selective electrode. Results: The average fluoride concentration in the measured water samples ranged between 0.1 and 0.27 mg\/L, depending on the region. The analysis revealed that 98% of the municipal drinking water samples contained fluoride at concentrations below 0.5 mg\/L. In almost one quarter of Austrian municipalities, the fluoride levels amounted to less than 0.1 mg\/L. The fluoride concentration in the drinking water of one Tyrolean municipality exceeded the recommended threshold. Conclusions: The results of the study reveal that the fluoride concentration in Austrian drinking water is generally too low to provide effective prevention against dental caries, affecting nearly all municipalities. Notably, the drinking water of one municipality reached potentially harmful fluoride levels. These findings could be used as a basis for targeted and individual fluoride supplementation, as well as for national or area-specific guidelines.<\/jats:p>","DOI":"10.3390\/dj13100446","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T12:59:46Z","timestamp":1759150786000},"page":"446","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fluoride Levels in Austrian Drinking Water Are Insufficient for Effective Caries Prevention"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2992-6099","authenticated-orcid":false,"given":"Alice","family":"Blufstein","sequence":"first","affiliation":[{"name":"Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Clinical Division of Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8164-3643","authenticated-orcid":false,"given":"Elias","family":"Salzmann","sequence":"additional","affiliation":[{"name":"Clinical Division of Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bledar","family":"Lilaj","sequence":"additional","affiliation":[{"name":"Clinical Division of Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rinet","family":"Dauti","sequence":"additional","affiliation":[{"name":"Clinical Division of Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0485-2142","authenticated-orcid":false,"given":"Oleh","family":"Andrukhov","sequence":"additional","affiliation":[{"name":"Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Nell","sequence":"additional","affiliation":[{"name":"Clinical Division of Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e10714","DOI":"10.1016\/j.heliyon.2022.e10714","article-title":"Changes in the global burden of untreated dental caries from 1990 to 2019: A systematic analysis for the Global Burden of Disease study","volume":"8","author":"Qin","year":"2022","journal-title":"Heliyon"},{"key":"ref_2","unstructured":"Schwarz, T., and K\u00f6lldorfer, B. (2025, September 24). \u00d6sterreichische Zahnstatuserhebung 2023\/24 6-Bis 7-J\u00e4hrige Kinder. Available online: https:\/\/www.sozialministerium.gv.at\/dam\/jcr:76d79e73-8b28-4931-a1a0-f6e03a8f4fea\/LZS%202024_Bericht_final.pdf."},{"key":"ref_3","unstructured":"World Health Organization. Regional Office for Europe (1999). HEALTH21: The Health for All Policy Framework for the WHO European Region."},{"key":"ref_4","first-page":"107","article-title":"Diagnosis and Prevention Strategies for Dental Caries","volume":"3","author":"Lee","year":"2013","journal-title":"J. Lifestyle Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1600-0528.1999.tb01989.x","article-title":"Prevention and reversal of dental caries: Role of low level fluoride","volume":"27","author":"Featherstone","year":"1999","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"595","DOI":"10.12968\/denu.2010.37.9.595","article-title":"Why Fluoride?","volume":"37","author":"McGrady","year":"2010","journal-title":"Dent. Updat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3507","DOI":"10.1016\/j.scitotenv.2010.04.029","article-title":"Fluoride in drinking water and dental fluorosis","volume":"408","author":"Mandinic","year":"2010","journal-title":"Sci. Total Environ."},{"key":"ref_8","unstructured":"(2022). Guidelines for Drinking-Water Quality: Fourth Edition Incorporating the First and Second Addenda."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"US. Department of Health, and Human Services Federal Panel on Community Water Fluoridation (2015). US Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries. Public Health Rep., 130, 318\u2013331.","DOI":"10.1177\/003335491513000408"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00784-007-0111-6","article-title":"Community water fluoridation and caries prevention: A critical review","volume":"11","author":"Pizzo","year":"2007","journal-title":"Clin. Oral Investig."},{"key":"ref_11","first-page":"172","article-title":"Measuring drinking water fluoridation in Vorarlberg","volume":"105","author":"Nell","year":"1993","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_12","first-page":"608","article-title":"Analysis of the fluoride content of drinking water in Austria 1993","volume":"106","author":"Nell","year":"1994","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_13","first-page":"1276","article-title":"Fluoride content of Swiss drinking water","volume":"113","author":"Baehni","year":"2003","journal-title":"Schweiz. Monatsschr. Zahnmed."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00715-008-0072-7","article-title":"Fluoridgehaltuntersuchung des Trinkwassers in \u00d6sterreich 2007","volume":"105","author":"Nell","year":"2008","journal-title":"Stomatologie"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Brewer, R.F. (2016). Fluorine. Methods of Soil Analysis, Part 2: Chemical and Microbiological Properties, American Society of Agronomy, Soil Science Society of America.","DOI":"10.2134\/agronmonogr9.2.c31"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/10937404.2013.769420","article-title":"Fluoride in Groundwater: Toxicological Exposure and Remedies","volume":"16","author":"Jha","year":"2013","journal-title":"J. Toxicol. Environ. Health Part B"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3190\/jgeosci.271","article-title":"Geochemical characteristics of the Late Proterozoic Spitz granodiorite gneiss in the Drosendorf Unit (Southern Bohemian Massif, Austria) and implications for regional tectonic interpretations","volume":"63","author":"Lindner","year":"2018","journal-title":"J. Geosci."},{"key":"ref_18","unstructured":"Schuster, R., Daurer, A., Krenmayr, H.G., Linner, M., Mandl, G.W., Pestal, G., and Reitner, J. (2019). Rocky Austria: The Geology of Austria\u2014Brief and Colourful."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/j.1600-0528.2004.00175.x","article-title":"Effective use of fluorides for the prevention of dental caries in the 21st century: The WHO approach","volume":"32","author":"Petersen","year":"2004","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_20","first-page":"437","article-title":"Understanding Caries From the Oral Microbiome Perspective","volume":"44","author":"Tanner","year":"2016","journal-title":"J. Calif. Dent. Assoc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/j.1834-7819.2008.00064.x","article-title":"Dental caries: A dynamic disease process","volume":"53","author":"Featherstone","year":"2008","journal-title":"Aust. Dent. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3109\/00016358109162287","article-title":"Oral hygiene and caries","volume":"39","author":"Bellini","year":"1981","journal-title":"Acta Odontol. Scand."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"887","DOI":"10.14219\/jada.archive.2000.0307","article-title":"The science and practice of caries prevention","volume":"131","author":"Featherstone","year":"2000","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_24","first-page":"69","article-title":"Fluoride Oral Health","volume":"33","author":"Baez","year":"2016","journal-title":"Community Dent. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1177\/00220345900690S119","article-title":"Physicochemical Perspectives on the Cariostatic Mechanisms of Systemic and Topical Fluorides","volume":"69","author":"Margolis","year":"1990","journal-title":"J. Dent. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jebdp.2014.02.004","article-title":"Focus on Fluorides: Update on the Use of Fluoride for the Prevention of Dental Caries","volume":"14","author":"Carey","year":"2014","journal-title":"J. Evid. Based Dent. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1159\/000325151","article-title":"Mechanisms of action of fluoride for caries control","volume":"22","author":"Buzalaf","year":"2011","journal-title":"Monogr. Oral Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s40368-019-00464-2","article-title":"Guidelines on the use of fluoride for caries prevention in children: An updated EAPD policy document","volume":"20","author":"Toumba","year":"2019","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/0003-9969(61)90035-8","article-title":"Caries frequency and fluorosis in Mallnitz and the Valley of \u00d6tz (1.0\u20131.8 p.p.m. F in the drinking water)","volume":"6","author":"Binder","year":"1960","journal-title":"Arch. Oral Biol."},{"key":"ref_30","first-page":"298","article-title":"Dental Fluorosis Trends in US Oral Health Surveys: 1986 to 2012","volume":"4","author":"Neurath","year":"2019","journal-title":"JDR Clin. Transl. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e2318406","DOI":"10.1001\/jamanetworkopen.2023.18406","article-title":"A National Study Exploring the Association Between Fluoride Levels and Dental Fluorosis","volume":"6","author":"Hung","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_32","first-page":"CD010856","article-title":"Water fluoridation for the prevention of dental caries","volume":"2015","author":"Worthington","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s40572-023-00412-9","article-title":"Fluoride Exposure and Skeletal Fluorosis: A Systematic Review and Dose-response Meta-analysis","volume":"10","author":"Veneri","year":"2023","journal-title":"Curr. Environ. Health Rep."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/10\/446\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T13:36:01Z","timestamp":1759152961000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/10\/446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,29]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["dj13100446"],"URL":"https:\/\/doi.org\/10.3390\/dj13100446","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,29]]}}}