Bioethical considerations about water fluoridation: a critical review

María Elisa Quinteros

doi:10.17126/joralres.2016.044

Abstract

Dental caries is one of the oral pathologies with greater disease burden in the Chilean population. Fluoridation of drinking water has been used as a caries prevention strategy. However, its application as a public policy has been questioned since its implementation. The aim of this article is to analyze whether fluoridation of drinking water is a justified measure in reducing the incidence and prevalence of caries from the perspective of bioethics, taking into account the current evidence on its effectiveness. The arguments reviewed are based on the belief that water fluoridation is effective and, in general terms, ethically acceptable. A recent systematic review concludes that there is not enough evidence to support fluoridation as a public policy. There is a gap of knowledge that ought to be closed so that public health authorities can assess the significance of the intervention and make a democratic decision on its continuation or suspension based on scientific evidence. This decision should be informed and disseminated within the community.

Highlights

Oral damage is a major problem for the population because it affects a large percentage of people
The arguments reviewed are based on the belief that water fluoridation is effective and, in general terms, ethically acceptable
There is a gap of knowledge that ought to be closed so that public health authorities can assess the significance of the intervention and make a democratic decision on its continuation or suspension based on scientific evidence

Summary

Introduction

Oral damage is a major problem for the population because it affects a large percentage of people. This damage has a negative effect on their nutrition, self-esteem, interpersonal relationships, resilience, discrimination and employment opportunities. Several biological factors have been documented and studied for many years, describing the multifactorial etiology of caries, including diet, oral bacteria, saliva and exposure to fluorides[5]. Some non-biological factors have been associated with the presence of caries in the population, including age, sex, socioeconomic status[6,7], place of residence[8] and access to dental care[9]

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Conclusion