Water fluoridation is considered one of the most significant public health interventions of the 20^th century due to its contribution to the prevention of tooth decay. Now, a new study led by Irish researchers has also demonstrated that this process has a low impact on the environment, strengthening the case for fluoridation programmes worldwide.  

Currently, over 35% of the world’s population has access to water fluoridation and studies show a significant reduction in dental caries as a result. However, the contribution of healthcare to the climate crisis is increasingly being considered and until now, there has been no data in relation to the environmental impact of water fluoridation.

Responding to this, researchers from Trinity College Dublin (TCD) and University College London (UCL) set out to quantify the environmental impact of water fluoridation for an individual five year-old child over a one-year period.

This was compared to the use of fluoride varnish and toothbrushing programmes, which take place in selected schools worldwide.

The researchers performed a life cycle assessment (LCA) by carefully measuring the combined travel, the weight and amounts of all products and the processes involved in all three preventative programmes (toothbrushing, fluoride varnish programmes and water fluoridation).

They then inputted data into a specific environmental programme (OpenLCA) and used the Ecoinvent database, enabling them to calculate environmental outputs, including the carbon footprint, the amount of land used and the amount of water used for each product.

The study found that water fluoridation had the lowest environmental impact of the three categories studied. It also had the lowest disability-adjusted life years impact when compared to all other community-level programmes aimed at preventing caries.

Furthermore,  water fluoridation was found to give the greatest return on investment.

Considering the balance between clinical effectiveness, cost effectiveness and environmental sustainability, the researchers concluded that water fluoridation should be the preventative intervention of choice.

They believe this strengthens the case internationally for water fluoridation programmes, particularly for vulnerable populations.

“As the climate crisis starts to worsen, we need to find ways of preventing disease to reduce the environmental impact of our health systems. This research clearly demonstrates the low carbon impact of water fluoridation as an effective prevention tool,” commented lead researcher, Brett Dunne, an associate professor in dental public health at TCD.

The study is published in the British Dental Journal and can be viewed here.