Question · asked by 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference): Wrist fractures

Population
general population
Intervention
Higher drinking-water fluoride exposure
Comparison
Null / lowest drinking-water fluoride exposure (reference)
Outcome
Wrist fractures

Wrist-fracture risk declined nearly linearly with increasing fluoride: RR 1.00 at 0.01 mg/L to 0.84 at 1.5 mg/L drinking-water fluoride vs null; ungraded.

What each review found

Current versions only
No studies found 0 · 0%GRADE not reported 2 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
FindingEffectStudiesGRADE certainty
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)
Risk of wrist fractures · General population (both sexes, all ages) · Long-term / lifetime fluoride exposure, General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride, Drinking-water fluoride 1.5 mg/L vs null
Wrist-fracture risk declined nearly linearly with increasing fluoride: RR 1.00 at 0.01 mg/L to 0.84 at 1.5 mg/L drinking-water fluoride vs null; ungraded.
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. (2025) All outcomes
RR 0.84 [0.43, 1.65]Not reportedGRADE not reported
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)
Risk of wrist fractures · General population (both sexes, all ages) · Long-term / lifetime fluoride exposure, General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride, Drinking-water fluoride 0.01 mg/L vs null
Wrist-fracture risk declined nearly linearly with increasing fluoride: RR 1.00 at 0.01 mg/L to 0.84 at 1.5 mg/L drinking-water fluoride vs null; ungraded.
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. (2025) All outcomes
RR 1.00 [0.99, 1.01]Not reportedGRADE not reported

Findings are shown side by side, never pooled across reviews.

The reviews

ReviewSearched up toIncluded studiesAMSTAR 2
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis.
2025 All outcomes
Inception to August 26, 202574Not applicable
How reviews are matched to this question

Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.