Question · asked by 1 review
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference): Risk of fragility fractures
- Population
- general population
- Intervention
- Higher drinking-water fluoride exposure
- Comparison
- Null / lowest drinking-water fluoride exposure (reference)
- Outcome
- Risk of fragility fractures
Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 mg/L drinking-water fluoride vs null; ungraded.
What each review found
Current versions onlyNo studies found 0 · 0%GRADE not reported 5 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) Risk of fragility 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 up to 0.9 mg/L vs null Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 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 0.93 [0.84, 1.02] | Not reported | GRADE not reported |
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) Risk of fragility 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 1.8 mg/L vs null Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 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 1.05 [0.82, 1.35] | Not reported | GRADE not reported |
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) Risk of fragility 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, Sensitivity (excluding high risk-of-bias studies): 0.8-1.5 mg/L vs null Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 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 0.93 [0.72, 1.21] | Not reported | GRADE not reported |
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) Risk of fragility 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 1.48 mg/L vs null Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 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 [0.82, 1.21] | Not reported | GRADE not reported |
Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) Risk of fragility 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, Sensitivity (excluding high risk-of-bias studies): 1.8 mg/L vs null Fragility-fracture risk overall was slightly U-shaped: RR 0.93 up to 0.9 mg/L, ~1.00 at 1.48 mg/L, 1.05 at 1.8 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 0.95 [0.70, 1.29] | Not reported | GRADE not reported |
Findings are shown side by side, never pooled across reviews.
The reviews
| Review | Searched up to | Included studies | AMSTAR 2 |
|---|---|---|---|
| The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes | Inception to August 26, 2025 | 74 | Not applicable |
Related questions
The same intervention and outcome, asked in another population or against another comparator.
- Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) · Females (all ages) · 1 review
- Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) · Females aged over 50 years · 1 review
- Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference) · Male participants · 1 review
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.