Lumbar spine bone mineral density (BMD) · general population
Spine BMD showed an inverted U-shaped association with fluoride (peak ~0.6 mg/L); excluding high risk-of-bias studies gave small positive MDs (e.g., 0.05 g/cm2, 95% CI 0.01-0.10, up to 2.27 mg/L); ungraded.
4 findings from 1 review
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The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-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): above 2.27 mg/L vs null
MD 0.04 [-0.21, 0.30]
Studies not reported
GRADE not reported
Tooth survival · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis
Cavity liners may make little or no difference to tooth survival (99.4% survival across groups; low certainty).
1 finding from 1 review
Oral health-related quality of life · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis
No included study reported oral health-related quality of life (a planned outcome), so no evidence is available.
1 finding from 1 review
no estimate extracted
0 studies
No studies found
Hip/femoral bone mineral density (BMD) · general population
Hip BMD increased with fluoride in both sexes (linearly in males, non-linearly above ~1.2 mg/L in females); no numeric MD reported in text for the main analysis; ungraded.
1 finding from 1 review
Salivary flow rate (stimulated) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Stimulated salivary flow rate was significantly lower in anorexia nervosa patients than controls, but only unstimulated flow was meta-analyzed; this outcome is ungraded.
1 finding from 1 review
Salivary pH · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Anorexia nervosa is associated with significantly lower salivary pH than healthy controls (MD -0.39, 95% CI -0.54 to -0.24; low certainty).
1 finding from 1 review
Wrist fractures · general population
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.
2 findings from 1 review
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-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
RR 0.84 [0.43, 1.65]
Studies not reported
GRADE not reported
The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomesLong-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
RR 1.00 [0.99, 1.01]
Studies not reported
GRADE not reported
Hip Fracture · general population
Overall hip-fracture risk showed little association with drinking-water fluoride and a nearly flat dose-response curve (narrow CI); no numeric RR reported in text; ungraded.
1 finding from 1 review
Secondary prevention of caries · Patients with deep caries lesions in mature or immature permanent (posterior) teeth, with no symptoms or reversible pulpitis
Cavity liners may make little or no difference to secondary caries prevention (~100% prevention across groups; low certainty).
1 finding from 1 review
Salivary alpha-amylase · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
There is no significant difference in salivary alpha-amylase between anorexia nervosa patients and healthy controls (MD 6.32 U/l, 95% CI -6.14 to 18.79; low certainty).
1 finding from 1 review
Salivary flow rate (unstimulated) · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Anorexia nervosa probably reduces unstimulated salivary flow rate versus healthy controls (MD -0.27 ml/min, 95% CI -0.31 to -0.24; moderate certainty).
1 finding from 1 review
Gingival (marginal) recession · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Gingival (marginal) recession was significantly higher in anorexia nervosa patients than controls in both reporting studies, but was not pooled or graded (ungraded).
1 finding from 1 review
Dental erosion · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Dental erosion was more prevalent in anorexia nervosa patients than controls (low erosive-wear severity), but was not pooled or graded (ungraded).
1 finding from 1 review
Plaque · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Anorexia nervosa patients tended to have higher plaque accumulation than healthy controls (significant in 2 of 3 studies), but results were not pooled or graded (ungraded).
1 finding from 1 review
Caries experience · Patients with anorexia nervosa aged >=12 years (mean age ~18.4; entirely female in reported data), general community-dwelling population
Anorexia nervosa is associated with significantly higher caries experience (DMFT) than healthy controls (MD 2.00 teeth, 95% CI 0.87 to 3.13; low certainty).
1 finding from 1 review
Ever utilised dental services · Adult residents of slums and non-slum urban settings of LMICs
Ever-use of dental services is low-to-moderate (17%-71%) and generally lower in slum/rural groups; ungraded.
1 finding from 1 review
Periodontal disease prevalence · Adult residents of slums and non-slum urban settings of LMICs
Periodontal disease prevalence is high (23%-99%) across LMIC urban/slum populations; ungraded.
1 finding from 1 review
Periodontal disease affected all ages, was more pronounced in older groups, and ranged from 23% to 99%, generally higher than dental caries; bleeding gum/gingivitis contributed the largest component.
9 studies
GRADE not reported
Dental service utilisation within the past year · Adult residents of slums and non-slum urban settings of LMICs
Past-year dental service use varies widely (4%-72%); ungraded.
1 finding from 1 review
Caries experience (mean DMFT) · Adult residents of slums and non-slum urban settings of LMICs
Mean DMFT ranges from 0.26 to 16.6 across LMIC urban/slum populations; ungraded.
1 finding from 1 review
Dental trauma prevalence · Adult residents of slums and non-slum urban settings of LMICs
Dental trauma appears more common in urban and disadvantaged settings; ungraded, few studies.
1 finding from 1 review