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Indeed, cavity rates This condition occurs when fluoride interferes with the cells that produce enamel, creating white flecks on the teeth.

On average, about 12 percent of people in fluoridated areas have fluorosis bad enough that it qualifies as an “aesthetic concern,” according to the review.

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But the researchers say they have serious doubts about the validity of this number.

For example, 70 percent of the cavity-reducing studies made no effort to control for important confounding factors such as dietary sources of fluoride other than tap water, diet in general (like how much sugar they consumed) or ethnicity.

The data suggest that toothpaste, besides other preventative measures like dental sealants, flossing and avoiding sugar, are the real drivers in the decline of tooth decay in the past few decades, Thiessen says.

The lack of good evidence of effectiveness has shocked him.

“I had assumed because of everything I’d heard that water fluoridation reduces cavities but I was completely amazed by the lack of evidence,” he says.

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