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Call for evidence on the health effects of water fluoridation

Closed on Friday, 22 August 2014, 10:00am (AEST). Submissions are no longer being accepted.

The National Health and Medical Research Council (NHMRC) is commencing an evaluation of the evidence on the health effects of water fluoridation. As part of this process, NHMRC has appointed a team from the University of Sydney to undertake a systematic review which asks specific research questions and uses a rigorous and clearly documented methodology to search for, select and evaluate studies.

The Australian community is invited to participate in this activity by providing citations for relevant published studies to NHMRC for evaluation in the systematic review.

Once the systematic review is complete, NHMRC will prepare an Information Paper that summarises the outcomes of the systematic review. The public will have an opportunity to comment on the draft Information Paper, which is expected to be available for public consultation around September 2015.

The scope of the systematic review and this call for evidence

The systematic review will focus on studies which examine the effects of water fluoridation on human health, published from 1 October 2006. Scientific research regarding the health effects of water fluoridation is being sought, not opinions or views on water fluoridation. Only studies that are in scope of the systematic review can be included in this public call for evidence.

Studies in the scope of the systematic review

To be accepted by NHMRC, published studies must be all of the following:

  • Published after 1 October 2006;
  • An examination of fluoridated drinking water, not other fluoride interventions (e.g. fluoridated milk, salt, bottled water or topical fluoride applications such as toothpaste, varnish, gel or mouth rinse);
  • Publicly available in English;
  • Available in full text;
  • A study or systematic review that includes a group exposed to drinking water that contains fluoride and a comparison group exposed to drinking water with a lower concentration of fluoride or non-fluoridated water (defined as having a concentration of fluoride less than 0.4 mg/L); and
  • A study which reports outcomes relevant for human health.

Studies outside the scope of the systematic review

Whilst of interest to the community, the following topics will be considered by NHMRC in other ways and so are outside the scope of the systematic review that will be undertaken by the University of Sydney team. Studies cannot be evaluated in the systematic review if they focus exclusively on the following topics:

Dental caries and dental fluorosis

Studies on the effects of water fluoridation on dental caries (tooth decay) and dental fluorosis (mottling of the teeth) are currently under investigation by the Cochrane Collaboration, an international not-for-profit organisation which conducts systematic reviews of the effects of health care. A report on Cochrane Collaboration’s findings will be published on the NHMRC website, and will be used in drafting the Information Paper that will be open to public consultation in 2015.

Chemicals used to fluoridate drinking water

The chemicals used to fluoridate drinking water will be considered by the NHMRC Water Quality Advisory Committee in their ongoing review of the Australian Drinking Water Guidelines. This is a separate project.

Ethics of water fluoridation

The systematic review is concerned only with the health effects of water fluoridation. Ethical issues associated with water fluoridation will be considered by the Australian Health Ethics Committee once the University of Sydney team completes the systematic review. This information will also be captured in the Information Paper.

Studies that will not be considered in the systematic review at any stage include:

  • Studies based on a type of evidence that is not appropriate to the systematic to the systematic review, e.g. personal story, medical record, raw data, narrative review, case series or case report.

How NHMRC will manage submissions

The systematic review will be guided by the NHMRC Fluoride Reference Group which will also advise on how relevant these findings are for Australia, given that concerns regarding water fluoridation are different in some northern hemisphere countries. Further information on the Fluoride Reference Group can be found on the NHMRC website.

Public submissions received via the online form will be provided to the Fluoride Reference Group and will serve as a record of what the Australian community identifies as relevant research evidence (published studies).

Research evidence in scope of the systematic review will be retrieved by the Office of the NHMRC and provided to the evidence review team at the University of Sydney for evaluation. They will evaluate studies identified by the community in exactly the same way that they evaluate studies found using their own systematic searches. They will then assess the quality and strength of the body of evidence.

All submissions must be made through the online public consultation portal. If this is not possible, please contact the NHMRC Fluoride Project Team to request alternative arrangements.


Consultation documents

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Consultation date

Please note the Timezone is AEST.

Closing date: 
Friday, 22 August 2014 - 10:00am
Please note that for some NHMRC consultations no extensions will be given. Where extensions are available you will need to contact the project officer using the contact details at the bottom of this page. However, in order for NHMRC to extend the date of a submission you will need to have created an account and started a submission.
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Page reviewed: 23 July, 2014