Scottish pilot models impact of water fluoridation

Dental Tribune International

Wed. 14 January 2026

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DUNDEE, Scotland: Water fluoridation may offer a route to improving children’s oral health in Scotland, according to new modelling work. The researchers used national data to estimate the effect of fluoridated water on caries experience in primary and permanent teeth. The findings suggest an improvement across socio-economic groups.

The question of whether government authorities should fluoridate the local water supply, and the implications this decision has for public health, is a crucial issue in many parts of the world. As recently reported on by Dental Tribune International, the practice has been most acutely politicised within the US, but has also become an issue in other countries, such as Australia.

While Scottish children have benefited from the Childsmile preventive programme, recent surveillance has shown signs of plateauing and persistent inequalities in caries experience. No active water fluoridation schemes currently operate in Scotland, despite Cochrane evidence supporting the intervention and historical Scottish studies demonstrating benefit.

Seeking to interrogate the potential impacts of fluoridation on caries in Scottish children, the pilot analysis used recent data from the National Dental Inspection Programme, a school-based oral health monitoring initiative. It applied published effect sizes to baseline dmft/DMFT and caries-free measures to model outcomes among Primary 1 (5-year-olds) and Primary 7 (11-year-olds) pupils. The modelling indicated reductions in dmft/DMFT scores for both year groups and increases in the proportion of caries-free children.

The comparison between age groups suggested that older children showed more favourable predicted outcomes, likely reflecting the cumulative impact of preventive programmes and lower baseline caries experience. The authors propose that earlier introduction of fluoridation could provide additional gains for younger children.

The study acknowledges several limitations, including the use of population-level rather than individual-level data. Despite these constraints, the work provides a pragmatic, transparent tool for policymakers to visualise the potential effect of fluoridation using existing data.

The authors suggest that fluoridation could provide a complementary public health intervention alongside Childsmile, particularly for deprived communities where disease levels remain highest. They conclude that further modelling incorporating socio-economic variation and refined effect estimates would strengthen future policy discussions.

The article, titled “Modelling the potential impact of water fluoridation on dental caries in Scotland: A pilot study”, was published online on 5 January 2026 in the British Dental Journal, ahead of inclusion in an issue.