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Swedish study finds no association between fluoridated water and hip fracture

Alexandria, Va.—Swedish researchers who studied the possible adverse health effects on bone tissue from long-term exposure to fluoridated drinking water found no association between chronic fluoride exposure and hip fracture.

The paper, "Estimated Drinking Water Fluoride Exposure and Risk of Hip Fracture: A Cohort Study," was published online Oct. 1 in the Journal of Dental Research, the scientific publication of the International and American Associations for Dental Research (http://jdr.sagepub.com).

The research team, led by Peggy Näsman at the Karolinska Institute Department of Dental Medicine in Stockholm, studied a large cohort of Swedish residents using nationwide registers to determine if there was an association between long-term exposure to fluoridated drinking water and hip fracture.

All individuals born in Sweden between 1900 and 1919, alive and living in the municipality of their birth at the time of the start of follow-up were identified in the Swedish Register of Population—more than 474,000 individuals. A small portion of the group—940 people—were excluded because of hip fracture before the start of the follow-up, leaving 473,277 individuals eligible for the study. Information on the study population was linked among the Swedish National In-Patient Register, the Swedish Cause of Death Register and the Register of Population and Population Changes.

Researchers stratified estimated individual drinking water fluoride exposure in four categories: very low (<.3 mg/L); low (0.3-0.69 mg/L); medium (.07-1.49 mg/L); and high (≥1.5 mg/L).

Scientists found no association between chronic fluoride exposure and the risk of hip fracture. Risk estimates did not change in analyses restricted to only low trauma osteoporotic hip fractures, suggesting that chronic fluoride exposure from drinking water does not seem to have any important effects on the risk of hip fracture in the investigated exposure range.

"Though research continues to prove the health benefits associated with drinking fluoridated water, the potential for health risks should continue to be studied," said IADR President Helen Whelton. "It is promising to know that this cohort study, performed in Sweden, doesn't find an association between fluoridated water and hip fractures.

The U.S. Centers for Disease Control and Prevention calls community water fluoridation "one of 10 great public health achievements of the 20th century." In 2010, the CDC reported that 73.9 percent of U.S. residents with access to public water systems were receiving the benefits of fluoridated water—more than 204 million people.

For more information on the benefits of community water fluoridation, visit ADA.org/fluoride.