Exploring fluoride safe water drinking habits in the African Rift Valley

The relationship between naturally fluoridated groundwater and dental fluorosis has been receiving attention. However, despite recognition that several factors influence this relationship, there is a lack of systematic studies analyzing results from across the world. To fill such a gap, this global systematic review and meta-analysis try to understand what and how several factors influence this relationship. The studies were selected by searching Web of Science, PubMed, Google Scholar and Scopus databases with keywords and Boolean operators between 2007 and 2017. Meta-regression was performed based on information collected with systematic review. The systematic review show that dental fluorosis affects individuals of all ages, with the highest prevalence below 11, while the impact of other factors (gender, environmental conditions, diet and dental caries) was not clear. Meta-regressions indicate that fluoride in drinking water and temperature negatively influences dental fluorosis. Meta-analysis also suggests possible publication bias. In synthesis, results of this study highlight the negative impact of fluoride in drinking water on physical health, especially in developing countries. Technological innovation to reduce fluoride below WHO recommendation (<1.5 mg/L) can provide health benefits to affected people through interdisciplinary research.