Publication Date: 
Wednesday, July 31, 2019

The Problem: Tooth decay, also known as dental caries, remains a major public health problem. Though largely preventable, it is the most commonly occurring chronic disease between the ages of 6 and 19 years old. CDC: Dental Carries Fact Sheet. Advanced tooth decay can cause significant pain and loss of the teeth, and can be costly to treat. CDC: Oral Health: At a Glance: 2009.

The Law: Milk fluoridation is required or authorized in various countries in Europe and elsewhere. In the US, milk fluoridation is not currently legal because it lacks FDA approval. However, for US jurisdictions without community water fluoridation, fluoridated milk may be a promising alternative source of fluoride. 

The Evidence: In a systematic review, Yeung et al. reviewed two randomized trials evaluating the effectiveness of milk fluoridation programs on reducing dental caries. Yeung A, et al. Fluoridated milk for preventing dental caries. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.:CD003876. Both trials compared the effects of fluoridated milk with non-fluoridated milk on community dental health. Effectiveness was measured by changes in decayed, missing, or filled teeth. One of the studies found a significant association between fluoridated milk and reduction in tooth decay; the other found a much less substantial association over a longer time period. Based on these findings and the limited number of primary studies, the reviewers concluded that milk fluoridation may be a promising intervention, but that there is currently insufficient evidence to establish its effectiveness as a measure aimed at improving oral health.

The Bottom Line: In the judgment of a Community Guide expert panel, there is insufficient evidence to establish the effectiveness of milk fluoridation as a public health intervention aimed at reducing tooth decay.

Impact: Uncertain