Resumo:
This study aimed to evaluate the influence of community water fluoridation on periodontal health through a scoping review of the literature and an epidemiological study in Brazilian adults. The thesis was structured into two scientific articles. The first article consisted of a scoping review designed to map the available evidence on the effects of fluoridated water consumption on the periodontium in children and adults. Searches were conducted in the Medline/PubMed, Embase, LILACS, and ProQuest databases, in addition to a manual search, including studies published between 2000 and 2024. Five cross-sectional studies met the eligibility criteria. The findings were heterogeneous, with results suggesting positive, negative, null, or contradictory effects of water fluoridation on periodontal parameters. Despite moderate methodological quality, important limitations were identified, such as methodological heterogeneity and insufficient control of confounding factors, precluding definitive conclusions. The second article was a population-based cross-sectional study conducted with Brazilian adults, using national epidemiological data and information on exposure to fluoridated water. The association between water fluoridation and periodontal status was assessed while considering sociodemographic, behavioral, and systemic factors. Periodontal outcomes included probing depth, clinical attachment loss, and gingival inflammation. After statistical adjustments, an association was observed between the duration of fluoridated water consumption and periodontitis in Brazil. It is concluded that the literature presents limited evidence regarding the impact of fluoridated water on periodontal health; however, in Brazil, longer exposure to fluoridated water appears to favor the development of periodontitis in adults. Nevertheless, longitudinal and methodologically more robust studies are needed to definitively clarify the effects of fluoride on the periodontium.
