To systematically review the correlation between fluoride exposure through drinking water and dental fluorosis of school-age children, and to provide a theoretical basis for further development of prevention strategies against dental fluorosis.

Such databases as China National Knowledge Infrastructure (CNKI), WanFang Data, VIP Database and China Biology Medicine Disc (CBM) were searched through computer to find out the relationship between fluoride exposure through dringking water and occurrence of dental fluorosis. The retrieval time was from January 1, 2000 to January 1, 2018. Meta-analysis was performed using RevMan 5.3. Funnel plot and fail-safe method were used to evaluate publication bias, and these data were analyzed sensitivity with random and fixed effect models.

Totally 20 literatures entered into this study, 79 814 people in fluoride exposure group, and 181 876 people in control group. The meta-analysis showed that, 20 literatures were inhomogeneous through the heterogeneity test, which was analyzed in the random effect model, the pooled odds ratio (OR) value and 95% confidence interval (95%CI) was 4.25 (3.66 - 4.94), which suggested that the risk of dental fluorosis in the fluoride exposure group was 4.25 times higher than that in control group. Funnel plot was asymmetrical, the fail-safe number was 47 791.56, which was 2 389.6 (47 792/20) times higher than included literatures. Literatures publication bias was small, sensitivity analysis revealed that the results were basically reliable.

Excessive fluoride exposure through dringking water could be one of the main risk factors leading to dental fluorosis.

Fluorosis, dental; Drinking; Meta-analysis; School-age children