Fluoride's Role in Preventing Dental Caries

Abstract

Fluoride plays a crucial role in preventing dental caries, particularly in children. Its effectiveness spans pre-eruptive, post-eruptive, systemic, and topical contexts. Fluoride's mechanisms of action include mitigating enamel demineralization, facilitating remineralization of early caries, and inhibiting bacterial activity in dental plaque. Various fluoride delivery modalities exist, ranging from community-based programs like water and salt fluoridation to school-based initiatives such as fluoridated milk and mouthrinse programs. At the individual level, home-based approaches include dietary fluoride supplements, fluoride toothpaste, and mouthrinses. Professionally applied topical fluorides, such as gels and varnishes, provide additional benefits for those at elevated caries risk. The combination of fluoride modalities enhances caries prevention compared to single methods. Fluoride varnish has gained popularity due to its ease of application and reduced ingestion risk, making it suitable for use by non-dental professionals in medical and community settings. Fluoride is considered highly safe at recommended dosages, with dental fluorosis being the most common side effect of chronic excessive intake during tooth development. Strategies to improve compliance with fluoride use include motivational interviewing and building public trust through open, understanding dialogue. Biomarkers like urinary fluoride excretion can assess group-level exposure. Recommendations for minimizing dental fluorosis risk include delaying fluoride toothpaste introduction, using age-appropriate amounts, and considering low-fluoride options for young children. Fluoride works synergistically with other preventive measures like dental sealants and non-fluoride agents to optimize caries prevention across populations.