Fluoride

8. What are the beneficial effects of fluoride on teeth?

• 8.1 Does fluoride protect teeth from cavities?
• 8.2 What fluoridated products have been used to prevent cavities?

Fluoride can have both beneficial and potentially detrimental effects on dental health. While an increase in the concentration of fluoride in drinking water means less chances of developing dental caries, it also means greater chances of developing dental fluorosis. The "optimum" level of fluoride in drinking water, associated with the maximum level of dental caries protection and minimum level of dental fluorosis, is considered to be approximately 1 mg/litre. More...

8.1 Does fluoride protect teeth from cavities?

Oral fluoride is considered as an effective means of reducing dental caries.
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Today, oral fluoride is still considered as an effective means of reducing dental caries.

Historically, populations consuming fluoridated drinking water have shown a much lower prevalence of dental caries than have those consuming non-fluoridated drinking water, but the difference in caries prevalence between those two groups has narrowed significantly over time. This apparent decrease in the protective virtue of fluoridated drinking water may be explained by the fact that individuals who do not have access to fluoridated drinking water may consume other fluoridated products in significant amounts, for example beverages prepared elsewhere with fluoridated drinking water and dental products such as fluoridated toothpaste.

There is now ample evidence that fluoride inhibits the development of caries because of its direct action on the enamel surface of teeth that have emerged from the gum. More...

8.2 What fluoridated products have been used to prevent cavities?

There is a variety of fluoridated products:

• Fluoridated drinking water is one of the most cost-effective means of delivering fluoride to large numbers of individuals. It requires a suitable community-wide drinking water delivery system along with a reasonable level of technological development. About 210 million individuals throughout the world consume such water.
• Fluoridated toothpaste, which usually contains approximately 1000 mg fluoride/kg, is considered to be one of the major factors responsible for the gradual decline in the prevalence of dental caries in most industrialized countries. About 500 million individuals throughout the world use such toothpaste.
• Fluoridated mouth rinse is popular among public health care programmes for school aged children. Such rinses contain 0.05 or 0.2% of fluoride depending on whether they are recommended for daily or weekly use. It is not suitable for children below the age of six who might swallow significant amounts of the product.
• Fluoridated solutions, gels or varnishes , applied by dentists, may be effective for individuals with an elevated risk of dental caries. Because of the high level of fluoride contained (up to 22 300 mg/kg), and to avoid acute toxic effects in younger children who may swallow them, such materials are applied according to strict protocols.
• Fluoridated salt is considered to act against the appearance of caries in a way similar to fluoridated drinking water. According to the WHO, it should contain at least 200 mg fluoride/kg salt.
• Fluoridated milk was formerly considered to be a suitable means of increasing children’s intake of fluoride; however, little information is available on the efficacy of this delivery method that requires close cooperation with the dairy industry as well as a widespread system of distribution.
• Fluoride supplements in the form of tablets, liquid drops or lozenges are intended to provide a source of fluoride when fluoridated drinking water is not available. There appears to be a growing consensus that fluoride supplements have a limited public health role in improving dental health.

The effectiveness of interventions other than drinking water fluoridation depends on the compliance by all sections of the population, particularly among socially and economically disadvantaged groups. More...