A review of systemic and topical fluorides for the prevention of dental caries

ABSTRACT Because community fluoridation constitutes nearly an ideal public health method, it should be the cornerstone of all national programs of dental caries prevention. Where fluoridation is not possible for technical or political reasons, some alternative methods of providing benefits from systemic fluorides are available, including school water fluoridation, dietary supplements of fluoride and the fluoridation of salt. Dietary supplements of fluoride are not recommended for pregnant women for caries protection in their offspring. In areas with low fluoride levels in drinking water, solutions of 2 % sodium fluoride, 8% stannous fluoride and acidulated phosphate‐fluoride (APF) (1.2% F ion) and the same concentration of an APF gel applied professionally can prevent dental caries. APF is currently the choice for these applications. Fluoride prophylaxis pastes should be used, particularly when a topical fluoride application is not scheduled to follow the prophylaxis. Effective unsupervised topical fluoride applications occur with use of fluoride containing dentifrices. Supervised self‐applications of fluoride for public health programs overcome the inefficiencies of individual professional applications. Many studies continue to be reported on mouth‐rinsing with fluoride solutions, toothbrushing with fluoride solutions and gels, toothbrushing with fluoride prophylaxis pastes and the application of fluoride gels in mouthpieces. Fluoride mouth‐rinsing has several advantages. Self‐application of fluorides will undoubtedly become the method of choice for delivering topical fluorides.