Fluoride Therapy

Fluoride Therapy

Fluoride therapy involves administering fluoride to the teeth either topically or systemically to prevent tooth decay (dental caries) and the formation of cavities. Typically, fluoride is applied directly to the teeth using gels, varnishes, toothpaste, or mouth rinse for topical delivery. Systemic delivery, on the other hand, involves fluoride supplementation through water, salt, tablets, or drops that are ingested. Tablets or drops are seldom used in areas where public water sources are already fluoridated.

There are various types of fluoride therapies available, ranging from at-home treatments like using fluoridated toothpaste to professionally administered treatments provided by dental offices, to community-wide initiatives such as water fluoridation or adding fluoride to commonly consumed substances like salt.

At-home treatments can further be divided into over-the-counter (OTC) and prescription strengths, and fluoride therapies, regardless of their type, are categorized based on their application method, including dentifrices, mouth rinses, gels/foams, varnishes, dietary fluoride supplements, and water fluoridation.

All methods of fluoridation result in low concentrations of fluoride ions in saliva, exerting a topical effect on the fluid surrounding the teeth. Fluoride primarily works by forming fluorapatite through the remineralization of enamel, which reduces the rate of enamel demineralization and increases the rate of remineralization during the early stages of cavity formation. The major impact of fluoride occurs through this process of demineralization and remineralization.

Additionally, fluoride affects the physiology of dental bacteria, although its impact on bacterial growth does not significantly contribute to cavity prevention. Fluoride's effectiveness in preventing cavities diminishes after it is swallowed. While fluoride technically does not prevent cavities, it controls the rate at which they develop. Although fluoride is the most well-documented agent with this property, some studies suggest that adding calcium to water may further reduce cavity formation.

Excessive fluoride intake can lead to fluoride poisoning and even death, although such cases typically involve ingestion of several ounces of fluoride for adults. Chronic intake and topical exposure may result in dental fluorosis, while excessive systemic exposure can lead to systemic effects such as skeletal fluorosis. Young children are particularly vulnerable to fluoride overdose, prompting the American Dental Association (ADA) to issue interim guidance on their fluoride consumption.