The  Preventive Role of Fluoride in Dental Caries Management: Mechanisms, Efficacy, and Clinical Applications

Salem Ibrahim Almishkhas; Mohammed Rasheed Almutairi; Rasha  Salem Baazeem; Omar Mohammed Sulaimani; Mohammed Abdullah  Alwadi; Shadi Safwat Alkhadra; May Mohammed Alanazi

Authors

Salem Ibrahim Almishkhas Kingdom of Saudi Arabia , Ministry of National Guard Health Affairs
Mohammed Rasheed Almutairi Kingdom of Saudi Arabia , Ministry of National Guard Health Affairs
Rasha Salem Baazeem Kingdom of Saudi Arabia , Ministry of National Guard Health Affairs
Omar Mohammed Sulaimani Kingdom of Saudi Arabia , Ministry of National Guard Health Affairs
Mohammed Abdullah Alwadi Kingdom of Saudi Arabia , Ministry of National Guard Health Affairs
Shadi Safwat Alkhadra Kingdom of Saudi Arabia , Ministry of National Guard Health Affairs
May Mohammed Alanazi Kingdom of Saudi Arabia , Riyadh Elm University

Keywords:

Dental caries, fluoride, remineralization, fluorosis, preventive dentistry, public health.

Abstract

Background: Dental caries is a prevalent global health issue, particularly affecting children, with multifactorial causes including bacterial activity, dietary habits, and poor oral hygiene. Fluoride has been a cornerstone in caries prevention due to its ability to enhance remineralization, inhibit demineralization, and suppress cariogenic bacteria. Despite its benefits, excessive fluoride intake, especially in early childhood, raises concerns about dental fluorosis.

Aim: This article reviews the mechanisms, efficacy, and clinical applications of fluoride in caries prevention while addressing challenges such as fluorosis risk, barriers to preventive care, and the impact of COVID-19 on dental services.

Methods: A comprehensive analysis of fluoride's anti-cariogenic mechanisms (topical vs. systemic effects), different fluoride delivery methods (water fluoridation, toothpaste, varnishes, gels, and slow-release devices), and ecological approaches (probiotics, arginine-enhanced products) was conducted. Evidence from clinical studies, public health data, and professional guidelines was synthesized.

Results: Topical fluoride applications (toothpaste, varnishes) are more effective than systemic fluoride in preventing caries. Water fluoridation remains a cost-effective public health measure, though bottled water consumption has reduced its impact. Fluorosis risk can be mitigated by regulating fluoride exposure in children under six. Emerging strategies like silver diamine fluoride (SDF) and slow-release beads show promise for high-risk populations.

Conclusion: Fluoride remains the most effective intervention for caries prevention, but its use must be tailored to individual risk factors. Interprofessional collaboration and public health policies are essential to optimize fluoride's benefits while minimizing adverse effects.

Dental caries, fluoride, remineralization, fluorosis, preventive dentistry, public health.

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