The role of dietary fluoride supplements in caries prevention

Nearly all dental researchers and public health authorities agree that fluoride supplements are highly effective in reducing dental caries in primary and permanent teeth, that benefits to all teeth are greater when administration begins at 2 years of age or younger, that both preeruptive and posteruptive exposure is important in imparting cariostatic benefits, that effectiveness is neither enhanced nor reduced by their being combined with vitamins, and that benefits to the offspring of pregnant women who take supplements are uncertain. Several studies show that fluoride supplements delivered in school-based programs effectively reduce dental caries, and benefits are greater to teeth that receive preeruptive exposure in addition to posteruptive exposure. Many parents who, for a variety of reasons, did not administer fluoride supplements at home will enroll their children in school-based fluoride tablet programs. Effectiveness of fluoride supplements today is undoubtedly smaller than observed previously because of dilution and diffusion effects from other fluoride sources; nevertheless, they still have the same potential efficacy. It is apparent that the current ADA dosage schedule is too high and requires modification; however, the availability of this known-to-be-effective regimen should not be eliminated or restricted.