Current and future role of fluoride in nutrition

Fluoride continues to be the cornerstone of dental caries prevention in North America and throughout the world, and there are a variety of sources of fluoride that may contribute to the dietary intakes of fluoride. Although the severe effect of chronic exposures to high levels of fluoride--skeletal fluorosis--is extremely rare in North America, dental fluorosis has become more prevalent. To address the increase in dental fluorosis prevalence, recommendations have been made to reduce fluoride ingestion early in life. These recommendations have included the introduction of lower concentration fluoride dentifrice for use by young children, labeling of the fluoride concentration of bottled water, and revised fluoride supplement guidelines to reduce or eliminate their use. Because our knowledge is incomplete regarding the amount, duration, and timing of fluoride ingestion that can result in dental fluorosis, however, further research is clearly needed before definitive recommendations can be made regarding the use of fluorides, including recommended intakes of fluoride in the diet.