Fluoride therapy for bone disease

The use of fluoride in the treatment of osteoporosis remains very controversial, despite its registration in many countries. Fluoride has been convincingly demonstrated to have a potent anabolic effect on osteoblastic trabecular bone formation, with a subsequent sustained increase in axial bone mass. However, its ability to reduce the vertebral fracture rate in established spinal osteoporosis is still debated, and questions have been raised regarding a potential negative effect on cortical bone mass and an increase in fractures of the peripheral skeleton, especially hip fractures. These data, including some very recent studies, are reviewed to draw some perspectives and recommendations for the use of fluoride in the treatment of osteoporosis.