[Salt fluoridation and dental caries: state of the question]

Objective: Dental caries remains a public health problem, particularly among socially deprived populations. In some developing countries, salt fluoridation programmes have been recently developed, but the use of fluoridated salt is limited worldwide and the level of evidence for its efficacy remains debated. Method: A literature review was conducted to identify epidemiological or clinical studies that have evaluated the effect of salt fluoridation on dental caries experiences in children. Results: After a literature search, 22 references were selected reporting data on the preventive effect of salt fluoridation programmes in Europe (Hungary, Switzerland, France, Germany) and South and Central America (Colombia, Mexico, Jamaica...). Data were mainly obtained from descriptive or retrospective epidemiological studies. The results indicate that, in the absence of topical fluoride support, salt fluoridation leads to a significant reduction in caries indexes among treated children compared to a control group. In a context of widespread use of fluoridated toothpastes, the additional effect achieved by salt fluoridation is limited. The prevalence of fluorosis is not markedly increased with fluoridated salt, but side effects were not always evaluated. Conclusion: Today, a salt fluoridation programme could be useful in areas in which fluoridated toothpastes are not widely used. The communication policy promoting the consumption of fluoridated salt is crucial to ensure the effectiveness of such a programme.