Facts and Fallacies of the Fluoride Controversy: A Contemporary Perspective

Fluoride is a natural element recognized for its dental benefits. Fluoride prevents caries due to its antimicrobial activity, enhancing enamel resistance and promoting remineralization After decades of fluoridation of municipal water supplies to reduce dental caries, an intense debate has resurfaced regarding water fluoridation as a public health strategy to combat caries. This renewed discourse occurs against the backdrop of extensive data that clearly demonstrate the vital role of fluoride in caries prevention. Indeed, the Centres for Disease Control and Prevention has stated water fluoridation as one of the top ten public health interventions in the twentieth century. The FDI World Dental Federation also advocates systemic fluoride use as a cost-effective caries prevention strategy, and supports its inclusion in public health policies through a number of policy directives. This debate in the US has intensified as a Court concluded that water fluoridation poses unreasonable risks such as reduction of the intelligence quotient (IQ) in children. Additionally, recent statements from the leadership of the US Health and Human Services agency suggest that water fluoridation may cause more harm than good leading some states, like Utah, to revoke fluoridation mandates This article aims to provide a contemporary perspective on fluoride by revisiting its benefits, controversies, and potential risks. It highlights the dual role of fluoride in both individual oral care and public health and underscores the necessity for safe, equitable, and effective delivery strategies tailored to the needs of diverse populations, balancing its preventive advantages with potential health concerns. The review culminates with a summary of policy statements from the FDI World Dental Federation regarding the promotion of oral health through both systemic and topical fluoridation.