The Cariostatic Mechanisms of Fluoride-An Updated Review

Area of Science:

• Dental science
• Preventive dentistry
• Biomineralization

Background:

• Fluoride is crucial for preventing dental caries by maintaining mineral balance.
• Current understanding highlights fluoride's post-eruptive, topical action, inhibiting demineralization and enhancing remineralization.
• pH-responsive reservoirs release fluoride during acid challenges, reinforcing its protective effects.

Purpose of the Study:

• To review the scientific evidence on fluoride's role in caries prevention.
• To elucidate the mechanisms of fluoride's action at the tooth-biofilm-saliva interface.
• To assess the safety and efficacy of topical fluoride applications.

Main Methods:

• Literature review of evidence-based caries prevention strategies.
• Analysis of fluoride's physicochemical and microbiome-modulating effects.
• Evaluation of fluoride concentrations in dental products and their clinical indications.

Main Results:

• Topical fluoride, particularly in toothpastes (1000-1500 ppm), shows dose-response benefits for children.
• Higher concentrations (5000 ppm) are recommended for high-risk cases like root caries and xerostomia.
• Fluoride modulates the oral microbiome beneficially and glass ionomer cements show promise in restorative dentistry.

Conclusions:

• Frequent, low-level topical fluoride exposure is the most effective strategy for caries prevention.
• Standard topical fluoride use at recommended concentrations is not associated with genotoxicity or adverse microbiome effects.
• Fluoride's cariostatic value is achieved by maintaining oral tissues in a state that favors repair.