[Fluoride, a preventive agent of caries: mechanisms, sources, risks]

Fluoride is a potent preventive agent of caries. It acts at two levels: local and systemic. At the local level it prevents the surface demineralisation of enamel by strengthening the superficial layers, and inhibiting the local bacterial activity. At the systemic level it improves the resistance of the enamel by forming with calcium, fluorapatite which is stronger than hydroxyapatite. Main sources are naturally fluorinated water, artificially enriched water, fluorinated salt, and fluoride medication. Recommended mean daily intake is 0.05 mg/kg, the risk of dental fluorosis occurring when daily intake exceeds 1 mg/kg. The large benefits of regular fluoride supplementation on children dental health must not live down the risk of dental fluorosis resulting from over administration. Therefore when prescribing fluoride to a child, the practitioner must carefully examine his/her possible other fluoride sources.