Toggle Main Menu Toggle Search

Open Access padlockePrints

Fluoride Revolution and Dental Caries: Evolution of Policies for Global Use

Lookup NU author(s): Emeritus Professor Andrew Rugg-Gunn


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


© International & American Associations for Dental Research 2019. Epidemiological studies over 70 y ago provided the basis for the use of fluoride in caries prevention. They revealed the clear relation between water fluoride concentration, and therefore fluoride exposure, and prevalence and severity of dental fluorosis and dental caries. After successful trials, programs for water fluoridation were introduced, and industry developed effective fluoride-containing toothpastes and other fluoride vehicles. Reductions in caries experience were recorded in many countries, attributable to the widespread use of fluoride. This is a considerable success story; oral health for many was radically improved. While previously, water had been the only significant source of fluoride, now there are many, and this led to an increase in the occurrence of dental fluorosis. Risks identified for dental fluorosis were ingestion of fluoride-containing toothpaste, water fluoridation, fluoride tablets (which were sometimes ingested in areas with water fluoridation), and infant formula feeds. Policies were introduced to reduce excessive fluoride exposure during the period of tooth development, and these were successful in reducing dental fluorosis without compromising caries prevention. There is now a much better understanding of the public perception of dental fluorosis, with mild fluorosis being of no aesthetic concern. The advantages of water fluoridation are that it provides substantial lifelong caries prevention, is economic, and reduces health inequalities: it reaches a substantial number of people worldwide. Fluoride-containing toothpastes are by far the most important way of delivering the beneficial effect of fluoride worldwide. The preventive effects of conjoint exposure (e.g., use of fluoride toothpaste in a fluoridated area) are additive. The World Health Organization has informed member states of the benefits of the appropriate use of fluoride. Many countries have policies to maximize the benefits of fluoride, but many have yet to do so.

Publication metadata

Author(s): Whelton HP, Spencer AJ, Do LG, Rugg-Gunn AJ

Publication type: Article

Publication status: Published

Journal: Journal of Dental Research

Year: 2019

Volume: 98

Issue: 8

Pages: 837-846

Online publication date: 08/07/2019

Acceptance date: 02/04/2018

ISSN (print): 0022-0345

ISSN (electronic): 1544-0591

Publisher: SAGE Publications Inc.


DOI: 10.1177/0022034519843495


Altmetrics provided by Altmetric