The Role of Fluoride in Modern Dentistry: Benefits and Controversies

Abstract

Dental caries is the localized destruction of dental hard tissues resulting from the acidic by-products, which are produced by the bacteria present in the oral cavity. Dental caries is considered the most common health condition affecting humanity, affecting 2.3 billion people worldwide. As a result, minimally invasive dentistry was developed to treat dental caries at an early stage and to decrease the high prevalence of dental caries among children and adults. Fluoride is one of the main components used in preventive measures in dentistry and in minimally invasive dentistry. It can inhibit enamel and dentin demineralization and induce enamel remineralization due to the replacement of fluoride ions with hydroxyl groups in the enamel hydroxyapatites, forming fluorohydroxyapatite, which has greater stability and reduced solubility in an acidic medium. Moreover, fluorapatite exhibits the lowest solubility and the greatest stability in the acidic medium. When these components are integrated into the composition of the enamel, it becomes more resistant to demineralization. Despite the presence of several studies confirming the benefits of fluoride in dentistry, it can result in multiple complications, such as dental fluorosis, skeletal fluorosis, and acute fluoride toxicity. Therefore, many countries have developed community water fluoridation to reduce the prevalence of dental caries. However, many individuals debated the ethics of community water fluoridation; therefore, several countries have developed alternatives to water fluoridation, such as fluoride in salt and milk. Additionally, caregivers and parents should be educated about the importance of topical fluoride, either in toothpastes or the topical fluoride that is applied professionally by dentists, to prevent the prevalence of dental caries in children.