INTRODUCTION: Appropriate oral health care is fundamental for any individual’s health. Dental caries is still one of the major public health problems. The most effective way of caries prevention is the use of fluoride.
AIM: The aim of our research was to review the literature about fluoride toxicity and to inform physicians, dentists and public health specialists whether fluoride use is expedient and safe.
METHODS: Data we used in our review were systematically searched and collected from web pages and documents published from different international institutions.
RESULTS: Fluoride occurs naturally in our environment but we consume it in small amounts. Exposure can occur through dietary intake, respiration and fluoride supplements. The most important factor for fluoride presence in alimentation is fluoridated water. Methods, which led to greater fluoride exposure and lowered caries prevalence, are considered to be one of the greatest accomplishments in the 20th century`s public dental health. During pregnancy, the placenta acts as a barrier. The fluoride, therefore, crosses the placenta in low concentrations. Fluoride can be transmitted through the plasma into the mother’s milk; however, the concentration is low. The most important action of fluoride is topical, when it is present in the saliva in the appropriate concentration. The most important effect of fluoride on caries incidence is through its role in the process of remineralization and demineralization of tooth enamel. Acute toxicity can occur after ingesting one or more doses of fluoride over a short time period which then leads to poisoning. Today, poisoning is mainly due to unsupervised ingestion of products for dental and oral hygiene and over-fluoridated water.
CONCLUSION: Even though fluoride can be toxic in extremely high concentrations, it`s topical use is safe. The European Academy of Paediatric Dentistry (EAPD) recommends a preventive topical use of fluoride supplements because of their cariostatic effect.
4.6 European directive for the use of fluorides
The European Academy of Paediatric Dentistry (EAPD) recommends to everybody, including pregnant women, the preventive use of fluoride toothpaste as a primary preventive measure against caries (7). The most effective way to prevent dental caries is tooth brushing twice a day. Children should only spit out the toothpaste and not rinse with water afterwards.
Parents should start brushing children’s teeth with fluoride toothpaste as soon as the first tooth erupts in the concentration and quantity recommended by the EAPD (Table 2) (7). Parents should use the recommended amount of toothpaste and assist or supervise their children with tooth brushing at least up to the age of 7.