Fluoride exists naturally in water sources and is derived from fluorine, the thirteenth most common element in the Earth's crust. It is well known that fluoride helps prevent and even reverse the early stages of tooth decay.
Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States is intended to provide guidance to dental and health care providers, public health officials and the general public on the best practices in using fluoride to prevent tooth decay. The document is based on the recommendations of a group of fluoride experts convened to evaluate the scientific evidence on the safety and effectiveness of fluoride products used in the United States.
Fluoridation of community drinking water, which began in the late 1940s, and use of other fluoride products, is credited for the dramatic reductions in tooth decay experienced by U.S. residents. In 1999, CDC included water fluoridation in its list of 10 great public health achievements of the 20th century. Studies show that fluoride prevents the formation of, slows the progression of, or even reverses newly forming cavities.
In addition to a comprehensive cavity-prevention program which includes the use of fluoride, the scientific panel recommended that clinicians consider applying a mixture of cholrhexidine-thymol varnish to the teeth of high-risk adults and the elderly every three months to reduce cavities developing in the root of the tooth, such as root canal endodontic.
The panel encouraged clinicians to consider advising parents and caregivers of healthy children older than 5 years who are at higher risk for cavities to chew sugar-free polyol gum after meals for 10 to 20 minutes to prevent cavities.
A polyol is a low-calorie sweetener such as xylitol, sorbitol or mannitol, which is not broken down by the bacteria in the mouth and therefore does not contribute to tooth decay. The panel also recommended that sucking xylitol-containing sugar-free lozenges or hard candy after meals may reduce cavities in children.
The panel's recommendations are based on a review of evidence from 71 published articles that described 50 randomized controlled trials and 15 nonrandomized studies to assess the effectiveness of various nonfluoride agents in preventing cavities.
Fluoride also benefits adults, decreasing the risk of cavities at the root surface as well as the enamel crown. Use of fluoridated water and fluoride dental products will help people maintain oral health and keep more permanent teeth.
Despite the good news about dental health, tooth decay remains one of the most common diseases of childhood. According to the Centers for Disease Control and Prevention (CDC), more than one quarter of 2- to 5-year-olds and half of kids 12 to 15 years old have one or more cavities, and tooth decay has affected two thirds of 16- to 19-year-olds.