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Fluorides and oral health
Fluoride has been remarkably successful in reducing the burden of dental caries. While the rise in dental caries, which has occurred in many countries, has been due to an increase in sugar consumption, the fall in caries has been due to the increased use of fluorides. Over 50 years ago, fluoride in drinking water was shown to protect against caries development. Since then, much research has shown that fluoride delivered in ways other than in water also protects against dental caries. These methods include: solutions, gels, toothpastes, mouthrinses, tablets, salt, milk, varnishes, mousses, and slow-release devices. It is common to class these as those providing a systemic effect (where fluoride is swallowed intentionally) and those providing a topical effect (formulated not to be swallowed). However, there is much overlap since these 'systemic' methods provide an important topical effect, and some of these 'topical' agents are swallowed, providing some systemic effect. Another way of classifying these methods is automatic, home-care and professional care. All are effective: they can be used in combination, with increased effectiveness, and the task is to choose appropriately to maximise benefit, especially for those with the greatest need, and at least cost. The World Health Organization has repeatedly promoted the appropriate use of fluorides, as illustrated in the statement adopted in May 2007 in Geneva by the Sixtieth World Health Assembly.
Fluoride controls caries effectively because it acts in several different ways. When present in dental plaque and saliva, it hastens the remineralisation of early enamel