Fluorides in caries control. Rationality, regulation, and safety

Abstract

Dental caries is a chronic, non-contagious, biofilm-mediated disease, primarily driven by the frequency of exposure to sugars —particularly sucrose. Although it cannot be completely prevented, it can be effectively controlled through evidence-based and rational actions: reducing the frequency of sugar consumption, regularly disrupting the biofilm, and ensuring daily fluoride exposure with toothpastes containing 1,000-1,500 ppm (mg F/kg) of soluble fluoride. Understanding fluoride safety is essential, especially in the context of antifluoride narratives currently amplified by social media. There is no evidence of neurotoxicity from fluorides used in dentistry, and a recent longitudinal study confirmed that early fluoride exposure through water does not affect cognitive neurodevelopment. Very mild or mild dental fluorosis remains the only systemic effect documented at optimal exposure levels. Scientific evidence is unequivocal: fluoride is safe, effective and the only substance capable of reducing the demineralizing effects of sugars in the development of dental caries.