Review of CDC Recommendations for Fluoride Use

s Three Restorative Materials and Topical Fluoride Gels used in Xerostomic Patients. A Clinical Comparison. Comparison of Two Commercially Available Chlorhexidine Mouth Rinses. The Effectiveness of Two Different Battery-Powered Toothbrushes on Whitening Through Removal of Stain. Frequently Asked Questions Ultrasonic Scaler Metal Prophy Angle Sensitive Teeth Treating Cancer Patients Bad Breath Dry Mouth S I N C E 1 9 0 0 INTRODUCTION Dental caries is an infectious, multifactorial disease afflicting the majority of the population. It has been well established that fluoride reduces the incidence of dental caries and slows or reverses the progression of existing lesions. Although pit and fissure sealants, meticulous oral hygiene, and appropriate dietary practices contribute to caries prevention and control, the most effective and widely-used approaches include the use of fluoride. Today, virtually all residents of the United States are exposed to fluoride to some degree and its widespread use has been a major factor in the dramatic decline, not only in the prevalence but in the severity of dental caries. Even though there has been a major decline in the incidence of dental caries, the disease is still pervasive in all age groups. The ability of fluoride to inhibit or even reverse the initiation and progression of dental caries is well documented. The first use of fluoride in water for the purpose of caries prevention began in the mid 1940s in the United States and Canada, when fluoride was introduced into the drinking water supplying four communities. The U.S. Public Health Service (PHS) developed recommendations in the 1940s and 1950s regarding fluoride concentrations in public water supplies. At that time, public health officials projected that drinking water would be the major source of fluoride for most U.S. residents. The success of water fluoridation in preventing and controlling dental caries led to the development of fluoride-containing products including toothpastes, mouth rinses, dietary supplements, and professionally-applied or prescribed gels, foams and varnishes. United States residents now have a multitude of fluoride sources available compared to just 30 years ago. Much of the research on the efficacy of individual fluoride modalities in preventing and controlling dental caries was conducted before 1980. Modalities were usually tested individually (not in combination with other methods of delivery) with the assumption that the method being tested would provide the main source of fluoride. Thus, various modes of fluoride use have evolved, each with its own recommended concentration, frequency of use and dosage schedule. Currently, we do not have a set of comprehensive recommendations for caries prevention and control through the use of combinations of all the fluoride modalities available. PURPOSE The purpose of this paper is to present information released in the “CDC Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States” in 2001. COMMUNITY WATER During the 1940s, researchers determined that 1 ppm of fluoride was the optimal concentration in community drinking water for climates similar to Chicago. This concentration proved to substantially reduce the occurrence of dental caries. Water fluoridation for caries control began in 1945 and 1946, when the fluoride concentration was adjusted in the drinking water supplying four communities in the United States and Canada. Today, only about half the population of the U.S. have access to fluoridated public water supplies. Current federal fluoridation guidelines, maintained by the Public Health Service since 1962, state that