Fluoride supplements useful but increase the risk of mild fluorosis

Abstract

Objectives To investigate whether the regular use of fluoride supplements in non-fluoridated communities during the period of tooth development increases the risk of dental fluorosis.Data sources Medline search 1966–Sept 1997 (English only papers) using following key words: fluorosis, dental, fluoride, fluoride supplement or supplements, drop or drops, and tablet or tablets.Study selection Twenty-four studies that assessed the development of dental fluorosis in children who had used fluoride supplements were identified. Ten cross-sectional/case control studies and four follow-up studies had data that allowed a quantitative estimation of the risk of developing dental fluorosis in users of fluoride supplements. Ten studies were excluded.Results A consistent and strong association between the use of fluoride supplements and dental fluorosis was found. Meta-analyses of the cross-sectional/case-control studies estimated the odds ratio of dental fluorosis in users of fluoride supplements between 2.1 and 2.3 (95% C.I. 1.5–3.4).Conclusions In non-fluoridated communities, the use of fluoride supplements during the first 6 years of life is associated with a significant increase in the risk of developing a very mild to mild type of dental fluorosis.