The multifaceted role of fluoride in preventing early childhood caries: A comprehensive review

Abstract

Early childhood caries (ECC) remains a prevalent and significant public health concern worldwide, particularly in underserved communities. Fluoride has long been recognized as a cornerstone in ECC prevention due to its multifaceted mechanisms of action, including topical effects on enamel, systemic effects on dental development, antimicrobial properties, and the ability to promote remineralization of early carious lesions. This comprehensive review explores the various roles of fluoride in preventing ECC, encompassing its sources, efficacy, safety considerations, delivery strategies, challenges, and future directions. Community water fluoridation, fluoride toothpaste, mouth rinses, professional treatments, and dietary sources constitute primary means of fluoride exposure. Extensive clinical trials, epidemiological studies, meta-analyses, and systematic reviews provide robust evidence supporting the effectiveness of fluoride in reducing ECC prevalence and severity. However, optimizing fluoride exposure levels while minimizing the risk of dental fluorosis remains a critical consideration, especially in vulnerable populations. Strategies for fluoride delivery in high-risk groups, such as early childhood interventions, school-based programs, and community outreach initiatives, play pivotal roles in promoting oral health equity. Nevertheless, challenges persist, including limited access to fluoride in underserved areas, public misconceptions, and the need for further research on novel fluoride formulations. Fluoride continues to be a vital tool in ECC prevention, with implications for both clinical practice and public health policy. Addressing disparities in fluoride access and enhancing community engagement are essential for maximizing its impact in reducing ECC burden globally. Future research endeavors should focus on innovative approaches to fluoride delivery and long-term oral health outcomes in diverse populations.