Optimal Fluoride Research Articles

Determination of Fluoride and PH Concentration Among Different Brands of Packaged Alkaline Water – An Analytical Study

Abstract Background: People consuming alkaline water for health benefits should have optimum fluoride and pH. Water fluoridation prevents caries. Aim and Objectives: To determine the fluoride concentration, pH levels, and relation between them in six different brands of alkaline water. Materials and Methods: Randomly, six different alkaline water package bottles were selected for fluoride and pH analysis using an electrochemical probe method and electrometric method, respectively. Results: The mean fluoride concentration of tested samples was 0.212 ± 0.376 mg/L with the highest value in Aava alkaline water (1.03 mg/L) and the lowest in Kangen alkaline water (0.02 mg/L). The mean pH was 7.754 ± 0.672, much below the claimed values of the manufacturers. Kangen alkaline water had the highest pH (8.66), and Aava alkaline water had lowest pH (7.05). There was a statistically significant difference, P < 0.001, between different brands of fluoride and pH levels. There was a negative correlation between fluoride and pH in alkaline water samples (P = 0.032). Conclusion: Tested alkaline water bottles should adhere to its pH and should contain optimum fluoride. Concerned authorities should make sure the availability of optimum fluoride concentration and specify the pH level on the alkaline water bottle label for better consumer awareness and making an informed choice.

Comparative evaluation of fluoride release profiles in new glass ionomer cements and conventional type II GIC: Implications for cariostatic efficacy

The fluoride release characteristics of two new Glass Ionomer Cements (GICs), Equia Forte HT and Micron Bioactive, with a conventional Type II restorative GIC is of interest. Fluoride release, a crucial cariostatic property, was evaluated using 18 disc specimens prepared in disposable silicone molds and stored in deionized water for 15 days. Measurements taken on days 1, 3, 7, and 14 with a fluoride ion-specific electrode showed that Equia Forte HT exhibited the highest fluoride release, followed by Micron Bioactive and Type II GIC. Statistical analysis, including ANOVA, confirmed significant differences among the groups, highlighting the superior performance of Equia Forte HT. These findings emphasize the importance of selecting GICs with optimal fluoride release for effective dental restorations and call for further research into their long-term clinical performance.

The Efficacy of Fluoride in Reducing Tooth Decay: A Systematic Review of Evidence-Based Interventions

Tooth decay, a significant global public health issue, affects billions of individuals and imposes substantial health and economic burdens. Fluoride has been widely recognized for its caries-preventive properties, functioning through mechanisms that enhance enamel remineralization and inhibit bacterial activity. Despite extensive research supporting its efficacy, variations in fluoride delivery methods, concentrations, and population-specific outcomes have resulted in inconsistent findings, necessitating a comprehensive review. This study systematically evaluates recent evidence to determine fluoride’s effectiveness in reducing tooth decay across various applications, including water fluoridation, toothpaste, mouth rinses, and professional treatments. By synthesizing data from peer-reviewed studies, the review aims to clarify optimal fluoride use practices and address safety concerns, such as dental fluorosis. Findings are expected to provide actionable insights for clinicians, policymakers, and public health professionals, contributing to the development of evidence-based guidelines to improve global oral health and reduce the burden of dental caries.

Optimum fluoride distribution - and a free sample

Optimum fluoride distribution - and a free sample

2015 United States Public Health Service optimal fluoride level adherence and operation among adjusting water systems in 40 states: 2016–2021

AbstractIn 2015, the United States Public Health Service (USPHS) set a target fluoride level for drinking water at 0.7 mg/L to maximize oral health benefits while minimizing any potential harms. Using water fluoridation operational data reported by water systems to the Centers for Disease Control and Prevention (CDC) Water Fluoridation Reporting System (WFRS) during 2016–2021, this study assesses how water systems performed around this target. The authors summarize completeness of data reporting, assess the distribution of monthly average fluoride readings (MAFR) values, and evaluate precision in maintaining fluoride levels. About 69% of adjusting systems provided data, with an average completeness of 63.8% among them. MAFR mean was 0.71 mg/L (SD: 0.20 mg/L), indicating that water systems have primarily adopted the USPHS target. About 76% of MAFRs fell ± 0.1 mg/L around the reporting system point's mean, indicating feasibility in maintaining precision around a target. State programs and water systems could work together to improve data quality and educate operators on best practices.

Optimum fluoride distribution - and a free sample.

Optimum fluoride distribution - and a free sample.

Ultrastructural evaluation of adverse effects on dentine formation from systemic fluoride application in an experimental mouse model.

Fluoride is widely used in dentistry for its caries prevention. To reduce dental caries, the optimal fluoride concentration of public water supplies in the United States is 0.7 ppm. However, excessive systemic fluoride consumption can lead to dental/enamel fluorosis. Numerous studies have explored the effects of fluoride on enamel and enamel-forming cells. However, research on systemic fluoride's impact on dentine is limited, particularly the effect of fluoride on the structure of the dentine-pulp complex. Therefore, this study aimed to identify how excessive fluoride affects dentine microstructure using an experimental mouse model. C57BL6/J male mice (6-9 weeks old) were randomized into four groups (Fluoride at 0, 50, 100, or 125 ppm in drinking water) (n = 4/group). Mice were provided water adlibitum for 6 weeks along with fluoride-free food. Thereafter, mandibular incisors were analysed. Enamel phenotypes were evaluated using light microscopy and quantitative light-induced fluorescence (QLF) to measure fluorosis levels. Dentine morphology was evaluated using micro-CT, scanning electron microscopy (SEM), SEM-EDX (energy-dispersive X-ray), microhardness test and histological imaging. Data were analysed using one-way ANOVA with Dunnett's multiple comparisons as a post hoc test and the Kruskal-Wallis test with Dunn's multiple comparisons post hoc test (p < .05). Mice treated with fluoride at 50-125 ppm developed enamel hypoplasia in their erupting incisors and micro-CT imaging revealed that fluoride 125 ppm caused external resorption of the growing incisor. Dentine mineral density, dentine volume decreased compared with the 0 ppm control, while pulp volume increased compared with the 0 ppm control group. SEM showed wider predentine layer and abnormalities in calcified matrix vesicles derived from odontoblasts in fluoride 100 and 125 ppm groups. Vickers microhardness of dentine significantly decreased in the high-dose group. Fluoride-induced dentine hypoplasia in a dose-dependent manner. Histological evaluation showed excessive fluoride 125 ppm induced micro abscess formation and inflammatory cell infiltration. Fluoride induced dentine dysplasia with a dentine microstructure resembling hypophosphatasia. High doses of systemic fluoride can cause dentine dysplasia. Both three-dimensional and microstructural analyses showed the structural, chemical and mechanical changes in the dentine and the mineralized tissue components, along with external resorption and pulp inflammation.

Access to dental services and use of toothpaste with optimal fluoride content in Peruvian children.

Leading international health organizations advise using toothpaste that contains at least 1,000 parts per million of fluoride, emphasizing that this practice should begin with the eruption of the first primary tooth. To determine the association between access to dental services and the use of toothpaste with 1,000 ppm fluoride or more in Peruvian children under twelve years of age. A cross-sectional analysis was conducted using data from the 2021 Demographic and Family Health Survey. The main variable studied was the use of toothpaste containing a fluoride concentration of 1,000 ppm or more. Additionally, the access to dental care, the time elapsed since the last dental visit, and the type of healthcare facility were analyzed. Multilevel regression was applied to examine the relationship between variables and the dependent variable, with Peru's 24 regions serving as the analytical level. According to the bivariate analysis, the natural region, area of residence, place of residence, wealth index, and age were associated with the use of fluoride toothpaste with 1,000 ppm or more. In the multilevel analysis, the access to dental services was not associated with the use of fluoride toothpaste with 1,000 ppm or more (p = 0.454); similarly, the time elapsed since the last dental visit also showed no association (p = 0.676), as did the type of healthcare facility (p = 0.752, p = 0.896, p = 0.983). Accessing dental services, the time elapsed since the last dentist visit, and the location where that care was received were not associated with the use of toothpaste containing 1,000 ppm or more of fluoride among Peruvian children during the year 2021.

Comparative Assessment of Compomers and Ormocers as Pit and Fissure Sealants in Permanent Molars among Children Aged 7-9 Years.

In recent years, the dental profession's focus has shifted from the therapeutic to the preventive aspect of dental caries. Pit and fissure sealants, optimal fluoridation, healthy dietary habits, and good oral hygiene have been recommended for caries prevention. Many sealant materials are available on the market. Compomers are hybrid dental materials that are modified composite resins with polyacids. The esthetic properties of traditional composite systems are combined with the fluoride-releasing and adhesive properties of glass ionomer cement (GIC). Organically modified ceramic (Ormocer) material has high abrasion resistance and better aesthetics, similar to natural teeth. To compare the sealing ability of compomer and ormocer as pit and fissure sealants in permanent mandibular first molars of 7-9-year-old children. A cross-sectional study with a split-mouth design was conducted on 88 children aged 7-9 years who attended the Department of Pediatric and Preventive Dentistry. Children were selected based on the inclusion and exclusion criteria. By tossing a coin, the placement of sealant material was selected for the right permanent first molar. Rubber dam isolation was done. The tooth surface was etched and washed. The respective sealants were applied. Sealants were cured with visible light, and occlusion was checked with articulating paper. Subsequently, the second sealant was placed in the next appointment, following the same clinical procedure in the opposite quadrant. Clinical evaluation was done at 3, 6, and 9 months for retention, marginal integrity, color match, wear, and presence of caries. The criteria were graded and rated as alpha, beta, and charlie based on modified Ryge United States Public Health Service (USPHS) criteria. All the data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) software 20.0. The retention rate of ormocer at the 9-month review interval was 88.3%. There was a statistically significant difference in retention rates between compomer and ormocer (p = 0.003). The marginal integrity and wear of ormocer at the 9-month review interval were 84.4% compared with compomer, which was statistically significant with p = 0.010 and p = 0.035, respectively. Children with the fewest caries belonged to the ormocer group (p = 0.010) compared to the compomer group. Children with ormocer as a pit and fissure sealant showed good retention, remarkable marginal integrity, absence of wear, and fewer dental caries compared to compomer sealants. Hence, ormocer-based sealants can be used in pediatric dental practice to protect children's oral hygiene and promote a healthy lifestyle. Saravanan SM, Srinivasan D, AR SE, et al. Comparative Assessment of Compomers and Ormocers as Pit and Fissure Sealants in Permanent Molars among Children Aged 7-9 Years. Int J Clin Pediatr Dent 2024;17(7):742-747.

Enhancing fluoride ion removal from aqueous solutions and glass manufacturing wastewater using modified orange peel biochar magnetic composite with MIL-53

In this study, we developed new adsorbents derived from orange peel biochar (BCOP) and enhanced them with CoFe2O4 magnetic nanoparticles (BCOP/CoFe2O4) and MIL-53(Al) (BCOP/CoFe2O4/MIL-53(Al)). These adsorbents were utilized to remove fluoride (FL) ions from aqueous solutions. We analyzed the properties of these adsorbents using a range of techniques, including FTIR, XRD, SEM, EDX-Map, VSM, Raman spectroscopy, and BET. Our findings indicate that the components interact effectively with one another. Specifically, the BCOP/CoFe2O4/MIL-53(Al) sample exhibited a specific surface area of 196.430m2/g and a magnetic saturation value of 9.704 emu/g. The maximum FL ion adsorption capacities for BCOP, BCOP/CoFe2O4, and BCOP/CoFe2O4/MIL-53(Al) were 7.618, 16.330, and 37.320mg/g, respectively, indicating that the modifications significantly enhanced the adsorption capacity. The optimum fluoride ion removal rates using BCOP, BCOP/CoFe2O4, and BCOP/CoFe2O4/MIL-53(Al) were 97.88%, 98.23%, and 99.06%, respectively, at adsorbent doses of 2.5, 1.5, and 0.8g/L, contact times of 90, 70, and 50min, pH 4, temperature 50°C, and a FL concentration of 10mg/L. Thermodynamic studies revealed that the adsorption process was spontaneous and endothermic, with increased randomness between the adsorbent and fluoride ions. Kinetic analyses showed that fluoride ion adsorption by BCOP/CoFe2O4/MIL-53(Al) followed a pseudo-second-order (PSO) model, while BCOP and BCOP/CoFe2O4 followed a pseudo-first-order (PFO) model. Additionally, the equilibrium data for fluoride ion adsorption on BCOP/CoFe2O4/MIL-53(Al) adhered to the Freundlich model, whereas the other samples conformed to the Langmuir model. The study evaluates the effectiveness of BCOP, BCOP/CoFe2O4, and BCOP/CoFe2O4/MIL-53(Al) in removing FL ions from glass manufacturing wastewater, highlighting the superior performance of the magnetic composite due to its enhanced surface area and functional groups. Notably, the adsorbents demonstrated good regenerative capabilities, maintaining high performance over multiple adsorption cycles.

Monolayer calcium-doped layered yttrium hydroxide adsorbent for rapid and efficient removal of fluoride from industrial wastewater

Monolayer calcium-doped layered yttrium hydroxide adsorbent for rapid and efficient removal of fluoride from industrial wastewater

Assessment of COMMUNITY Pharmacists' Knowledge, Attitude, and Practice Towards Oral Health Care in Jordan

Background Community chemists now provide more professional and public health care, which is beneficial to the community, in addition to traditional medication distribution. While community pharmacists play a vital role in maintaining and promoting health, further research is required to accurately evaluate their knowledge, attitude, and practice toward oral health care among Jordanian pharmacists in northern Jordan. Methods A prospective cross-sectional study was conducted using an anonymous self-administered questionnaire in Arabic language, targeting 250 community pharmacists in four cities (Irbid, Jerash, Ajloun, and Al-Mafraq) in northern Jordan. The questionnaire comprised four domains: socio-demographic, knowledge, attitudes and practice concerning oral health care. The Statistical Package for the Social Sciences (SPSS) software version 22.0 was used to analyze the collected data, and the significance level was set at P ≤ 0.05. Results A total of 198 respondents returned the survey form, returning a response rate of 79.2%. Community pharmacists showed a good knowledge score of 58.2%. Only 40.9% said periodontal disease was the most frequent cause of tooth loss. The majority lacked knowledge of the optimal fluoride levels in toothpaste. The average attitude score was 71.05%. The most common oral health issues raised by patients were gingivitis and toothache (43.4% and 38.9%), respectively. Conclusion Community pharmacists have the general knowledge and attitude needed to play a significant role in providing dental care counselling to patients dental care. Nonetheless, community pharmacists stated they needed education and training to improve their practice. Continuing education courses related to oral health are recommended to reduce the risk of oral diseases and improve quality of life.

HZrO2@PPy nanocomposite for effective fluoride removal from environmental water

HZrO2@PPy nanocomposite for effective fluoride removal from environmental water

Fluoride concentration and pH in bottled waters commercialized in Chile: Implications for oral health

Fluoride concentration and pH in bottled waters commercialized in Chile: Implications for oral health

Should we be concerned about the use of non-fluoride toothpaste? A survey study in two European countries.

Toothpastes available in Europe contain a range of fluoride concentrations, with some meeting the recommended level for caries prevention (>1000 ppm fluoride (ppm)) and others containing low or no fluoride. This study evaluated toothpaste fluoride concentrations in Latvia and Lithuania to inform targeted public health strategies in regions with a high prevalence of dental caries. This cross-sectional study was conducted from May 2019 to May 2020, using a validated questionnaire in Latvia and Lithuania. Nationally representative samples (1309 families and 5436 members) provided data through a mixed-mode survey (paper and online) on sociodemographic information, toothpaste type, brand, and type. Descriptive statistics and chi-square tests (p < 0.05) were used for analysis. Fifteen percent of families used non-fluoridated toothpaste and 12% used <1000 part per million (ppm) fluoride. In Latvia, 56.8% of preschoolers and 28.7% of schoolchildren used <1000 ppm or non-fluoride toothpaste, whereas in Lithuania, 47.2% of preschoolers and 29.1% of schoolchildren used <1000 ppm or non-fluoride toothpaste; 63% of adolescents and 73% of adults used toothpaste with optimal fluoride content (≥1000 ppm). Of the 228 registered toothpaste types, 62% contained more than 1000 ppm, which is optimal for caries prevention; 29% of Latvian and 24% of Lithuanian families used at least one non-fluoridated toothpaste. This study revealed significant gaps in the use of fluoride toothpaste among families in Latvia and Lithuania, especially among children. To effectively prevent dental caries, targeted interventions, and education must promote optimal fluoride toothpaste use, particularly among vulnerable populations.

Effect of fluoridated water on invasive NHS dental treatments for adults: the LOTUS retrospective cohort study and economic evaluation.

Most water fluoridation studies were conducted on children before the widespread introduction of fluoride toothpastes. There is a lack of evidence that can be applied to contemporary populations, particularly adolescents and adults. To pragmatically assess the clinical and cost effectiveness of water fluoridation for preventing dental treatment and improving oral health in a contemporary population of adults, using a natural experiment design. Retrospective cohort study using routinely collected National Health Service dental claims (FP17) data. National Health Service primary dental care: general dental practices, prisons, community dental services, domiciliary settings, urgent/out-of-hours and specialised referral-only services. Dental patients aged 12 years and over living in England (n = 6,370,280). Individuals exposed to drinking water with a fluoride concentration ≥ 0.7 mg F/l between 2010 and 2020 were matched to non-exposed individuals on key characteristics using propensity scores. Primary: number of National Health Service invasive dental treatments (restorations/'fillings' and extractions) received per person between 2010 and 2020. Secondary: decayed, missing and filled teeth, missing teeth, inequalities, cost effectiveness and return on investment. National Health Service Business Services Authority dental claims data. Water quality monitoring data. Predicted mean number of invasive dental treatments was 3% lower in the optimally fluoridated group than in the sub/non-optimally fluoridated group (incidence rate ratio 0.969, 95% CI 0.967 to 0.971), a difference of -0.173 invasive dental treatments (95% CI -0.185 to -0.161). This magnitude of effect is smaller than what most stakeholders we engaged with (n = 50/54) considered meaningful. Mean decayed, missing and filled teeth were 2% lower in the optimally fluoridated group, with a difference of -0.212 decayed, missing and filled teeth (95% CI -0.229 to -0.194). There was no statistically significant difference in the mean number of missing teeth per person (0.006, 95% CI -0.008 to 0.021). There was no compelling evidence that water fluoridation reduced social inequalities in treatments received or missing teeth; however, decayed, missing and filled teeth data did not demonstrate a typical inequalities gradient. Optimal water fluoridation in England in 2010-20 was estimated to cost £10.30 per person (excluding original setup costs). Mean National Health Service treatment costs for fluoridated patients 2010-20 were 5.5% lower per person, by £22.26 (95% CI -£23.09 to -£21.43), and patients paid £7.64 less in National Health Service dental charges per person (2020 prices). Pragmatic, observational study with potential for non-differential errors of misclassification in fluoridation assignment and outcome measurement and residual and/or unmeasured confounding. Decayed, missing and filled teeth data have not been validated. Water fluoridation cost estimates are based on existing programmes between 2010 and 2020, and therefore do not include the potentially significant capital investment required for new programmes. Receipt of optimal water fluoridation between 2010 and 2020 resulted in very small health effects, which may not be meaningful for individuals, and we could find no evidence of a reduction in social inequalities. Existing water fluoridation programmes in England produced a positive return on investment between 2010 and 2020 due to slightly lower National Health Service treatment costs. These relatively small savings should be evaluated against the projected costs and lifespan of any proposed capital investment in water fluoridation, including new programmes. National Health Service dental data are a valuable resource for research. Further validation and measures to improve quality and completeness are warranted. This trial is registered as ISRCTN96479279, CAG: 20/CAG/0072, IRAS: 20/NE/0144. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR128533) and is published in full in Public Health Research; Vol. 12, No. 5. See the NIHR Funding and Awards website for further award information.

Optimal fluoride levels in pediatric toothpastes: A review of the literature

Aim:Through this literature review, we seek to determine the optimal level of fluoride present in pediatric toothpastes, identifying the recommended amount according to scientific literature, in addition to evaluate the effects of fluoride on children's dental health and its effectiveness in prevention of caries and also identify the risks of excessive fluoride exposure. Materials and methods: Searches were carried out for articles published in the last 5 years in electronic databases such as PubMed, Scopus, Scielo, ScienceDirect, UpToDate, Google Academic. The search used a combination of the following keywords: "toothpaste" AND "pediatrics" AND "dosage" AND "fluoride". Results: 14,118 abstracts were registered: 1,407 from PubMed, 1,043 from Scopus, 355 from ScienceDirect, 10,200 from Google Academic, 913 from Scielo, 200 from UpToDate. After reviewing the abstracts, 14,095 records were removed according to the inclusion and exclusion criteria, leaving 31 full-text articles for examination. Finally, 19 full-text articles were included and evaluated in this review. Conclusion: The presence of adequate concentrations of fluoride in toothpastes has a positive influence in oral health, especially on the prevention of dental caries. Several reviewed studies reveal that the optimal amount of fluoride in pediatric toothpastes should be greater than 1000 ppm but not exceed 1500 ppm to obtain the maximum anti-caries effect and prevent adverse effects such as dental fluorosis.

Salivary Fluoride and pH Levels After Using Toothbrush With 2-Minute Timer (Prototype Trial)

The recommended tooth brushing duration is 2 minutes to obtain optimal fluoride levels in the mouth. Unfortunately, many people, especially teenagers and children, struggled to comply with the minimum duration. This study developed and tested the effectiveness of a toothbrush with a 2-minute timer prototype. This study determined the gaps and the mean scores of salivary pH, fluoride levels, plaque scores, and the number of Streptococcus mutants between the control group that used manual toothbrushes and the experimental group that used the prototype. A crossover and single-blind method was employed, involving 40 second-grade junior high school students selected using a simple random sampling technique. Data was collected by measuring the pH, fluoride levels, and the number of Streptococcus mutants bacteria in unstimulated saliva. The plaque score was also calculated using the Quigley-Hein modified Turesky plaque index (TMQHPI). The average fluoride level obtained by the experimental group was higher (8.86 ± 1.29) than the one of the control group (1.46 ± 0.44). The Independent T-test showed a significant difference in fluoride levels (p = 0.0001), while no significant difference in salivary was found in pH (p = 0.58) between both groups. The toothbrush with a 2-minute timer prototype developed in this study increased the fluoride levels, preventing dental caries and restoring salivary pH levels.

Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries: a randomised clinical trial

Knowledge gaps exist regarding optimal silver diammine fluoride (SDF) regimens and the efficacy of new products for arresting dental caries in young children. We evaluated the effectiveness of 38%-SDF (SDI-RivaStar), Tiefenfluorid (TF) comparing with Placebo (P), all in conjunction with behavioural modification (BM), in preventing major complications (endodontic/extractions/pain)—a patient-centred outcome—due to early childhood caries over 12 months in children under 71-months. A six-arm, patient/parent-blinded, superiority, placebo-controlled randomised control trial at the university clinic in Riga, Latvia, from 1/9/20-31/8/22 (Protocol registration ISRCTN17005348). The trial tested six protocols, using three compounds (P/SDF/TF) under two regimes: annual and biannual (P1/P2/TF1/TF2/SDF1/SDF2) for major complications. Secondary outcomes included minor complications and parental satisfaction. All groups received BM. 373/427 randomised children (87.3%) completed the study. SDF2 had a significantly lower rate and risk of major (21.5%, OR = 0.28, 95%CI [0.11, 0.72], p < 0.05) and minor complications (OR = 0.16 (95%CI [0.05, 0.50], p = 0.002). Overall satisfaction was 96% (p > 0.05). SDF biannual application with BM effectively prevented major complications of early childhood caries and was well accepted by children and their parents. Trial registration number: ISRCTN17005348, principal investigator: Ilze Maldupa, registration date: 30/06/2021.Clinical trial registration number: ISRCTN registry: ISRCTN17005348, https://doi.org/10.1186/ISRCTN17005348, registration date: 30/06/2021.

Effects of maternal anxiety and sociodemographic factors on fluoride knowledge and opinions about fluoride-containing oral products. A cross-sectional study.

To assess the relationship between maternal anxiety and so- cioeconomic status, focusing on mothers' knowledge of fluoride and their views on fluoride-containing oral products. In a cross-sectional study design involving 224 mother- child pairs, mothers' socioeconomic status, level of knowledge on fluoride, and perspectives on fluoride toothpaste and topical fluoride gel/varnish were assessed through self-administered questionnaires. Maternal anxiety levels were measured using the Spielberg State-Trait Anxiety Inventory. Mothers with higher socioeconomic status had a greater level of knowledge regarding fluoride. However, higher socio- economic status was associated with having negative opinions about fluoride gel/varnish. No relationship was found between mothers' anxiety levels and their perspectives toward fluoride toothpaste and topical fluoride gel/varnish. The general public should be informed about optimum fluoride dosage, possible side effects, and caries- preventive effects. More studies are required to evaluate the causes of negative thoughts about topical fluoride oral products.