Skip to main content
SpringerLink
Log in

Caries preventive effect of fluoride in milk, salt and tablets: A literature review

  • Published:
European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

BACKGROUND: There are a number of studies in the literature about the effectiveness of fluoride in tablets, fluoride added to frequently-consumed food like milk, or to food additives like salt, in prevention of dental caries. This literature has been evaluated in different evidence based reviews. AIM: The scope of this paper was to identify the most recent evidence-based reviews on the effect in caries prevention from added fluoride in milk, salt and fluoride tablets/drops including newer RCT studies, and to synthesize the findings into practice guidelines. The key question was as follows: Does regular use of fluoride in milk, salt and fluoride tablets/drops prevent dental caries among children and adolescents? METHODS: MEDLINE, EMBASE and EBM reviews (Cochrane database of systematic reviews) were searched using modified filters from a Cochrane review. One evidence-based report on fluoridated milk was identified. Salt fluoridation was covered by three HTA reviews. One Cochrane protocol on the caries preventive effect of fluoridated salt was identified. RESULTS: Very few studies of good quality were identified in general. Two studies on fluoridated milk were tabulated and seven studies dealing with fluoride tablets/drops were analysed. One study showed a 78% reduction in caries in newly erupted permanent teeth among 8 year olds after 3 years with fluoridated milk. For primary teeth one study showed 31% caries reduction. The differences between fluoride-group and control were statistically significant. The reduction in caries prevalence in the fluoride tablet group compared with a negative control varied from 81% (carious surfaces in permanent teeth erupted in the study period) to 49% in DMFS for all permanent teeth. No RCT studies on fluoridated salt were identified. CONCLUSION: There is limited evidence that F tablets and drops are effective, and compliance is a key factor. There are good reasons to believe that fluoride in different applications and formulas does work as caries preventive agents under supervision. There is a need for new, well-designed studies within this field, but the use of negative controls without any fluoride exposure is difficult due to ethical reasons. In particular new research is needed concerning possible caries preventive effect of fluoridated milk and salt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Björnström H, Naji S, Simic D, Sjöström I, Twetman S. Fluoride levels in saliva and dental plaque after consumption of snacks prepared with fluoridated salt. Eur J Paediatr Dent 2004: 5(1):41–45.

    PubMed  Google Scholar 

  • Burt BA. Fluoridation and social equity. J Public Health Dent 2002: 62(4):195–200.

    Article  PubMed  Google Scholar 

  • Burt BA, Marthaler TM. Fluoride tablets, salt fluoridation, and milk fluoridation. In: Fejerskov O, Ekstrand J, Burt BA, eds. Fluoride in dentistry. København: Munksgaard, 1996:291–310.

    Google Scholar 

  • Centers for Disease Control and Prevention. Recommendations for using fluoride to prevent and control dental caries in the united states. MMWR Recomm Rep 2001: 50 (RR-14):1–42.

    Google Scholar 

  • Driscoll WS, Heifetz SB, Brunnelle JA. Treatment and posttreatment effects of chewable fluoride tablets on dental caries: Findings after 7 1/2 years. J Am Dent Assoc 1979: 99(5):817–821.

    PubMed  Google Scholar 

  • Driscoll WS, Nowjack-Raymer R, Selwitz RH, Li SH, Heifetz SB. A comparison of the caries-preventive effects of fluoride mouthrinsing, fluoride tablets, and both procedures combined: Final results after eight years. J Public Health Dent 1992:52(2):111–116.

    Article  PubMed  Google Scholar 

  • Estupinan-Day SR, Baez R, Horowitz H, et al. Salt fluoridation and dental caries in jamaica. Community Dent Oral Epidemiol 2001: 29(4):247–252.

    Article  PubMed  Google Scholar 

  • Gillespie GM, Marinho VCC, Marthaler TM, et al. Salt fluoridation for preventing dental caries (protocol). Cochrane Database of Systematic Reviews 2005: (4).

  • Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. BMJ 2001: 323(7308):334–336.

    Article  PubMed  Google Scholar 

  • Haugejorden O, Birkeland JM. Analysis of the ups and downs of caries experience among norwegian children aged five years between 1997 and 2003. Acta Odontol Scand 2005: 63(2):115–122.

    PubMed  Google Scholar 

  • Hedman J, Sjoman R, Sjostrom I, Twetman S. Fluoride concentration in saliva after consumption of a dinner meal prepared with fluoridated salt. Caries Res 2006: 40(2):158–162.

    Article  PubMed  Google Scholar 

  • Irigoyen ME, Sanchez-Hinojosa G. Changes in dental caries prevalence in 12-year-old students in the state of mexico after 9 years of salt fluoridation. Caries Res 2000: 34(4):303–307.

    Article  PubMed  Google Scholar 

  • Ismail AI. Prevention of early childhood caries. Community Dent Oral Epidemiol 1998: 26 (1 Suppl):49–61.

    PubMed  Google Scholar 

  • Ismail AI, Hasson H. Fluoride supplements, dental caries and fluorosis: A systematic review. J Am Dent Assoc 2008: 139(11):1457–1468.

    PubMed  Google Scholar 

  • Jones S, Burt BA, Petersen PE, Lennon MA. The effective use of fluorides in public health. Bull World Health Organ 2005: 83(9):670–676.

    PubMed  Google Scholar 

  • Kallestal C. The effect of five years’ implementation of caries-preventive methods in swedish high-risk adolescents. Caries Res 2005: 39(1):20–26.

    Article  PubMed  Google Scholar 

  • Limeback H, Ismail A, Banting D, et al. Canadian consensus conference on the appropriate use of fluoride supplements for the prevention of dental caries in children. J Can Dent Assoc 1998: 64(9):636–639.

    PubMed  Google Scholar 

  • Lin YT, Tsai CL. Comparative anti-caries effects of tablet and liquid fluorides in cleft children. J Clin Dent 2000:11(4):104–106.

    PubMed  Google Scholar 

  • Macpherson LM, Stephen KW. The effect on human salivary fluoride concentration of consuming fluoridated salt-containing baked food items. Arch Oral Biol 2001: 46(10):983–988.

    Article  PubMed  Google Scholar 

  • Marthaler TM, Petersen PE. Salt fluoridation-an alternative in automatic prevention of dental caries. Int Dent J 2005: 55(6):351–358.

    PubMed  Google Scholar 

  • Mascarenhas AK, Scott T. Does exposure to fluoridated water during the crown completion and maturation phases of permanent first molars decrease pit and fissure caries? J Evid Based Dent Pract 2008: 8(1):17–18.

    Article  PubMed  Google Scholar 

  • Maslak EE, Afonina IV, Kchmizova TG, Litovkina LS, Luneva NA. The effect of amilk fluoridation project in volgograd. Caries Res 2004:38(4):377 (abstract 360).

    Google Scholar 

  • National Health and Medical Research Council. A systematic review of the efficacy and safety of fluoridation. Canberra, Australia, 2007.

  • Pakhomov GN, Kolesnik AG, Shamsheva AA, Kuz’min EM, Stepanova IA. Milk fluoridization efficacy in a controlled study and dental caries experience dynamics in conditions of wide availability of local f-containing means (Russian). Stomatologiia (Mosk) 2005: 84(4):37–42.

    Google Scholar 

  • Poulsen S, Gadegaard E, Mortensen B. Cariostatic effect of daily use of a fluoride-containing lozenge compared to fortnightly rinses with 0.2% sodium fluoride. Caries Res 1981: 15(3):236–242.

    Article  PubMed  Google Scholar 

  • Singh KA, Spencer AJ. Relative effects of pre- and post-eruption water fluoride on caries experience by surface type of permanent first molars. Community Dent Oral Epidemiol 2004: 32(6):435–446.

    Article  PubMed  Google Scholar 

  • Singh KA, Spencer AJ, Brennan DS. Effects of water fluoride exposure at crown completion and maturation on caries of permanent first molars. Caries Res 2007: 41(1):34–42.

    Article  PubMed  Google Scholar 

  • Solorzano I, Salas MT, Chavarria P, Beltran-Aguilar E, Horowitz H. Prevalence and severity of dental caries in costa rican schoolchildren: Results of the 1999 national survey. Int Dent J 2005: 55(1):24–30.

    PubMed  Google Scholar 

  • Stecksen-Blicks C, Holgerson PL, Twetman S. Effect of xylitol and xylitolfluoride lozenges on approximal caries development in high-caries-risk children. Int J Paediatr Dent 2008: 18(3):170–177.

    Article  PubMed  Google Scholar 

  • Stephen KW. Fluoride prospects for the new millennium-community and individual patient aspects. Acta Odontol Scand 1999: 57(6):352–355.

    Article  PubMed  Google Scholar 

  • Stephen KW, Boyle IT, Campbell D, McNee S, Boyle P. Five-year double-blind fluoridated milk study in scotland. Community Dent Oral Epidemiol 1984: 12(4):223–229.

    Article  PubMed  Google Scholar 

  • Stephen KW, Campbell D. Caries reduction and cost benefit after 3 years of sucking fluoride tablets daily at school. A double-blind trial. Br Dent J 1978: 144(7):202–206.

    Google Scholar 

  • Stephen KW, Creanor SL, Russell JI, et al. A 3-year oral health dose-response study of sodium monofluorophosphate dentifrices with and without zinc citrate: Anti-caries results. Community Dent Oral Epidemiol 1988: 16(6):321–325.

    Article  PubMed  Google Scholar 

  • Swedish Council on Technology Assessment in Health Care. Att förebygga karies. En systematisk litteraturöversikt (Swedish). Stockholm, Sweden, 2002.

  • The Scottish Intercollegiate Guidelines Network. Sign 50: A guideline developer’s handbook. 2008.

  • Weintraub JA, Ramos-Gomez F, Jue B, et al. Fluoride varnish efficacy in preventing early childhood caries. J Dent Res 2006: 85(2):172–176.

    Article  PubMed  Google Scholar 

  • Wennhall I, Matsson L, Schroder U, Twetman S. Outcome of an oral health outreach programme for preschool children in a low socioeconomic multicultural area. Int J Paediatr Dent 2008:18(2):84–90.

    Article  PubMed  Google Scholar 

  • Yeung CA. A systematic review of the efficacy and safety of fluoridation. Evid Based Dent 2008: 9(2):39–43.

    Article  PubMed  Google Scholar 

  • Yeung CA, Hitchings JL, Macfarlane TV, et al. Fluoridated milk for preventing dental caries. Cochrane Database Syst Rev 2005: (3): CD003876.

Download references

Author information

Authors and Affiliations

  1. Dept. of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, University of Oslo, P.O.Box 1109, NO-0317, Blindern, Oslo, Norway

    I. Espelid

Authors
  1. I. Espelid
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I. Espelid.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Espelid, I. Caries preventive effect of fluoride in milk, salt and tablets: A literature review. Eur Arch Paediatr Dent 10, 149–156 (2009). https://doi.org/10.1007/BF03262676

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03262676

Key Words

Search

Navigation