An Update on Fluorides and Fluorosis with Reference to Oral Health Status in the Gulf Region: Review

Fluoride (F) has exerted the most significant impact on practice of dentistry because of its effectiveness in preventing dental caries. Despite improvements in the oral health of populations, dental caries remains a public health problem worldwide affecting most schoolchildren and present costly burden to health care services. Water fluoridation remains the cornerstone of caries prevention programs. It is the most effective means of reducing caries, cost-effective, convenient, and reliable method of providing the benefits of F to the general population. Without a doubt, the most widely used method of applying F topically is by means of dentifrices. Additional F-modes should be targeting at high-risk populations. The decision to use F in caries prevention requires a balance between benefits and the risk of fluorosis. Fluoride treatment is systemic and local. Modes of systemic fluorides include water fluoridation, dietary F supplements, fluoridated table salt and milk. Topical fluorides are self-applied toothpastes, mouthrinses, gels or professionally-applied F solutions, gels, foams, and varnishes. Acidulated F gels (APF, 1.23% F) are the most potential hazardous F products currently used in pediatric dentistry due to the inadvertent ingestion of the gel during treatment. This article reviews F and fluorosis in relation to water, foods, and beverage’s intake, dental products, and industrial emissions. Fluoride metabolism, safety and toxicity is discussing. The therapeutic effects and safety of F treatment can only be answered by understanding the mechanism of F metabolism. The incidence of fluorosis is increasing due to multiple sources of F. The severity of the dental fluorosis depends on the dose, duration, and timing of fluoride intake. Dental health of children in the Arabian Gulf region will be discussed in this review.