Objective:

To review the history, effectiveness, and current criticisms of fluoride use in dental health, with a specific focus on community water fluoridation and topical applications.

Key Findings:

• Community water fluoridation significantly reduced dental caries in historical studies, particularly before 1975.
• Recent reviews indicate a diminished impact of water fluoridation post-1975 due to the widespread use of fluoridated toothpaste, with specific data on caries reduction.
• Fluoride's primary caries-preventive effect is topical rather than systemic, supported by recent laboratory and epidemiological studies.

Interpretation:

While fluoride remains beneficial for dental health, its effectiveness may be more pronounced through topical application, necessitating a reevaluation of community water fluoridation's role, especially for populations with limited access to fluoride products like toothpaste.

Limitations:

• Recent studies have raised concerns about fluoride's safety, particularly regarding children's IQ, with insufficient evidence to fully understand the implications.
• Insufficient evidence exists to determine the necessity of water fluoridation for lower socioeconomic groups, highlighting the need for further research.

Conclusion:

The necessity of community water fluoridation should be reconsidered in light of the evidence supporting topical fluoride use, particularly as access to fluoridated toothpaste improves.