Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States

Widespread use of fluoride has been a major factor in the decline in the
prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. All U.S.
residents are likely exposed to some degree to fluoride, which is available from
multiple sources. Both health-care professionals and the public have sought
guidance on selecting the best way to provide and receive fluoride. During the late 1990s, CDC convened a work group to develop recommendations for using
fluoride to prevent and control dental caries in the United States. This report
includes these recommendations, as well as a) critical analysis of the scientific
evidence regarding the efficacy and effectiveness of fluoride modalities in
preventing and controlling dental caries, b) ordinal grading of the quality of the
evidence, and c) assessment of the strength of each recommendation.

The recommendations in this report guide dental and other health-care
providers, public health officials, policy makers, and the public in the use of
fluoride to achieve maximum protection against dental caries while using
resources efficiently and reducing the likelihood of enamel fluorosis. The
recommendations address public health and professional practice, self-care,
consumer product industries and health agencies, and further research. Adoption of these recommendations could further reduce dental caries in the United States and save public and private resources.