Tooth decay (dental caries) can cause pain and lead to loss of teeth. In most developed countries, the prevalence of dental caries has decreased in the past 30 years in child populations. Nevertheless, some individuals or populations experience an increased caries challenge and are considered as being at 'high caries risk'.
Fluoride is a mineral that prevents tooth decay. Fluoride can be administered in different ways, either topically (toothpastes, mouth rinses, varnishes, gels) or systemically (fluoride supplements, fluoridated water, salt). Today, posteruptive (topical) preventive effect of fluoride is considered as being more important than the pre-eruptive (systemic) effect. Topical fluorides have been shown to be highly effective and the use of fluoride-containing toothpastes is now almost universal. When daily toothbrushing with a fluoridated toothpaste is not carried out or when the caries-risk is increased, additional sources of fluoride could be recommended.
Fluoride supplements are administered in the form of lozenges, tablets or liquids. In this review, we only considered fluoride administered through supplements.
The review indicates that in schoolchildren (greater than 6 years of age), fluoride supplements when compared with no fluoride supplementation had a preventive effect on caries in permanent teeth. There was no differential effect between fluoride supplements and topical fluorides for preventing dental caries. Many of the studies included in the review had been conducted at a time when topical fluorides were not widely used. There is thus a lack of evidence from the review to make actual good recommendations. Today, the effect of fluoride supplements in children using fluoride toothpastes on a regular basis would probably be limited.
In the review, no conclusion could be reached about the effectiveness of fluoride supplements in preventing tooth decay in young children (less than 6 years of age) with deciduous teeth. Moreover, insufficient evidence exists to show whether or not using fluoride supplements in young children (less than 6 years of age) could mottle teeth (fluorosis), an effect of chronic ingestion of excessive amounts of fluoride.