Topical fluoride therapy: discussion of some aspects of toxicology, safety, and efficacy.

Although ingestion of an acute toxic dose of fluoride is extremely rare in dental treatments, practitioners should be familiar with the signs and symptoms and with emergency measures of treating accidental overdosage. The amount of fluoride ingested chronically from the use of self-applied topical fluoride can be reduced to safe limits by instructing parents to dispense small amounts of toothpaste for their young children and to ensure that fluoride dentifrices and mouthrinses are fully expectorated. Similarly, when custom-fitted trays are used, only minimal amounts of fluoride gels are necessary. The minimal amount of such gels that can be dispensed appears to be influenced by their viscosity. Clinical efficacy does not support a reduction in the concentration of fluoride in commercial dentifrices.