The value of self-applied fluorides at home.

Dental research workers from several scientific disciplines have combined over the years to give much greater insight into the basic mechanisms whereby fluoride protects the teeth against dental decay. These basic investigations have enabled clinical research workers to test new fluoride delivery systems rationally rather than empirically, and it now seems that two entirely different modes need to be combined to form maximum protection. First, fluoride ions need to be introduced at the correct level into the forming enamel crystals during tooth development; secondly, fluoride ions need to be present at optimal concentrations at the plague-enamel interface during active carious attack. Both these situations require low levels of fluoride concentration to be delivered to the subject at very regular intervals. Water fluoridation is the best method of achieving this situation, but in the absence of this important public health measure, dental scientists have developed a battery of other vehicles which, when used on a daily basis at home, will have a considerable impact on caries activity. While further work continues to improve the effectiveness of these techniques, enough has been achieved already to encourage their use by the general public. What are required now are the necessary skills in health politics and behavioral science to gain public acceptance and application of these endeavours.