Fluoride supplements: current effectiveness, side effects, and recommendations.

A critical review of the literature was conducted to determine the current effectiveness of fluoride supplements in caries prevention and their role as risk factors for dental fluorosis. Use of fluoride supplements by young children is idiosyncratic and all of the studies which investigated the effectiveness of this regimen suffered from a significant drop in the number of participants receiving daily supplements. The scientific evidence supports the efficacy of fluoride supplements in caries prevention but there is weaker support for their effectiveness. Fluoride supplements are a risk factor for dental fluorosis, though their contribution to the increase in fluorosis prevalence is less than that of water fluoridation and fluoridated dentifrices because of their more limited and shorter use. There is also evidence that fluoride supplements are used inappropriately in fluoridated areas. The availability of optimal levels of fluorides in beverages in non-fluoridated communities raises the question of whether fluoride supplements are needed in the 1990s, and whether it is time to consider the total fluoride intake not only from water but also from foods, beverages, and dentifrices, when recommending supplements. A re-evaluation of the need for and dosage schedules of fluoride supplements is warranted.