Narrative review reports water fluoridation reduces dental caries rates across populations, indicating fluoride serves as an essential nutrient for enamel maintenance.
Key Points
To review the historical evidence, dietary intake parameters, and biochemical mechanisms establishing fluoride as an essential nutrient for dental and skeletal health.
Narrative synthesis of historical and epidemiological data on communal water fluoridation involving nearly 90 million persons across 7,500 communities.
Evaluation of dietary intake estimates (0.1–0.5 ppm baseline) relative to targeted water fluoridation levels (1.0 ppm in temperate regions).
Review of in vivo and in vitro evidence on the mineral composition of enamel and bone calcified tissues.
Community water fluoridation produces a significant reduction in the incidence of dental caries compared to rates observed in the general population consuming low-fluoride water.
Adjusting community water supplies to 1.0 ppm provides a total daily fluoride ingestion of approximately 1.5 mg, compared to 0.5 mg daily from customary diet and unfluoridated water.
In vivo and in vitro analyses confirm that fluoride integrates into calcified enamel and bone matrices, yielding protective hydroxy- and fluor-apatite crystal complexes.