Video Demonstration

Video failed to load. Please try again.

MDK would like to thank Colgate for providing a grant, which makes this training module possible

Learning Objectives

  • Demonstrate knowledge and understanding of the evidenced-based dentistry recommendations for the use of fluoride in caries prevention
  • Understand the mechanism of action of fluoride
  • Identify which patients would benefit from systemic fluoride supplementation
  • List and perform the steps of applying fluoride varnish to a patient’s dentition

Module Outline

  • History of fluoride
  • Introduction
  • Fluoride delivery method 
  • When to utilize fluoride in oral disease prevention 
  • Contraindications
  • Safety and toxicity  
  • Fluoride varnish application step-by-step procedure
  • Key points


Arnold F. A., Jr (1957). Grand Rapids fluoridation study; results pertaining to the eleventh year of fluoridation. American journal of public health and the nation’s health, 47(5), 539–545. https://doi.org/10.2105/ajph.47.5.539

Barker, J. C., Guerra, C., Gonzalez-Vargas, M. J., & Hoeft, K. S. (2016). Acceptability of Salt Fluoridation in a Rural Latino Community in the United States: An Ethnographic Study. PloS one, 11(7), e0158540. https://doi.org/10.1371/journal.pone.0158540

Beltran, E. D., & Burt, B. A. (1988). The pre- and posteruptive effects of fluoride in the caries decline. Journal of public health dentistry, 48(4), 233–240. https://doi.org/10.1111/j.1752-7325.1988.tb03204.x

Croll, T. P., & Berg, J. (2020). Delivery Methods of Silver Diammine Fluoride to Contacting Proximal Tooth Surfaces and History of Silver in Dentistry. Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995), 41(2), 84–90.

Johnston, N. R., & Strobel, S. A. (2020). Principles of fluoride toxicity and the cellular response: a review. Archives of toxicology, 94(4), 1051–1069. https://doi.org/10.1007/s00204-020-02687-5

Jordan, R. A., Schulte, A., Bockelbrink, A. C., Puetz, S., Naumova, E., Wärn, L. G., & Zimmer, S. (2017). Caries-Preventive Effect of Salt Fluoridation in Preschool Children in The Gambia: A Prospective, Controlled, Interventional Study. Caries research, 51(6), 596–604. https://doi.org/10.1159/000479892

King, A. Bad science: To fluoridate or not to fluoridate: the saga continues. Br Dent J 224, 209–210 (2018). https://doi.org/10.1038/sj.bdj.2018.146

Lynch R. J. (2013). The primary and mixed dentition, post-eruptive enamel maturation and dental caries: a review. International dental journal, 63 Suppl 2, 3–13. https://doi.org/10.1111/idj.12076

Marinho, V. C., Higgins, J. P., Sheiham, A., & Logan, S. (2003). Fluoride toothpastes for preventing dental caries in children and adolescents. The Cochrane database of systematic reviews, 2003(1), CD002278. https://doi.org/10.1002/14651858.CD002278

Matsuo, G., Aida, J., Osaka, K., & Rozier, R. G. (2020). Effects of Community Water Fluoridation on Dental Caries Disparities in Adolescents. International journal of environmental research and public health, 17(6), 2020. https://doi.org/10.3390/ijerph17062020

Mohd Said, S. N., Ekambaram, M., & Yiu, C. K. (2017). Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions. International journal of paediatric dentistry, 27(3), 163–173. https://doi.org/10.1111/ipd.12243

O’Mullane, D. M., Baez, R. J., Jones, S., Lennon, M. A., Petersen, P. E., Rugg-Gunn, A. J., Whelton, H., & Whitford, G. M. (2016). Fluoride and Oral Health. Community dental health, 33(2), 69–99.

Otten, M. P., Busscher, H. J., Abbas, F., van der Mei, H. C., & van Hoogmoed, C. G. (2012). Plaque-left-behind after brushing: intra-oral reservoir for antibacterial toothpaste ingredients. Clinical oral investigations, 16(5), 1435–1442. https://doi.org/10.1007/s00784-011-0648-2

Peterson J. (1997). Solving the mystery of the Colorado Brown Stain. Journal of the history of dentistry, 45(2), 57–61.

Pollick H. (2018). The Role of Fluoride in the Prevention of Tooth Decay. Pediatric clinics of North America, 65(5), 923–940. https://doi.org/10.1016/j.pcl.2018.05.014

Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep 2001; 50: pp. 1-42. Available at: https://www-cdc-gov.proxy.lib.ohio-state.edu/mmwr/preview/mmwrhtml/rr5014a1.htm

Schluter, P. J., Hobbs, M., Atkins, H., Mattingley, B., & Lee, M. (2020). Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA pediatrics, 174(10), 969–976. https://doi.org/10.1001/jamapediatrics.2020.2201

Seifo, N., Robertson, M., MacLean, J., Blain, K., Grosse, S., Milne, R., Seeballuck, C., & Innes, N. (2020). The use of silver diamine fluoride (SDF) in dental practice. British dental journal, 228(2), 75–81. https://doi.org/10.1038/s41415-020-1203-9

Singh, K. A., & Spencer, A. J. (2004). Relative effects of pre- and post-eruption water fluoride on caries experience by surface type of permanent first molars. Community dentistry and oral epidemiology, 32(6), 435–446. https://doi.org/10.1111/j.1600-0528.2004.00182.x

U.S. Department of Health and Human Services. The story of fluoridation. National Institute of Dental and Craniofacial Research. Retrieved June 19, 2022, from https://www.nidcr.nih.gov/health-info/fluoride/the-story-of-fluoridation

U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation (2015). U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries. Public health reports (Washington, D.C. : 1974), 130(4), 318–331. https://doi.org/10.1177/003335491513000408

Whitford G. M. (2011). Acute toxicity of ingested fluoride. Monographs in oral science, 22, 66–80. https://doi.org/10.1159/000325146



You’ve reached the end of this lesson