ABSTRACT
An evaluation of the safety of fluoride prophylaxis in dental health care must be based on knowledge of the injurious effects of excess fluoride intake. A substantial number of clinical studies attest to the value of systemic fluoride supplements, especially in tablet form, in the prevention of dental caries. In a sizable number of studies involving thousands of subjects in which the efficacy of fluoride tablets has been demonstrated, systemic ill effects are rarely considered and have been reported only once. The hazards attending the use of fluoride tablets or drops have been separated into two groups: those of primary concern-dental fluorosis; systemic adverse reactions, and those of secondary concern-acute poisoning; allergy; repeated overdose for brief periods. In the United States, no moderate fluorosis develops in children living in a temperate climate where the drinking water concentration is 2 ppm of fluoride or less.
