The AADOCR Position Statement on Topical Fluoride

Topical fluorides play a critical role in the prevention and management of dental caries and have been a cornerstone of evidence-based oral health promotion for decades. A rigorous understanding of the improved acid resistance of fluorapatite, with more recent evidence of the antimicrobial actions of fluorides, has helped establish its key role in caries management. The American Association for Dental, Oral, and Craniofacial Research (AADOCR) recommends using fluoride-containing dentifrices at 1,000 to 1,500 ppm twice daily based on the current evidence. For preschool-aged children, only a small amount (a smear about the size of a grain of rice) should be used to effectively prevent caries while minimizing the risk of dental fluorosis from unintentional ingestion. Furthermore, for patients at increased caries risk, the use of topical fluoride agents, such as professionally applied gels, varnishes, and/or silver diamine fluoride, could be used at 6-mo intervals, along with daily or weekly fluoride mouth rinses and gels; frequency should be adjusted to individual risk status and other sources of fluorides. Due to their high fluoride concentration, mouth rinses and prescription gels are not recommended for preschool-aged children. The AADOCR supports continued high-quality research to refine clinical guidelines and ensure that topical fluoride use remains aligned with scientific understanding and public health priorities.