Dentists’ knowledge of fluoride cariostatic mechanisms

Introduction. The use of age- and risk-adjusted caries prevention requires up-to-date knowledge on the cariostatic effects of fluoride, as well as the methods and safety of fluoride prophylaxis. Aim. The aim of the study was to assess dentists’ knowledge of the safety and mechanism of anticaries effects of fluoride. Material and methods. An anonymous questionnaire was conducted among 212 dentists participating in dental training. The questions included in the questionnaire related to knowledge about water fluoridation, fluoride cariostatic mechanisms and the safety of fluoride prophylaxis. The chi-square test and the Spearman’s rank correlation coefficient were used for statistical analysis. A significance level of 0.05 was used. Results. Incorrect knowledge about water fluoridation was demonstrated by 26.9% of respondents in the country and 16.0% of respondents in Europe. Most respondents (80.7%) reported higher efficacy of exogenous vs endogenous anticaries approaches, and more than half of respondents (59.0%) considered the processes of remineralisation and demineralisation as the most important anticaries activity. Almost all respondents (95.7%) agreed that the use of fluoride for caries prevention is controversial, mainly due to its dose-dependent therapeutic or toxic effects (85.4%). According to about 20% of respondents, cariostatic fluoride doses have adverse effects on the general health, mainly in the form of bone fragility (10.4%). Conclusions. Lack of correct knowledge about the dominant cariostatic effects of fluoride may result in the choice of an inappropriate preventive method or avoiding local application of fluoride preparations for fear of adverse systemic effects, which may in turn lead to increased caries prevalence in a given population.