Toothpastes with fluoride in the prevention of cavities. Literary review
Keywords:
Fluoride, tooth decay, childrenAbstract
Introduction: The fluoride present in toothpastes constitutes a key agent in the prevention of cavities, by strengthening tooth enamel, promoting the remineralization of initial lesions and reducing demineralization caused by bacterial acids. Objective: To analyze the effectiveness of toothpastes with fluoride in preventing cavities, evaluating their ability to strengthen enamel, reduce bacterial plaque and prevent demineralization. Materials and methods: A systematic search was conducted in the PubMed database for articles published between 2020 and 2025, using keywords related to fluoride toothpaste, cavity prevention, and dental fluoride. Studies available in full text, in Spanish or English, that directly evaluated the effectiveness of fluoride pastes were included, excluding duplicates, research without clinical application and products without fluoride. Of the 79 articles identified, 26 met the inclusion criteria. Results: The effectiveness of toothpastes depends on the concentration and stability of fluoride, its controlled release and the interaction with the enamel structure. Formulations with soluble fluoride greater than 1000 ppm and combinations with biomimetic hydroxyapatite promote remineralization, strengthen enamel and reduce bacterial activity, protecting against new lesions and the progression of caries. Conclusion: The regular use of toothpastes with fluoride constitutes an effective, safe and accessible strategy to prevent dental caries, improve oral health and maintain the integrity of primary and permanent teeth.
Downloads
References
Chatzidimitriou, K., Theodorou, K., Seremidi, K., Kloukos, D., Gizani, S., & Papaioannou, W. (2025). The role of hydroxyapatite-based, fluoride-free toothpastes on the prevention and the remineralization of initial caries lesions: A systematic review and meta-analysis. Journal of Dentistry, 156. https://doi.org/10.1016/j.jdent.2025.105691
Clark, D., & Levin, L. (2020). Comparison of new formulas of stannous fluoride toothpastes with other commercially available fluoridated toothpastes: A systematic review and meta-analysis of randomised controlled trials. International Dental Journal, 70(6), 418–426. https://doi.org/10.1111/idj.12588
Cocco, F., Salerno, C., Wierichs, R. J., Wolf, T. G., Arghittu, A., Cagetti, M. G., & Campus, G. (2025). Hydroxyapatite-Fluoride Toothpastes on Caries Activity: A Triple-Blind Randomized Clinical Trial. International Dental Journal, 75(2), 632–642. https://doi.org/10.1016/j.identj.2024.09.037
Fernandes, N. L. S., Silva, J. G. V. C., de Sousa, E. B. G., D’Alpino, P. H. P., de Oliveira, A. F. B., de Jong, E. de J., & Sampaio, F. C. (2022). Effectiveness of fluoride-containing toothpastes associated with different technologies to remineralize enamel after pH cycling: an in vitro study. BMC Oral Health, 22(1). https://doi.org/10.1186/S12903-022-02429-2
Filho, A. M. L., Valdivia-Tapia, A. C., Costa, R. D. C. N. P., Espinoza, E. V., Filho, A. P. R., & Cury, J. A. (2022). Fluoride concentration in toothpaste marketed to children in Brazil and Mexico, and discussion on current regulations. Brazilian Dental Journal, 33(2), 52–60. https://doi.org/10.1590/0103-6440202204522
Iheozor, Z., Walsh, T., Lewis, S. R., Riley, P., Boyers, D., Clarkson, J. E., Worthington, H. V., Glenny, A. M., & O’Malley, L. (2024). Water fluoridation for the prevention of dental caries. The Cochrane Database of Systematic Reviews, 10(10). https://doi.org/10.1002/14651858.CD010856.PUB3
Jullien, S. (2021). Prophylaxis of caries with fluoride for children under five years. BMC Pediatrics, 21(Suppl 1). https://doi.org/10.1186/S12887-021-02702-3
Koc, U., Bagdatli, Z., Yilmaz, A., Yalçın, F., Altundaşar, E., & Gurgan, S. (2021). Effects of charcoal-based whitening toothpastes on human enamel in terms of color, surface roughness, and microhardness: an in vitro study. Clinical Oral Investigations, 25(10), 5977–5985. https://doi.org/10.1007/S00784-021-03903-X
Limeback, H., Enax, J., & Meyer, F. (2021). Biomimetic hydroxyapatite and caries prevention: a systematic review and meta-analysis. Canadian Journal of Dental Hygiene, 55(3), 148. https://pmc.ncbi.nlm.nih.gov/articles/PMC8641555/
Limeback, H., Enax, J., & Meyer, F. (2023). Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence. Biomimetics (Basel, Switzerland), 8(4). https://doi.org/10.3390/BIOMIMETICS8040331
Miranda, L. F. B., Tabchoury, C. P. M. H., & Cury, J. A. (2023). Optimization of a Validated Protocol That Determines Bioavailable Fluoride in Toothpastes. Caries Research, 57(5–6), 619–624. https://doi.org/10.1159/000533154
Nicholson, J. W. (2025). Stannous Fluoride in Toothpastes: A Review of Its Clinical Effects and Likely Mechanisms of Action. Journal of Functional Biomaterials, 16(3). https://doi.org/10.3390/JFB16030073
O’Hagan, K., Enax, J., Meyer, F., & Ganss, B. (2022). The use of hydroxyapatite toothpaste to prevent dental caries. Odontology, 110(2), 223–230. https://doi.org/10.1007/S10266-021-00675-4
Orilisi, G., Vitiello, F., Notarstefano, V., Furlani, M., Riberti, N., Monterubbianesi, R., Bellezze, T., Campus, G., Carrouel, F., Orsini, G., & Putignano, A. (2023). Multidisciplinary evaluation of the remineralization potential of three fluoride-based toothpastes on natural white spot lesions. Clinical Oral Investigations, 27(12), 7451–7462. https://doi.org/10.1007/S00784-023-05334-2
Parkinson, C. R., Burnett, G. R., Thomas, G. V., Davies, L., & Payne, D. (2021). Randomised study of intra-oral kinetics of fluoride-containing toothpastes. Journal of Dentistry, 106. https://doi.org/10.1016/j.jdent.2021.103587
Pérez, A., Cury, J., Martínez, Y., Serna, C., Cabello, I., & Ortiz, A. (2021). Concentración de fluoruro total y soluble en pastas dentales de uso infantil en España. Revista Española de Salud Pública, ISSN 1135-5727, ISSN-e 2173-9110, No. 95, 2021, 95, 163. https://dialnet.unirioja.es/servlet/articulo?codigo=7957693&info=resumen&idioma=ENG
Phonghanyudh, A., Duangthip, D., Mabangkhru, S., & Jirarattanasopha, V. (2022). Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial. International Journal of Environmental Research and Public Health, 19(15). https://doi.org/10.3390/IJERPH19158992
Rajendiran, M., Trivedi, H. M., Chen, D., Gajendrareddy, P., & Chen, L. (2021). Recent Development of Active Ingredients in Mouthwashes and Toothpastes for Periodontal Diseases. Molecules (Basel, Switzerland), 26(7). https://doi.org/10.3390/MOLECULES26072001
Ruff, R. R., Barry Godín, T. J., & Niederman, R. (2024). Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence: A Randomized Clinical Trial. JAMA Pediatrics, 178(4), 354–361. https://doi.org/10.1001/JAMAPEDIATRICS.2023.6770
Ruff, R. R., Barry-Godín, T., & Niederman, R. (2023). Effect of Silver Diamine Fluoride on Caries Arrest and Prevention: The CariedAway School-Based Randomized Clinical Trial. JAMA Network Open, 6(2), E2255458. https://doi.org/10.1001/JAMANETWORKOPEN.2022.55458
Schiffner, U. (2021). [Use of fluorides for caries prevention]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 64(7), 830–837. https://doi.org/10.1007/S00103-021-03347-4
Soares, R. C., da Rosa, S. V., Moysés, S. T., Rocha, J. S., Bettega, P. V. C., Werneck, R. I., & Moysés, S. J. (2021). Methods for prevention of early childhood caries: Overview of systematic reviews. International Journal of Paediatric Dentistry, 31(3), 394–421. https://doi.org/10.1111/IPD.12766
Veneri, F., Vinceti, S. R., & Filippini, T. (2024). Fluoride and caries prevention: a scoping review of public health policies. Annali Di Igiene : Medicina Preventiva e Di Comunita, 36(3), 270–280. https://doi.org/10.7416/AI.2024.2593
Vieira, A. (2022). Fluoride Toxicity. Monographs in Oral Science, 140–148. https://doi.org/10.1159/000520789
Weiss, G. S., Garcia, R. M., Sakae, L. O., Scaramucci, T., Silva, F. R. O., Viana, Í. E. L., Hara, A. T., & Lima, L. C. (2024). Experimental toothpastes containing β-TCP nanoparticles functionalized with fluoride and tin to prevent Erosive Tooth Wear. Journal of Dentistry, 149. https://doi.org/10.1016/j.jdent.2024.105273
Zamperini, C., & Bedran, A. (2023). Immediate and Sustained Root Caries Prevention of Fluoride Varnish Combined with Toothpastes. Caries Research, 57(5–6), 592–601. https://doi.org/10.1159/000533279
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Emily Karellys Cofre Recalde, Cristina Rockenbach
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
