The use of fluorides in Australia: guidelines

In October 2005, the Australian Research Centre for Population Oral Health (ARCPOH) hosted a Workshop on the Use of Fluorides in Australia. The workshop was attended by 35 experts, university, jurisdictional and peak-body representatives from all states and territories of Australia. ARCPOH hosted the workshop at the request of the National Advisory Committee on Oral Health (NACOH) which had considered the need for Australia to update its guidelines on the use of fluorides as part of promoting the oral health of the population in Australia’s National Oral Health Plan 2004–2013 (AHMC, 2004). One short-term national action in the National Oral Health Plan called for a ‘consensus conference on use of discretionary sources of fluoride and other preventive agents, as a first step towards establishing an evidence-based suite of health promotion messages’. Therefore, the workshop was part of the implementation of the National Oral Health Plan. The two-day workshop in Adelaide, South Australia aimed: • to update information on the nature and distribution of dental caries and fluorosis in Australia; • to update information on the nature and distribution of use (or exposure) to fluorides in Australia; • to consider the trade-off of the benefit of caries prevention versus the risk of dental fluorosis; • to review the evidence of the efficacy/effectiveness of a range of individual fluorides in caries prevention and their risks for creation of dental fluorosis; and • to develop guidelines for the use of fluorides in Australia. Seventeen working papers were prepared by invited experts and distributed in advance of the workshop. These papers covered topics underpinned by Australian research ranging from exposure to fluorides in Australia, the effectiveness of water fluoridation, the prevalence of dental fluorosis, preand post-eruptive exposure to fluoride and the prevention of caries, and the relationship between fluoride exposure, fluorosis and caries. Further evidence built on systematic reviews in the literature was presented on a range of individual fluoride vehicles such as fluoride supplements, fluoridated toothpaste, fluoride gels, mouthrinses and varnish. Finally, a rationale was presented to underpin the guidelines. Guidelines had also been drafted and distributed prior to the workshop. The guidelines were extensively discussed and during the subsequent three months further comment was considered and editing completed. The resulting guidelines are presented below. INTRODUCTION