The Institute of Medicine, the Healthy People 2020 initiative, and the U.S. Surgeon General agree that oral health directly affects overall health.1–3 Fluoride is an important aspect of good oral care. It is inexpensive, easy to deliver, and effective. With 181 million Americans not visiting the dentist annually,4 family physicians have an essential role in oral health care.

Fluoride is used in three formats: systemic ingestion, personal topical application, and professional topical application. When used systemically, fluoride is incorporated into teeth to reduce enamel solubility and is also excreted in saliva, producing a topical effect. Topical fluoride application has the greatest impact, slowing demineralization (tooth breakdown), enhancing remineralization (tooth strengthening), and inhibiting bacterial metabolism.