Abstract
Research and recommendations on fluoride application are changing and should be updated to reflect the current situation in Japan. This paper is the first of a two-part report on recent scientific evidence regarding fluoride application.
1. Discussion on the revision of recommendations for the use of fluoride toothpaste in Japan explained the joint recommendations published by four Japanese academic societies in 2023, stating that toothbrushing should be performed twice a day, in line with international recommendations. However, considering the upper level of fluoride intake, there were no safety issues associated with toothbrushing three times a day. There is a risk of dental fluorosis from swallowing too much fluoride toothpaste; therefore, it is important to follow guidelines on the recommended amount.
2. Global recommendations and the situation in Japan on topical fluoride application for children less than six years old explained about the use of high-concentration fluoride varnish recommended by WHO and other organizations, which have not been approved for caries prevention in Japan. The fluoride concentration of topical agents in Japan is lower than that in other countries. In addition, in Japan, topical fluoride application is not self-care but performed by dental hygienists or dentists. Therefore, professional topical fluoride application should be recommended for children younger than six years old, in compliance with an amount of 2 mL or less in Japan.
3. The situation in Japan regarding WHO’s view that fluoride mouthrinsing is not recommended for children below the age of 6 years, recommends fluoride mouthrinsing in Japan considering WHO’s introduction of a school-based fluoride mouthrinsing program in the country.
