{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:53:55Z","timestamp":1787957635403,"version":"build-2784847793"},"reference-count":94,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission\u2014NextGenerationEU","doi-asserted-by":"publisher","award":["SFZG-07-2025_LIPOR"],"award-info":[{"award-number":["SFZG-07-2025_LIPOR"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"award":["SFZG-07-2025_LIPOR"],"award-info":[{"award-number":["SFZG-07-2025_LIPOR"]}],"id":[{"id":"https:\/\/ror.org\/00k4n6c32","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Fluoride remains the keystone of evidence-based caries prevention by stabilizing the mineral balance at the tooth\u2013biofilm\u2013saliva interface. Contemporary understanding emphasizes a predominantly post-eruptive, topical mode of action where fluoride inhibits demineralization and accelerates remineralization. This interfacial catalysis is reinforced by pH-responsive calcium-fluoride-like reservoirs that release fluoride during acid challenges. While community water fluoridation confers population-level reductions, the most effective approach is sustaining low-level fluoride in the biofilm environment. Evidence confirms that toothpastes with 1000\u20131500 ppm fluoride provide a dose\u2013response benefit in children, while 5000 ppm concentrations are indicated for high-risk scenarios such as root caries and xerostomia. Beyond physicochemical effects, fluoride modulates the oral microbiome by inhibiting bacterial enzymes and proton pumps, shifting community function toward a health-associated state without reducing overall diversity. In restorative dentistry, glass ionomer cements offer superior preventive effects against secondary caries compared to amalgam; however, marginal integrity, adhesive performance, and clinical technique, rather than fluoride release alone, remain the primary determinants of success. Despite well-known risks associated with high systemic intake, such as fluorosis, current evidence does not indicate genotoxic or adverse microbiome effects in humans from routine topical use of standard fluoride products at recommended preventive concentrations. Overall, fluoride\u2019s cariostatic value rests on frequent, low-level exposures that maintain tissues in a repair-favoring state.<\/jats:p>","DOI":"10.3390\/dj14070390","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:57:24Z","timestamp":1782287844000},"page":"390","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Cariostatic Mechanisms of Fluoride\u2014An Updated Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7654-0079","authenticated-orcid":false,"given":"Ivana","family":"\u0160utej","sequence":"first","affiliation":[{"name":"School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9854-5708","authenticated-orcid":false,"given":"Kre\u0161imir","family":"Ba\u0161i\u0107","sequence":"additional","affiliation":[{"name":"School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0797-9587","authenticated-orcid":false,"given":"Kristina","family":"Pero\u0161","sequence":"additional","affiliation":[{"name":"School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Epple, M., Enax, J., and Meyer, F. 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