The effect of fluoride on the developing tooth

Despite a very large and often confusing literature concerning the mechanisms which lead to dental fluorosis a relatively clear and well-supported concept is emerging, at least for exposure to concentrations which are not overtly toxic. It seems likely that, at least in enamel, the effect on the developing mineral phase per se coupled with associated effects on the surrounding and modulating protein matrix could account for most of the observed effects of the fluoride ion on tooth development. The most obvious feature of fluorosis – impaired growth of apatite crystals – seems attributable to retention of modulating matrix proteins through enhanced binding of mineral to matrix proteins and/or enhanced binding of the proteases responsible for processing prior to matrix removal.