The cariostatic effects of tooth-bound fluoride reported in the recent literature are reviewed. Several treatment procedures which can increase the tooth-bound fluoride content are described. Based on this information, it is suggested that effectiveness of currently used topical fluoride treatments may be significantly increased by (1) including in the regimen a dicalcium-phosphate-dihydrate-forming treatment so that a portion of the labile fluoride is re-incorporated as tooth-bound fluoride, and (2) employing application methods which ensure the effective delivery of treatment agents to the fissures, and to approximal and cervical surfaces, where most caries occurs.
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