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Milk is an important part of children’s diet and the addition of fluoride to milk combines nutritional and oral health benefits. Fluoride forms a soluble complex with the protein fraction of milk and is bioavailable after ingestion. Community-based milk fluoridation programs have been implemented in several countries in Europe, South America and Asia.
Fluoride is added to fresh, UHT or powdered milk in school-based community schemes at levels of 2.5 to 5 mg/L. One glass of milk supplemented with fluoride is served to preschool and/or schoolchildren once daily on school days. It is important to monitor the fluoride levels regularly.
Worldwide cohort studies have consistently reported substantial caries reduction, particularly in the primary dentition with a preventive effect around 30% but the certainty of the evidence is low.
Milk fluoridation is reported to be safe with only a low occurrence of mild dental fluorosis.
The cost of milk fluoridation programs is low, with significant savings per averted caries lesion after four years. Costs vary depending on region, availability of product and distribution.
Fluoridated milk is a community-based alternative for children living in countries with limited access to community dental care and/or where water fluoride is not feasible.
Updated March 2025
Key Further Reading
O’Mullane DM, Baez RJ, Jones S, Lennon MA, Petersen PE, Rugg-Gunn AJ, Whelton H, Whitford GM. Fluoride and Oral Health. Community Dent Health. 2016;33:69-99.
2- Fluoridated milk for preventing dental caries.
Yeung CA, Hitchings JL, Macfarlane TV, Threlfall AG, Tickle M, Glenny AM. Fluoridated milk for preventing dental caries. Cochrane Database Syst Rev. 2005(3):CD003876.