A Systematic Review on a Variety of Alternate Fluoride Options Effective in Preventing Dental Caries.

Conventional fluoride therapies are effective in preventing dental caries but present limitations, such as esthetic concerns and fluoride sensitivity This has led to the development of alternate agents with comparable or improved preventive potential. To systematically review and evaluate the effectiveness of alternate fluoride-based and fluoride-free interventions in the guidelines. A prevention of dental caries. This review adhered to PRISMA 2020 comprehensive literature search was conducted across five databases and grey literature sources. Studies included randomized controlled trials, in vitro experiments, and systematic reviews without meta-analysis that examined the efficacy of agents, such as "silver diamine fluoride (SDF)," "nano-silver fluoride (NSF)," grape seed extract, hydroxyapatite, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), probiotics, and bioactive glasses Data were extracted regarding intervention type, mechanism, outcomes, and patient acceptability. Twenty studies met inclusion criteria. SDF was found to be noninferior to conventional sealants, while NSF offered superior esthetic outcomes with better caries arrest. Hydroxyapatite, CPP-ACP, and bioactive glasses demonstrated significant remineralization potential. Natural agents, such as theobromine and grape seed extract, showed antimicrobial and surface hardening benefits. Probiotics effectively reduced cariogenic bacterial load. Alternative caries-preventive strategies, especially NSF, CPP-ACP, and natural agents, demonstrate strong potential. Further long-term clinical trials are needed.