Fluoride: Importance and History Quiz

Introduction

• Fluoride is an ionic compound from fluorine, the most reactive element on the periodic table
• Fluoride is found naturally in rocks, water, soil, and cryolite
• It's essential for humans and animals
• Fluoride is commonly found in drinking water (added at 1 ppm) and toothpaste
• Fluoride is toxic at high concentrations
• It's essential in bone and tooth formation

History of Fluorides

• In the early 1900's, GV Black and Dr. McKay observed "mottled enamel"
• They discovered that people with mottled enamel had less dental decay
• In 1930, the relationship between fluorides and mottled enamel was discovered
• Research revealed that 1 ppm of fluoride reduces dental caries without causing mottling

Sources of Fluorides

• Drinking water
• Toothpaste
• Soda cool drinks
• Some foods
• Dietary supplements
• Unfluoridated bottled water
• Cooked food from Teflon pans

Fluorosis

• Fluorosis is a permanent enamel defect caused by excessive fluoride intake during tooth development (first 8 years of life)
• Damage is permanent but can be treated cosmetically

Sources of Excessive Fluoride Exposure

• Public water fluoridation
• Soda cool drinks
• Abnormally high fluoride concentrations in water
• Fluoridated toothpaste and mouth rinses
• Untested bottled water
• Fluoride supplements

Effects of Fluorosis

• White spots
• Chalky appearance
• Mottling: light to dark brown
• Severe fluorosis: cracks, pitting, overall corroded appearance

Water Fluoridation

• Water fluoridation is the controlled addition of fluoride to public water supplies.
• This is typically done by adding sodium fluoride, fluorosilicic acid, or sodium fluorosilicate
• Fluoridated water reduces caries
• Grand Rapids, Michigan (1945) was one of the first cities to add fluoride to its water supply
• Water fluoridation reduced dental caries by 60%

Advantages and Disadvantages of Water Fluoridation

• Advantages: effective, efficient, reliable, inexpensive, equitable way to improve oral health, reduces the cost of dental care
• Disadvantages: no choice for the individual

Types of Fluorides in Dentistry

• Sodium fluoride (most common)
• Stannous fluoride
• Acidulated phosphate fluoride (common)
• Amine fluoride

Mechanism of Action

• Fluoride is absorbed in the gastrointestinal tract.
• It replaces the hydroxyl molecule in hydroxyapatite, making teeth more resistant to acid attack.

Systemic Fluorides

• Systemic fluorides are ingested and become incorporated into forming tooth structures.
• Examples: naturally occurring food groups, beverages, community drinking water, dietary supplements

Topical Fluorides

• Topical fluorides are directly applied to the teeth and strengthen enamel, making them more decay resistant.
• Topical fluorides remineralize teeth externally.

Effects of Topical Fluorides

• Antibacterial
• Disrupts enzyme systems
• Remineralization of small defects
• Improved quality of enamel
• Inhibits demineralization

Professionally Applied Topical Fluorides

• Gel application
• Varnish application
• Polishing paste
• Polishing procedure

Indications for Professionally Applied Fluorides

• Primary teeth
• Active caries
• Orthodontic appliance wearers
• Compromised salivary flow
• Lack of compliance
• Post-eruptive period
• Secondary caries
• Teeth supporting a denture
• Fixed dental prosthesis
• Exposed root surface
• Low or no fluoride in water
• Early carious lesion
• After periodontal surgery

Home Care

• Toothpaste
• Mouth rinses

Fluoride Toxicity

• Acute fluoride poisoning occurs with a large ingestion of fluoride in a short period of time (rare)
• Chronic fluoride poisoning occurs with long-term exposure to high fluoride levels
• Fluoride overdose symptoms include: nausea, vomiting, diarrhea, abdominal pain, and muscle weakness
• Suspected fluoride overdose: administer milk to bind the fluoride

Benefits of Fluoride

• Fluoride promotes tooth mineralization
• Reduces enamel demineralization
• Promotes enamel remineralization
• Reduces dentin sensitivity
• Decreases caries
• Reduces tooth loss due to caries
• Reduces the need for dental restorations
• Improves bone density and periodontal health