What is fluoride and how useful is it against dental caries?
Fluoride is a trace element (natural metal) found on the earth's surface and is widely dispersed in nature. Food sources (fish, tea) and water contain fluoride but in small concentrations.
In 1930, researchers discovered that people who grew up drinking naturally fluoridated water had 2/3 less dental caries than people who lived without fluoridated water. Since then, research has shown that when fluoride is added to community water the tooth decay is significantly reduced because fluoride can reach the enamel through the blood.
According to the World Health Organization, access to fluoride is an inalienable right of health to protect oral health and is considered one of the most important discoveries for public health (FDI world dental federation, IADS international association of dental research, WHO world health organization: ' 'Global consultation on oral health through fluoride'.
The American Dental Association (ADA), the World Health Organization (WHO) and the American Medical Association (AMA), among many other organizations, recommend the use of fluoride in water precisely because of its effectiveness against caries and emphasize that it is completely safe for health. It has, since been added to drinking water in many communities to help reduce caries (1 ppm maximum). In Cyprus, however, drinking water and bottled water from various sources contain negligible amounts of fluoride.
Which other sources can we find we find dental fluoride?
Almost all toothpastes today have fluoride. The fluoride indication in toothpastes is in ppmF and usually have a content of 1350-1500 ppmF for ages 6 and up. For 2-6 years they are limited to fluoride amounts of 500-1000 ppmF.
• Oral solutions
Fluoride is also present in mouthwashes that the patient can rinse 2-3 times a day. These have a concentration of about 250 ppmF and are recommended for over 6 years where it is best controlled to avoid swallowing.
• Fluoride tablets
Taking fluoride supplements through a water-soluble tablet is something that is now applied in the schools of Cyprus in the fifth grade of primary school, where fluoride is provided to children within the preventive dental program of the Ministry of Health.
What is dental fluoridation?
Fluoridation of the teeth is a procedure in Dentistry with the main goal of preventing dental caries. It is applied topically on the surface of the teeth in the form of gel or varnish. This fluoride is very high in content, applied only to the teeth with care and its use at home by parents or children themselves is not recommended. It is done with the help of the special saliva pump so that the child does not swallow the material but instead is applied in a controlled and local way only on the surfaces of the teeth.
Through these preparations (placed by the dentist on the teeth), fluoride with its antimicrobial properties acts against the harmful effects of various pathogenic oral caries germs and which are responsible for the formation of tooth decay. In addition, it enters the enamel of the teeth (enamel) and thus makes it harder and more resistant to the acids of these pathogenic microbes. At the same time it can even recover from very early stages of caries (onset of caries damage).
How does the fluorescence mechanism work?
The mechanism by which fluoride works has been known for years. There are two processes in the mouth, desalination (calcification) and desalination (decalcification). The surface of the teeth loses and gains calcium ions as a normal process that intensifies as a result of frequent food and drink intake, the sugar content of these foods and the poor oral hygiene applied by the patient, which favors germs instead of removes from the oral environment. Thus these caries germs (S.mutans) find ground to multiply, to produce acids and to attack the surface of the teeth in order to develop carious lesions on their surface.
However, when fluoride is present during re-salting (a process that occurs normally in the mouth and involves filling the tooth surface with calcium and phosphorus) the deposited metals are harder than they would otherwise be, helping and by strengthening the teeth and preventing them from dissolving during desalination (the process of dissolving calcium and phosphorus on the surface of the teeth that occurs in our mouth).
Fluoridation of the teeth is recommended to be done 1-2 times a year, depending on the needs of the child, where in combination with the general control of the teeth and mouth, they greatly contribute to the reduction of caries.
It usually begins at the age of 6 with the beginning of the appearance of permanent teeth in the mouth (first permanent molars) with the main purpose of preventive (to harden the enamel of the teeth that have erupted) but also therapeutic (to stop the beginning of caries lesions). Of course, because the baby teeth are just as important, fluorination can start earlier in children at the age of 3-4 years, who have now grown all the baby (baby) teeth. Even in these people with a high caries index (high risk of caries). Other signs of fluoridation include children with orthodontic appliances, people with health problems and disabilities, or people with dental hypersensitivity. Extra children with white spots that indicate calcium loss from the teeth.
Is fluoride safe?
Fluoride has a side effect due to overconsumption. This is called fluorosis and can be observed if at the age of less than 8 years it is consumed in twice the permissible amount daily. Fluorescence is damage to the enamel of permanent teeth and is more common in countries with fluoridated water. In Cyprus, as mentioned above, the water is not fluoridated, so the possibility of fluoridation is negligible.
In order to be toxic to the body and to cause side effects that threaten the general health of the patient, the dosage must be huge (eg swallowing the entire toothpaste tube, etc.).
Concluding and keeping in mind that prevention is always the best treatment, we want to emphasize the important effect of fluoridation where as we explained it prevents tooth decay and thus reduces caries to a considerable extent.
At Dental Clinic Constantina Papamia we mainly use fluoride varnish that is simpler and safer to apply. It is certainly a much easier process than the need to treat the dental caries itself with an obstruction, which is certainly a more complex intervention but also more expensive. Most varnishes on the market contain 5% NaF with an alcohol and resin based solution. Evaporation of the alcohol makes the system faster to dry and the resin contained works better to allow fluoride to adhere to the teeth. It leaves a noticeable film on the teeth as it is a very sticky material but this enhances its prolonged action.
There are different flavors that make it quite enjoyable for our young patients who choose the flavor they prefer in each of our appointments. Instructions are provided to avoid eating or drinking for a while depending on the manufacturer's instructions.
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