Source of fluoride
Mechanism of action of fluoride and their delivery methods.
Indication for topical fluoride use
Fluoride tablets/drops,use and dosage.
Toxicity of fluoride.
The cariostatic efficacy of fluorides has been
convincingly demonstrated and the recent
decline in caries prevalence is primarily
attributed to the increased use of fluoride
Fluoride may occurs in combined form in a wide
variety of minerals.
Fluorspar[fluorite CaF2]- 49%
SOURCES OF FLUORIDE
It is estimated that the intake of from fish by populations where fish
represents a significant portion of the diet is about 0.5mg/day.
Jawar,banana,potatoes also contain substatial quantities of fluoride.
Certain plants,such as taro,yams,and cassava,have been found to contain
relatively high fluoride levels.
Fluoride content of rock salt ranges between 40 and 200ppm.
The dried tea leaves contain 100-400 ppm fluoride.
Mineral water usually contains considerably higher concentration,from 1.5-
Mechanism of action of fluoride
The benefits of fluoride in the reduction of dental caries
have been known for years,but its exact mechanism of action
is not completely understood.
The mechanisms by which fluoride increases caries resistance
may arise from both systemic and topical application of
1. increases enamel resistance or reduction in enamel
2. increases rate of posteruptive maturation.
3. remineralization of incipient lesions.
4. Interference with plaque microorganisms.
5. modification in tooth morphology.
Fluoride delivery methods
1. topical fluoride are placed directly on the teeth.
Topically applied fluoride is used to describe those delivery
system which provide fluoride for a local chemical reaction to
exposed surfaces of the erupted dentition.
The delivery system includes containing prophylactic
pastes,solutions,gels and varnishes as well as systems
designed for unsupervised home use,such as fluoride
dentifrices and rinses.
Indications for topical fluoride use
1.caries- active individual
2.children shortly after periods of tooth eruption,especially
those who are not caries free.
3.Those who take medication that decreases salivary flow or
have received radiation to head and neck.
4.after periodontal surgery when roots of teeth have been
5.patients with fixed or removable prosthesis and after
placement or replacement of restoration.
6.patient with eating disorder.
7.mentally and physically challenged individuals.
Fluoride tablets/drops/lozenges may be prescribed to individual patient or may be
part of a school or home based public health preventive dentistry program.
Fluoride compound used:-
Sodium fluoride is most commonly used.
The other compound used are acidulated phosphate fluoride,potassium fluoride or
Supplements contains a measured amount of fluoride typically 0.25mg,0.5mg or
Fluoride drops are dispensed with a measured dropper and are convenient for
Tablets and lozenges should be chewed, swished and swallowed.
Frequency of use and dosage:-
The council on dental therapeutic of the dosage schedule for dietary supplement
as shown in the table:-
Toxicity of fluorides
Fluorides is often called as a double-edges sword as an expression for anything
that can simultaneously help and hinder.
This is because inadequate ingestion of fluoride is associated with dental caries and
an excessive intake of fluoride can lead to dental and skeletal fluorosis.
ACUTE TOXICITY OF FLUORIDES:-
Acute fluoride toxicity results from rapid excessive ingestion of fluoride at one
The speed and severity of the response are dependent on the amount of fluoride
ingested and the weight and age of the individual.
The most frequently encountered adverse effect to topical fluoride encountered
adverse effect of topical fluoride therapy is nausea.
This is caused by fluoride combining with hydrogen in the gastric juices to form
hydrofluoric acid a stomach irritant.
Other symptoms of fluoride toxicity include…
5.dehydration and thirst.
CHRONIC FLUORIDE TOXICITY
Chronic fluoride toxicity results from long term ingestion of small amounts of
The effect of chronic fluoride toxicity on enamel is dental fluorosis.
other problem such as skeletal fluorosis may occurs.
effect dosages duration
Dental fluorosis >2 times optimal Until 5 years
Skeletal fluorosis 10-25 mg/day 10-20 years
Dental fluorosis is caused by excessive intake of fluoride during tooth development.
Ingestion of water with a fluoride concentration two or three times greater than the
recommended amount causes white flecks and chalky opaque areas on the tooth
Consumption of water containing four times the recommended amount of fluoride
causes a brown pitted corroded appearance on the enamel surface.
However although these teeth represent cosmetic problems they are highly to carious
When used appropriately, fluoride is s safe and effective
agent that can be used to prevent and control dental caries.
Fluoride has contributed profoundly to the improved dental
health of persons all over the world.
Fluoride is needed regularly throughout life to protect teeth
against tooth decay.
To ensure additional gains in oral health,water fluoridation
should be extended to additional communities and fluoride
toothpaste should be used widely.