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Prevention of dental caries . The role of
fluoride in the prevention of caries
.fluoridation of water.additional sources
of fluoride.
SANA MOHAJER SAEM
To prevent dental caries there are four main principles: oral
hygiene; healthy eating advice; increasing fluoride availability;
and placement of fissure sealants. Dental health education (ie
information giving) is most beneficial on a one-to-one basis, and
within the dental setting.
If caries is left untreated it can cause both pain and
infection, which can be, in extreme cases, life-
threatening.6 Unfortunately many children experience
toothache.7 A child suffering as a result of dental pain
can disrupt normal family life: they may not be able to
sleep at night, concentrate in school, or have to miss
school completely. They may also struggle to eat at
mealtimes.1,7,8
How we can prevent dental caries?
 Prevention
 Brush with fluoride toothpaste after eating or drinking. ...
 Rinse your mouth. ...
 Visit your dentist regularly. ...
 Consider dental sealants. ...
 Drink some tap water. ...
 Avoid frequent snacking and sipping. ...
 Eat tooth-healthy foods. ...
 Consider fluoride treatments.
How can you prevent caries naturally
 The following home remedies might help prevent cavities or treat “pre-
cavities” by remineralizing weakened areas of your enamel before a cavity
develops:
 Sugar-free gum. ...
 Vitamin D. ...
 Brush with fluoride toothpaste. ...
 Cut out sugary foods. ...
 Oil pulling. ...
 Licorice root.
?
The role of fluoride in the prevention
of caries
 Fluoride is a good preventive aid for dental caries through elevating the buffering
capacity of saliva thus preventing tooth structure de-mineralization.
 The hydroxyapatite of tooth enamel is primarily composed of phosphate ions
(PO4
3–) and calcium ions (Ca2+). Under normal conditions, there is a stable
equilibrium between the calcium and phosphate ions in saliva and the
crystalline hydroxyapatite that comprises 96% of tooth enamel. When the pH
drops below a critical level (5.5 for enamel, and 6.2 for dentin), it causes the
dissolution of tooth mineral (hydroxyapatite) in a process called
demineralization. When the natural buffer capacity of saliva elevates pH,
minerals are reincorporated into the tooth through the process of
remineralization
The initial stage of the caries process results in white spot formation, a
result of acid penetration and solubilization of some (but not all) of the
subsurface mineral (Figure 11A). Left untreated, this subsurface damage
can progress to a point where the crystal can no longer provide sufficient
support to the enamel surface structure, and the surface collapses
(cavitates).
 The caries process can be affected in several ways. One of the most effective methods
to prevent caries is by promoting remineralization and slowing down demineralization.
This can be accomplished with fluoride therapy. It is widely accepted that the regular
use of fluoride, such as in dentifrice and drinking water, is extremely effective at
preventing dental caries. In 1999, the US Center for Disease Control (CDC) issued a
statement that water fluoridation is one of the 10 most important public health
measures of the 20th century.48 Fluoride’s presence in low concentration and high
frequency is more effective at preventing caries than high levels of fluoride used in
low frequency. Because water fluoridation is not available in many countries,
dentifrice is considered to be one of the most important sources of fluoride globally.
When fluoride is present in oral fluids (i.e., saliva), fluorapatite, rather than
hydroxyapatite, forms during the remineralization process. Fluoride ions (F–) replace
hydroxyl groups (OH–) in the formation of the apatite crystal lattice resulting in a
stronger, fluoridated tooth mineral (fluorapatite). Fluorapatite is less soluble than
hydroxyapatite, even under acidic conditions. Because fluorapatite is less soluble
than hydroxyapatite, it is also more resistant to subsequent demineralization when
acid challenged.
 Caries is generally considered to be a sub-surface phenomenon. With
fluoride treatment, a non-cavitated lesion can be remineralized with
fluorapatite and have greater resistance to subsequent demineralization
than hydroxyapatite. Even at very low concentrations, fluoride is effective
as an anticaries agent.49
 In the US, there are three commonly used sources of fluoride in oral care
products; sodium fluoride (NaF), sodium monofluorophosphate (SMFP) and
stannous fluoride (SnF2). All three of these fluoride sources provide the
important F- ion, which both inhibits demineralization and promotes
remineralization of damaged tooth mineral. In addition, SnF2 is considered
to have unique properties, as it provides efficacy against bacterial acids in
addition to its fluoridating benefits.
A) Demineralization – the caries formation process. Damage occurs in
subsurface regions of the enamel, leaving an intact outer layer on the
enamel surface. B) Remineralization – the caries reversal process.
Caries is reversed through the process of remineralization, in which
calcium, phosphate and fluoride are incorporated in the areas damaged
due to demineralization processes, resulting in a stronger, fluoridated
mineral.
fluoridation of water
Water fluoridation is the controlled adjustment of fluoride to a public water
supply solely to reduce tooth decay. Fluoridated water contains fluoride at a
level that is effective for preventing cavities; this can occur naturally or by
adding fluoride.
 When did they start fluoridating water?
 When did water fluoridation begin in the United States? In 1945, Grand
Rapids, Michigan, adjusted the fluoride content of its water supply to 1.0 ppm
and thus became the first city to implement community water fluoridation.
 Drs Trendley Dean and Elias Elvove first came up with a method to measure
fluoride levels in water. Together, they developed a state-of-the-art method
to measure fluoride levels in water with an accuracy of 0.1 parts per million
(ppm).
 As of 2012, 25 countries have artificial water fluoridation to varying degrees,
11 of them have more than 50% of their population drinking fluoridated water.
A further 28 countries have water that is naturally fluoridated, though in
many of them the fluoride is above the optimal level. As of 2012, about 435
million people worldwide received water fluoridated at the recommended
level (i.e., about 5.4% of the global population). About 214 million of them
live in the United States.Major health organizations such as the World Health
Organization and FDI World Dental Federation supported water fluoridation as
safe and effective.The Centers for Disease Control and Prevention lists water
fluoridation as one of the ten great public health achievements of the 20th
century in the U.S.Despite this, the practice is controversial as a public health
measure. Some countries and communities have discontinued fluoridation,
while others have expanded it.Opponents of the practice argue that neither
the benefits nor the risks have been studied adequately, and debate the
conflict between what might be considered mass medication and individual
liberties
GOAL?
 The goal of water fluoridation is to prevent tooth decay by adjusting the
concentration of fluoride in public water supplies. Tooth decay (dental caries) is
oneThe goal of water fluoridation is to prevent tooth decay by adjusting the
concentration of fluoride in public water supplies. Tooth decay (dental caries) is
one of the most prevalent chronic diseases worldwide.Although it is rarely life-
threatening, tooth decay can cause pain and impair eating, speaking, facial
appearance, and acceptance into society, and it greatly affects the quality of life
of children, particularly those of low socioeconomic status. In most industrialized
countries, tooth decay affects 60–90% of schoolchildren and the vast majority of
adults; although the problem appears to be less in Africa's developing countries, it
is expected to increase in several countries there because of changing diet and
inadequate fluoride exposure. In the U.S., minorities and the poor both have
higher rates of decayed and missing teeth, and their children have less dental
care. Once a cavity occurs, the tooth's fate is that of repeated restorations, with
estimates for the median life of an amalgam tooth filling ranging from 9 to 14
years.Oral disease is the fourth most expensive disease to treat.The motivation
for fluoridation of salt or water is similar to that of iodized salt for the prevention
of congenital hypothyroidism and goiter of the most prevalent chronic diseases
worldwide
additional sources of fluoride
Fluoride tends to accumulate in a mixture of both healthy and unhealthy
foods including tea, coffee, shellfish, grapes (raisins, wine, grape juice),
artificial sweeteners, sodas, potatoes, flavored popsicles, baby foods,
broths, stews, and hot cereals made with tap water.
What can I use instead of fluoride toothpaste?
 Fluoride-Free Toothpaste Ingredients
 Xylitol.
 Green tea extract.
 Papaya plant extract.
 Hydrated silica.
 Sodium bicarbonate (baking soda)
Is fluoride made from fluorine?
 Fluoride is created when salts from the element fluorine combine with
minerals in soil or rocks. Due to its simple origins, fluoride is found naturally
in soil, water and many foods. It also occurs naturally in the human body in
bones and teeth.
 Is there fluoride in bottled water?
 Bottled water may not have a sufficient amount of fluoride, which is
important for preventing tooth decay and promoting oral health. Some
bottled waters contain fluoride, and some do not. Fluoride can occur
naturally in source waters used for bottling or it can be added.
Thank you for
attention

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Prevent Tooth Decay with Fluoride

  • 1. Prevention of dental caries . The role of fluoride in the prevention of caries .fluoridation of water.additional sources of fluoride. SANA MOHAJER SAEM
  • 2. To prevent dental caries there are four main principles: oral hygiene; healthy eating advice; increasing fluoride availability; and placement of fissure sealants. Dental health education (ie information giving) is most beneficial on a one-to-one basis, and within the dental setting. If caries is left untreated it can cause both pain and infection, which can be, in extreme cases, life- threatening.6 Unfortunately many children experience toothache.7 A child suffering as a result of dental pain can disrupt normal family life: they may not be able to sleep at night, concentrate in school, or have to miss school completely. They may also struggle to eat at mealtimes.1,7,8
  • 3. How we can prevent dental caries?  Prevention  Brush with fluoride toothpaste after eating or drinking. ...  Rinse your mouth. ...  Visit your dentist regularly. ...  Consider dental sealants. ...  Drink some tap water. ...  Avoid frequent snacking and sipping. ...  Eat tooth-healthy foods. ...  Consider fluoride treatments.
  • 4. How can you prevent caries naturally  The following home remedies might help prevent cavities or treat “pre- cavities” by remineralizing weakened areas of your enamel before a cavity develops:  Sugar-free gum. ...  Vitamin D. ...  Brush with fluoride toothpaste. ...  Cut out sugary foods. ...  Oil pulling. ...  Licorice root. ?
  • 5. The role of fluoride in the prevention of caries  Fluoride is a good preventive aid for dental caries through elevating the buffering capacity of saliva thus preventing tooth structure de-mineralization.
  • 6.  The hydroxyapatite of tooth enamel is primarily composed of phosphate ions (PO4 3–) and calcium ions (Ca2+). Under normal conditions, there is a stable equilibrium between the calcium and phosphate ions in saliva and the crystalline hydroxyapatite that comprises 96% of tooth enamel. When the pH drops below a critical level (5.5 for enamel, and 6.2 for dentin), it causes the dissolution of tooth mineral (hydroxyapatite) in a process called demineralization. When the natural buffer capacity of saliva elevates pH, minerals are reincorporated into the tooth through the process of remineralization The initial stage of the caries process results in white spot formation, a result of acid penetration and solubilization of some (but not all) of the subsurface mineral (Figure 11A). Left untreated, this subsurface damage can progress to a point where the crystal can no longer provide sufficient support to the enamel surface structure, and the surface collapses (cavitates).
  • 7.  The caries process can be affected in several ways. One of the most effective methods to prevent caries is by promoting remineralization and slowing down demineralization. This can be accomplished with fluoride therapy. It is widely accepted that the regular use of fluoride, such as in dentifrice and drinking water, is extremely effective at preventing dental caries. In 1999, the US Center for Disease Control (CDC) issued a statement that water fluoridation is one of the 10 most important public health measures of the 20th century.48 Fluoride’s presence in low concentration and high frequency is more effective at preventing caries than high levels of fluoride used in low frequency. Because water fluoridation is not available in many countries, dentifrice is considered to be one of the most important sources of fluoride globally. When fluoride is present in oral fluids (i.e., saliva), fluorapatite, rather than hydroxyapatite, forms during the remineralization process. Fluoride ions (F–) replace hydroxyl groups (OH–) in the formation of the apatite crystal lattice resulting in a stronger, fluoridated tooth mineral (fluorapatite). Fluorapatite is less soluble than hydroxyapatite, even under acidic conditions. Because fluorapatite is less soluble than hydroxyapatite, it is also more resistant to subsequent demineralization when acid challenged.
  • 8.  Caries is generally considered to be a sub-surface phenomenon. With fluoride treatment, a non-cavitated lesion can be remineralized with fluorapatite and have greater resistance to subsequent demineralization than hydroxyapatite. Even at very low concentrations, fluoride is effective as an anticaries agent.49  In the US, there are three commonly used sources of fluoride in oral care products; sodium fluoride (NaF), sodium monofluorophosphate (SMFP) and stannous fluoride (SnF2). All three of these fluoride sources provide the important F- ion, which both inhibits demineralization and promotes remineralization of damaged tooth mineral. In addition, SnF2 is considered to have unique properties, as it provides efficacy against bacterial acids in addition to its fluoridating benefits. A) Demineralization – the caries formation process. Damage occurs in subsurface regions of the enamel, leaving an intact outer layer on the enamel surface. B) Remineralization – the caries reversal process. Caries is reversed through the process of remineralization, in which calcium, phosphate and fluoride are incorporated in the areas damaged due to demineralization processes, resulting in a stronger, fluoridated mineral.
  • 10. Water fluoridation is the controlled adjustment of fluoride to a public water supply solely to reduce tooth decay. Fluoridated water contains fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride.  When did they start fluoridating water?  When did water fluoridation begin in the United States? In 1945, Grand Rapids, Michigan, adjusted the fluoride content of its water supply to 1.0 ppm and thus became the first city to implement community water fluoridation.  Drs Trendley Dean and Elias Elvove first came up with a method to measure fluoride levels in water. Together, they developed a state-of-the-art method to measure fluoride levels in water with an accuracy of 0.1 parts per million (ppm).
  • 11.  As of 2012, 25 countries have artificial water fluoridation to varying degrees, 11 of them have more than 50% of their population drinking fluoridated water. A further 28 countries have water that is naturally fluoridated, though in many of them the fluoride is above the optimal level. As of 2012, about 435 million people worldwide received water fluoridated at the recommended level (i.e., about 5.4% of the global population). About 214 million of them live in the United States.Major health organizations such as the World Health Organization and FDI World Dental Federation supported water fluoridation as safe and effective.The Centers for Disease Control and Prevention lists water fluoridation as one of the ten great public health achievements of the 20th century in the U.S.Despite this, the practice is controversial as a public health measure. Some countries and communities have discontinued fluoridation, while others have expanded it.Opponents of the practice argue that neither the benefits nor the risks have been studied adequately, and debate the conflict between what might be considered mass medication and individual liberties
  • 12. GOAL?  The goal of water fluoridation is to prevent tooth decay by adjusting the concentration of fluoride in public water supplies. Tooth decay (dental caries) is oneThe goal of water fluoridation is to prevent tooth decay by adjusting the concentration of fluoride in public water supplies. Tooth decay (dental caries) is one of the most prevalent chronic diseases worldwide.Although it is rarely life- threatening, tooth decay can cause pain and impair eating, speaking, facial appearance, and acceptance into society, and it greatly affects the quality of life of children, particularly those of low socioeconomic status. In most industrialized countries, tooth decay affects 60–90% of schoolchildren and the vast majority of adults; although the problem appears to be less in Africa's developing countries, it is expected to increase in several countries there because of changing diet and inadequate fluoride exposure. In the U.S., minorities and the poor both have higher rates of decayed and missing teeth, and their children have less dental care. Once a cavity occurs, the tooth's fate is that of repeated restorations, with estimates for the median life of an amalgam tooth filling ranging from 9 to 14 years.Oral disease is the fourth most expensive disease to treat.The motivation for fluoridation of salt or water is similar to that of iodized salt for the prevention of congenital hypothyroidism and goiter of the most prevalent chronic diseases worldwide
  • 14. Fluoride tends to accumulate in a mixture of both healthy and unhealthy foods including tea, coffee, shellfish, grapes (raisins, wine, grape juice), artificial sweeteners, sodas, potatoes, flavored popsicles, baby foods, broths, stews, and hot cereals made with tap water.
  • 15. What can I use instead of fluoride toothpaste?  Fluoride-Free Toothpaste Ingredients  Xylitol.  Green tea extract.  Papaya plant extract.  Hydrated silica.  Sodium bicarbonate (baking soda)
  • 16. Is fluoride made from fluorine?  Fluoride is created when salts from the element fluorine combine with minerals in soil or rocks. Due to its simple origins, fluoride is found naturally in soil, water and many foods. It also occurs naturally in the human body in bones and teeth.  Is there fluoride in bottled water?  Bottled water may not have a sufficient amount of fluoride, which is important for preventing tooth decay and promoting oral health. Some bottled waters contain fluoride, and some do not. Fluoride can occur naturally in source waters used for bottling or it can be added.