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Fluorine 
Tal Kaplan 
3313
Source of fluorine 
Fluorine is a chemical element with the symbol F and atomic number 9. 
It is the lightest halogen and exists as a highly toxic pale yellow 
diatomic gas at standart condition. 
Elemental fluorine in Earth's atmosphere would easily react with rocks, 
precluding its natural occurrence; it is found only in combined mineral 
forms, of which flurite, fluorapetite and cryolite are the most 
industrially significant. Fluorite or fluorspar (CaF2), colorful and 
abundant worldwide, is fluorine's main source 
For the human organism fluorine source are of Natural sources : 
• Seafood. 
• tea. 
• fluoridated drinking water. 
• Soda. 
• Fish.
Metabolism & Toxicity Of Fluoride 
Oral uptake: 
In humans and animals, ingested fluoride occurs as hydrogen fluoride (HF) in the acidic 
environment of the stomach and is effectively absorbed from the gastrointestinal tract, 
although there is no proved absorption from the oral cavity. Highly soluble 
fluoride compounds, such as NaF present in tablets, aqueous solutions and toothpaste 
are almost completely absorbed, whereas compounds with lower solubility, such as 
CaF2, MgF2, and AlF3, are less well absorbed. 
Dermal absorption: 
No experimental data on the extent of dermal absorption of fluoride from dilute 
aqueous solutions are available (like in shower). 
Inhalation: 
No systematic experimental data on the absorption of fluoride after inhalation are 
available. 
Once absorbed, fluoride is rapidly distributed throughout the body via the blood. 
The short term plasma half-life is normally in the range of 3 to 10 hours. fluoride is 
distributed between the plasma and blood cells, with plasma levels being twice as high 
as blood cell levels. fluoride concentrations are not homeostatically regulated, but rise 
and fall according to the pattern of fluoride intake.
Approximately 99% of the fluoride in the human body is found in bones and 
teeth. fluoride is incorporated into tooth and bone by replacing the hydroxyl ion in 
hydroxyapatite to form fluorohydroxyapatite. The level of fluoride in bone is 
influenced by several factors including age, past and present fluoride intake, and 
the rate of bone turnover. fluoride is not irreversibly bound to bone and is mobilized 
from bone through bone remodelling. 
Soft tissues do not accumulate fluoride, but a higher concentration has been 
reported for the kidney due to the partial re-absorption. The blood-brain barrier 
limits the diffusion of fluoride into the central nervous system, where 
the fluoride level is only about 20% that of plasma. Human studies have shown that 
fluoride is transferred across the placenta, and there is a direct relationship 
between fluoride levels in maternal and cord blood. 
Ingestion of high concentration fluoride can produce gastrointestinal discomfort at 
doses at least 15 to 20 times lower (0.2–0.3 mg/kg) than lethal doses. Although 
helpful for dental health in low dosage, chronic exposure to fluoride in large 
amounts interferes with bone formation. In this way, the greatest examples of 
fluoride poisoning arise from fluoride-rich ground water, that can cause fluorosis 
(developmental disturbance of dental enamel changes of tooth color – brown).
Mechanism Of Fluorine In Dental Tissue 
Dental fluorosis (DF) is an undesirable developmental defect of tooth 
enamel attributed to greater-than-optimal systemic fluoride exposure 
during critical periods of amelogenesis. DF is characterized by increased 
porosity (subsurface hypomineralization) with a loss of enamel 
translucency and increased opacity. Ameloblasts in the maturational phase 
appear to be the cellular target of chronic fluoride exposure (DenBesten 
and Thariani, 1992), whereas acute fluoride toxicity targets the transitional 
and early-secretory ameloblasts. The mechanism(s) underlying DF remain 
obscure, but likely contribute to the observed retention of enamel matrix 
proteins and may include reduced removal of enamel matrix proteins 
during enamel maturation, perturbation of extracellular transport, or 
initiation of the ER stress-response pathway.
Water Fluoridation 
Water fluoridation is the controlled addition of fluoride to a public water supply to 
reduce tooth decay. Fluoridated water has fluoride at a level that is effective for 
preventing cavities; this can occur naturally or by adding fluoride. Fluoridated water 
operates on tooth surfaces: in the mouth it creates low levels of fluoride in saliva, 
which reduces the rate at which tooth enamel demineralizes and increases the rate at 
which it remineralizes in the early stages of cavities. 
Effectiveness: 
Water fluoridation effectively reduces cavities in both children and adults:[9] earlier 
studies showed that water fluoridation reduced childhood cavities by fifty to sixty 
percent, but more recent studies show lower reductions (18–40%) likely due to 
increasing use of fluoride from other sources, notably toothpaste, and also the 'halo 
effect' of food and drink that is made in fluoridated areas and consumed in 
unfluoridated ones.
Fluoride level's 
Infant's: 
Age AI 
0-6 months 0.01 mg/day 
7-12 months 0.50 mg/day
Adult's 
Age AI 
Men 
19-30 yr 4 mg/day 
31-50 yr 4 mg/day 
51-70 yr 4 mg/day 
>70 yr 4 mg/day 
Women 
19-30 yr 3 mg/day 
31-50 yr 3 mg/day 
51-70 yr 3 mg/day 
>70 yr 3 mg/day
Pragnancy: 
Age AI 
14-18 yr 3 mg/day 
19-30 yr 3 mg/day 
31-50 yr 3 mg/day 
Lactation: 
Age AI 
14-18 yr 3 mg/day 
19-30 yr 3 mg/day 
31-50 yr 3 mg/day
Tal Kaplan 
3313

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General knowledge - Fluorine in dentistry

  • 2. Source of fluorine Fluorine is a chemical element with the symbol F and atomic number 9. It is the lightest halogen and exists as a highly toxic pale yellow diatomic gas at standart condition. Elemental fluorine in Earth's atmosphere would easily react with rocks, precluding its natural occurrence; it is found only in combined mineral forms, of which flurite, fluorapetite and cryolite are the most industrially significant. Fluorite or fluorspar (CaF2), colorful and abundant worldwide, is fluorine's main source For the human organism fluorine source are of Natural sources : • Seafood. • tea. • fluoridated drinking water. • Soda. • Fish.
  • 3. Metabolism & Toxicity Of Fluoride Oral uptake: In humans and animals, ingested fluoride occurs as hydrogen fluoride (HF) in the acidic environment of the stomach and is effectively absorbed from the gastrointestinal tract, although there is no proved absorption from the oral cavity. Highly soluble fluoride compounds, such as NaF present in tablets, aqueous solutions and toothpaste are almost completely absorbed, whereas compounds with lower solubility, such as CaF2, MgF2, and AlF3, are less well absorbed. Dermal absorption: No experimental data on the extent of dermal absorption of fluoride from dilute aqueous solutions are available (like in shower). Inhalation: No systematic experimental data on the absorption of fluoride after inhalation are available. Once absorbed, fluoride is rapidly distributed throughout the body via the blood. The short term plasma half-life is normally in the range of 3 to 10 hours. fluoride is distributed between the plasma and blood cells, with plasma levels being twice as high as blood cell levels. fluoride concentrations are not homeostatically regulated, but rise and fall according to the pattern of fluoride intake.
  • 4. Approximately 99% of the fluoride in the human body is found in bones and teeth. fluoride is incorporated into tooth and bone by replacing the hydroxyl ion in hydroxyapatite to form fluorohydroxyapatite. The level of fluoride in bone is influenced by several factors including age, past and present fluoride intake, and the rate of bone turnover. fluoride is not irreversibly bound to bone and is mobilized from bone through bone remodelling. Soft tissues do not accumulate fluoride, but a higher concentration has been reported for the kidney due to the partial re-absorption. The blood-brain barrier limits the diffusion of fluoride into the central nervous system, where the fluoride level is only about 20% that of plasma. Human studies have shown that fluoride is transferred across the placenta, and there is a direct relationship between fluoride levels in maternal and cord blood. Ingestion of high concentration fluoride can produce gastrointestinal discomfort at doses at least 15 to 20 times lower (0.2–0.3 mg/kg) than lethal doses. Although helpful for dental health in low dosage, chronic exposure to fluoride in large amounts interferes with bone formation. In this way, the greatest examples of fluoride poisoning arise from fluoride-rich ground water, that can cause fluorosis (developmental disturbance of dental enamel changes of tooth color – brown).
  • 5. Mechanism Of Fluorine In Dental Tissue Dental fluorosis (DF) is an undesirable developmental defect of tooth enamel attributed to greater-than-optimal systemic fluoride exposure during critical periods of amelogenesis. DF is characterized by increased porosity (subsurface hypomineralization) with a loss of enamel translucency and increased opacity. Ameloblasts in the maturational phase appear to be the cellular target of chronic fluoride exposure (DenBesten and Thariani, 1992), whereas acute fluoride toxicity targets the transitional and early-secretory ameloblasts. The mechanism(s) underlying DF remain obscure, but likely contribute to the observed retention of enamel matrix proteins and may include reduced removal of enamel matrix proteins during enamel maturation, perturbation of extracellular transport, or initiation of the ER stress-response pathway.
  • 6. Water Fluoridation Water fluoridation is the controlled addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water has fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride. Fluoridated water operates on tooth surfaces: in the mouth it creates low levels of fluoride in saliva, which reduces the rate at which tooth enamel demineralizes and increases the rate at which it remineralizes in the early stages of cavities. Effectiveness: Water fluoridation effectively reduces cavities in both children and adults:[9] earlier studies showed that water fluoridation reduced childhood cavities by fifty to sixty percent, but more recent studies show lower reductions (18–40%) likely due to increasing use of fluoride from other sources, notably toothpaste, and also the 'halo effect' of food and drink that is made in fluoridated areas and consumed in unfluoridated ones.
  • 7. Fluoride level's Infant's: Age AI 0-6 months 0.01 mg/day 7-12 months 0.50 mg/day
  • 8. Adult's Age AI Men 19-30 yr 4 mg/day 31-50 yr 4 mg/day 51-70 yr 4 mg/day >70 yr 4 mg/day Women 19-30 yr 3 mg/day 31-50 yr 3 mg/day 51-70 yr 3 mg/day >70 yr 3 mg/day
  • 9. Pragnancy: Age AI 14-18 yr 3 mg/day 19-30 yr 3 mg/day 31-50 yr 3 mg/day Lactation: Age AI 14-18 yr 3 mg/day 19-30 yr 3 mg/day 31-50 yr 3 mg/day