Caries Process, Prevention and Management: Intervention
Course Number: 718
Course Contents
Introduction
It can be argued that the role of fluoride in caries prevention is one of the biggest success stories in the field of public health. In fact, in 1999, the U.S. Center for Disease Control (CDC) declared water fluoridation to be “one of the 10 most important public health measures of the 20th century.” However, just as it is well-documented that fluoride has beneficial effects on dentition because of its ability to reduce caries, it is also well known that ingestion of an excessive amount of fluoride during the early stages of tooth development can also have detrimental effects on teeth, namely in the form of dental fluorosis. Because of that, there are many in the dental profession who advocate the use of fluoride, and some who are adamantly against it.1 What follows is a summary of what is known about the effects of fluoride on developing and erupted teeth, as well as information on the current forms of fluoride delivery. The goal is to get dental health professionals on the road to making informed decisions about fluoride use that maximize the anticaries benefits, while minimizing the risk of dental fluorosis.
Clinical Significance Snapshot
How can I find out if my patients are getting fluoridated water?
Contact the local water supplier or State Health Department. Almost 70% of the US population receives water in which the concentration of fluoride has been adjusted to optimal levels. This percentage cannot increase much more, as it is challenging to adjust the fluoride content of wells and other individual water sources. With the increased consumption of bottled water, not all people living in an area of water fluoridation may be receiving the optimal amount of fluoride.
Are all fluoride toothpastes the same?
Not necessarily. Every manufacturer uses its own proprietary formulations. Fluoride compounds are very reactive, and without good chemistry at the formulation stage, some or all of the fluoride can become bound to other ingredients in the paste and not be available for binding to the surfaces of teeth.
Commonly used fluoride sources include Stannous fluoride, Sodium fluoride, and Sodium monofluorophosphate. A toothpaste brand carrying the Seal of Acceptance of the American Dental Association will have demonstrated in various studies that the fluoride is both safe and effective.