FLUORIDES IN DENTISTRY

CONTENTS:- Introduction Composition 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. Dental fluorosis. Conclusion.

INTRODUCTION 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 agents.

composition Fluoride may occurs in combined form in a

wide variety of minerals. Fluorspar[fluorite CaF2]- 49% Fluorapatite[Ca10F2(PO4)6]- 3.4% Cryolite[Na3ALF6]- 54%

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 1.5-7

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 fluoride.

1. increases enamel resistance or reduction in enamel solubility.

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 exposed. 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:-

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 calcium fluoride. Supplements contains a measured amount of fluoride typically

0.25mg,0.5mg or 1.0mg.

Fluoride drops are dispensed with a measured dropper and are convenient for infants.

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 time. 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… 1.abdominal cramps. 2.vomiting 3.diarrhea 4.increased salivation 5.dehydration and thirst.

CHRONIC FLUORIDE TOXICITY

Chronic fluoride toxicity results from long term ingestion of small amounts of fluoride.

The effect of chronic fluoride toxicity on enamel is dental fluorosis. other problem such as skeletal fluorosis may occurs.

effect dosages durationDental fluorosis >2 times optimal Until 5 yearsSkeletal fluorosis 10-25 mg/day 10-20 years

DENTAL FLUOROSIS 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 enamel.

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 attack.

CONCLUSION 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.