ve safety• Low and moderate intake results to: – Skeletal fluorosis – Mottled enamel – Osteosclerosis (hardening of bone) – Exostoses (bony projections) – Calcification of ligaments• High intake may result to death.
Mottled Exostoses enamelSkeletalfluorosis osteosclerosi s
Mottled enamel (Endemic Dental Fluoride)• White or brown spotty staining of tooth enamel. – May be due to food, debris, or plaque.• Sometimes will have horizontal striations.• Enamel is deficient in: 1. Number of cells producing enamel causes pitting (hypoplasia). 2. Hypocalcification causes chalkiness.
Mottled enamel (Endemic Dental Fluoride)• Occurs only in teeth that are being formed. – When exposed to high concentrations of fluoride, opaque spots will develop on the enamel.• High intake of fluoride results to mottled enamel. – Protection of fluoride is decreased by severe fluorosis.
Fluoride and dental caries• Communal Water Fluoridation – Most effective, practical, feasible and economical public health measure for preventing caries. – Greatest resistance to caries and greatest amount of fluoride deposition are acquired by starting the intake as early as possible and using it continuously.
Fluoride and dental caries – Other factors to the decline of caries: 1. Greater dental health awareness. 2. Expansion in dental resources. 3. Application of preventive dentistry.
Fluoride and dental caries• School Water Fluoridation – Fluoridated with levels of three to seven times the optimum for communal water fluoridation resulting to reduction in caries incidence.
Fluoride and dental caries• Fluoride Tablets – Ingestion daily beginning at 5 – 9 years: permanent teeth can still be significantly protected from caries.
Fluoride and dental caries – Lozenge is much preferred than tablets or drops. Dissolves slowly, produces both topical and systemic effects. – Advantage: specific and precise dosage – Disadvantage: assurance of continuous daily ingestion and cost is greater.
Fluoride and dental caries• Prenatal Fluoride Supplement – Fluorides supplements are not recommended for adults, especially pregnant women, for reducing dental caries. • The concentration of fluoride that reaches the fetus is generally lower than that in the maternal blood. • Infants exposed will have higher plasma, skeletal and developing enamel fluoride levels.
Fluoride and dental caries• Fluoride Supplements (Infants and Children) – Fluoride supplementation at birth gives some protection against caries to the deciduous teeth. – No fluoride supplements must be given to infants less than 6 months of age ( exception of infants consuming milk)
Fluoride and dental caries• Fluoride Rinses – 3 years is necessary to achieve the maximum benefit from a rinse program. – Effective in children with a higher caries baseline than low caries baseline. The lower the incidence of caries, the more limited the effect of each preventive measure.
Fluoride and dental caries• Sustained Release Delivery Systems – Advantages: lower required dosage, reduced toxicity, release constant level of fluoride, better use of fluoride and better patient compliance. – Clinical studies showed exposure to low levels of fluoride is more effective in decreasing the incidence of caries.
Fluoride and dental caries – Useful in children who tend to get caries easily, xerostomia, adults with rampant root or coronal caries.
Fluoride and dental caries• Fluoridated Milk – Milk is used as an instrument for fluoride administration. – Fluoridated milk was found to be as effective as fluoridated water in reducing dental caries.
Fluoride and dental caries• Fluoridated Salt – Use salt as a vehicle for fluoride in the diet. – Salt is about 2/3 as effective as the water.
Mechanisms of anticaries action of fluoride1. Increase in the enamel’s resistance to acid solubility − Enamel formed has more perfect and larger crystals, less soluble in acid, and less likely to develop caries. Fluoride favors formation of fluorapatite, a more acid – resistant apatite than hydroxyapatite.
Mechanisms of anticaries action of fluoride2. Remineralization − Greater con