Fight tooth decay with flouride

CLICK onto the the Internet and you’ll find scores of people selling a multitude of mineral formulas that claim to treat ailments from liver spots to diabetes. The age-old nutritional wisdom held that you needed only minute quantities of these minerals to treat shortage-related problems. But, today, given the state of the typical modern diet, reserchers say that a pill may be just what you need to prevent deficiencies in the first place as well as to supplement yourself for a balanced diet. Minerals, in this age, are being touted as the answer to a large number of health-related fears. One such formula to battle tooth decay is fluoride.

Without doubt the repeated use of fluorides is of critical importance for the control and prevention of dental caries in both children and adults. Fluoride, when incorporated into the enamel of newly-erupted teeth, enhances enamel calcification (hardening) by forming a complex called ‘fluorhydroxyapatite’ making the tissue more resistant to future attack by acids than the original structure was. The following outline states the currently recommended use of fluorides for caries control and teeth decay in children.

Communal water fluoridation

This is the single most effective public health procedure for caries prevention and consists of addition of low concentrations of fluoride to public water supply. Optimal concentraton varies with mean annual area tenoeratyre, Betweeb 0.7 to 1.2 ppm (parts per million) is considered optimal. Fifty to sixty per cent overall caries reduction has been recorded in children residing in fluoridated area during enamel forming years.

Topical fluoride measures for home use

1. Fluoride mouth rinses : Public health situations (e.g., school rinse programs) show 35 per cent caries reduction with daily or weekly rinses. Daily use of mouth rinse at home is recommended for patients with rampant caries. It does not serve as a replacement for other fluoride applications in the dental office.

2. Fluoride dentifrices : Brushing with fluoride toothpaste (containing 0.1 to 0.11 per cent fluoride), especially before retiring at night results in decrease in teeth decay of at least 25 per cent. There is increased benefit from two or three brushings per day as compared to one.

Pediatric oral supplements

These are fluoride or fluoride-vitamin tablets, which offer 50 to 60 per cent caries reduction and are prescribed only if the water fluoride content is less than 70 per cent of the optimal concentration (less than 0.7 ppm). The dosage is dependent on age and water fluoride content as shown in the table.

Dental office fluoride regimen

Once the dentist decides that topical application is required for that particular case, he selects from 3 FDA approved systems i.e., 2 per cent sodium fluoride 8 per cent stannous fluoride or 1.23 per cent acidulated phosphate fluoride (APF). Each has its own advantages and disadvantages but the technique is pretty similar wherein foam trays are loaded with the gel and placed over each dental arch and allowed to remain for 4 minutes. Soon after, the patient is asked to expectorate and advised not to eat, drink or rinse for 30 minutes.The frequency differs with each case; for rampant caries it is 4-5 applications during qa 4-6 week period, for moderate caries it is a single application at 2-3 month intervals and for minimal caries activity it is single application every 6 months.Fluoride effects are additive; no single treatment or procedure provides maximum disease control. Since fluoride usage has the potential of producing dental fluorosis and systemic overdose, all forms of fluoride must be used with care under professional supervision.

Fluoride supplements (in mg F/ day) Fluoride content of Birth to 2 to 3 3 to 13 drinking water (ppm) 2 yrs yrs yrs Less than 0.3 0.25 0.50 1.00 0.3-0.7 0 0.25 0.50

The author is a dental surgeon and can be contacted at ALL SMILES DENTAL CLINIC 6673439, 9845085230