Fluoride therapy is the use of fluoride for medical purposes. Fluoride supplements are recommended to prevent tooth decay in children older than 6 months in areas where drinking water is low in fluoride. Usually used as a liquid, pill, or paste by mouth. Where further public fluoride fluoride water supplies are usually not required. Fluoride has also been used to treat a number of bone diseases.
Normal doses sometimes produce white marks on teeth. Excessive doses can result in dyeing of teeth that are brown or yellow. Fluoride therapy typically uses sodium fluoride, although stannous fluoride can also be used. Fluoride appears to reduce damage by acid, increase remineralization, and decrease bacterial activity. It is believed to work mostly through direct contact with the teeth after they appear.
Fluoride began to be used to prevent tooth decay in the 1940s. Fluorides, such as sodium fluoride, are listed in the World Health Organization's Essential Medicines List, the most effective and safe drugs needed in the health system. In the United Kingdom, the usual monthly supply cost the NHS about 0.36 kilograms. It's also not too expensive in the United States.
Video Fluoride therapy
Medical use
Fluoride therapy has been shown to have beneficial effects on the prevention of dental caries. Strong evidence supports the use of fluoride toothpaste (with concentrations of 1000 ppm and above) and fluoride supplements, in the form of drops and tablets, to reduce the risk of dental caries in school-age and adolescent children. Swallowing fluoride as the main tooth under development has shown that the tooth has formed stronger and more resistant to caries. Fluoridation of water and milk are two forms of systemic fluoride therapy that have been shown to be effective in preventing dental caries.
Osteoporosis
Fluoride supplements have been studied extensively for the treatment of postmenopausal osteoporosis. This supplementation seems ineffective; Although sodium fluoride increases bone density, it does not reduce the risk of fractures.
Maps Fluoride therapy
Side effects
Fluorosis
- See Dental fluorosis main article.
The use of fluoride toothpaste (with concentrations of 1000 ppm and above) and fluoride supplementation in children under the age of six, and especially in the first three years of life, are associated with a greater risk of dental fluorosis. However, the use of fluoride supplements during the last 6 months of pregnancy did not have a significant impact on the incidence of fluorosis in children. It is also estimated that optimal water fluoridation for the prevention of dental caries increases the prevalence of dental fluorosis by 4 to 5%. The observed effects are mild to moderate, usually with minimal aesthetic attention.
Other risks
Reports claim that water fluoridation can be linked to the development of osteoporosis and various cancers, but recent systematic reviews have found no evidence to support this claim.
Overdose
Consumption of large amounts of fluoride can lead to poisoning and death fluoride; the lethal dose for most human adults is estimated at 5 to 10 g (equivalent to 32 to 64 mg/kg of fluoride/kg body weight). Ingestion of fluoride can cause discomfort at a dose of at least 15 to 20 times lower (0.2-0.3 mg/kg) than a lethal dose. Chronic intake and topical exposure may cause dental fluorosis, and excessive systemic exposure can cause systemic effects such as skeletal fluorosis. Young people are at risk of receiving excess fluoride, and ADA has recently issued temporary guidance on their fluoride consumption.
In 1974, a three-year-old boy swallowed 45 milliliters of 2% fluoride solution, estimated to triple the fatal amount, and then died. Fluoride was given during her first visit to the dentist, and the dental office was later found to be responsible for death.
Mechanism
In fact, improving fluoride therapy rather than preventing tooth decay, causes mineral fluorapatite to be inserted into the damaged tooth enamel. Fluorapatite is not a natural component of human teeth, although it is found in shark teeth. The main mineral found in natural tooth enamel is hydroxyapatite instead of fluorapatite made in the presence of fluoride. Even without fluoride, teeth experience an alternating increase and decrease in mineral content, depending on how acidic or basic the mouth is, and depending on the concentration of other substances in the mouth, such as phosphate and calcium.
Fluoride reduces tooth enamel decay by fluorapatite formation and its incorporation into tooth enamel. The fluoride ion decreases the rate of demineralization of tooth enamel and increases the rate of tooth remineralization at an early stage of the cavity. Fluoride is given this effect by the demineralization cycle and remineralization. The remineralization cycle, critical to the prevention of decay, occurs when fluoride is present in the oral cavity. Once fluoride is swallowed, it has minimal effect.
Fluoride ions are involved in three reactions of the principle of remineralization:
- Iso-ionic Exchange F - for OH - in apatit: Ca 10 (PO 4 2 (OH) 2 2F - -> Ca 10 (PO 4 ) 6 F 2 2OH -
- Crystals of fluorapatite growth from super saturated solution: 10 Ca 2 6PO 4 3 - 2F - -> Ca 10 (PO 4 ) 6 F 2
- Dissolution of apatite with CaF2 formation: Ca 10 (PO 4 ) 6 (OH) 2 20F < soup> - -> 10 CaF 2 6PO 4 3 - 2OH -
Iso-ionic exchanges with F-substitution for OHÃ, Â in apatite crystal growth and fluorapatite from saturated solutions can occur during low fluoride level exposure (0.01-10 ppm F) over a long period of time. The apatite dissolution reaction with CaF2 formation occurs at higher fluoride levels (100-10,000 ppm F) and the addition of CaF2 or CaF2 compounds.
The effect of fluoride on oral microflora and the significance of this effect on overall fluoride effectiveness against cavities currently has no consensus. Many studies on bacterial cells in the laboratory have shown fluoride has many effects on them as an antimicrobial agent. Antimicrobial effects require a fluoride concentration of at least 10 ppm F, which occurs only briefly in the mouth with products containing oral fluoride. A study looked at the effects of fluoride on oral microflora and concluded that fluoride not only interacts as an antimicrobial agent, acts additionally to reduce adhesion of bacteria to the tooth, along with the main action of demineralization decrease. Further investigation needs to be done to verify this claim.
Fluoride can be administered through many chemical methods (sodium fluoride, stannous fluoride, amine fluoride, monofluorophosphate, and more). Differences in anti-caries performance among them have been shown to have less effect than variations in behavior exhibited by individuals in brushing, using fluoride products and post-use behavior. Often fluoride chemical forms are driven by compatibility with other elements mixed with, price, and the like.
All fluoridation methods provide a low concentration of fluoride ions in the saliva, thereby exerting a topical effect on plaque fluid. Fluoride does not prevent cavities but controls its growth rate, so repeated exposure throughout the day is essential for its effective functioning. The more constant the more useful fluoride supply will be in cavity prevention.
Shipping
Water fluoridation
Water fluoridation is the addition of controlled fluoride to the public water supply to reduce tooth decay. Its use in the US began in the 1940s, after studying children in areas where water naturally contains fluoride. It is now used for about two-thirds of the US population on public water systems and around 5.7% of people worldwide. Although the best available evidence shows no association with side effects other than fluorosis, which is mostly mild, water fluoridation has become a debate and resistance to fluoridation of water exists despite being supported by public health organizations.
Toothpaste
Most toothpastes contain between 0.22% (1,000ppm) and 0.312% (1,450ppm) of fluoride, usually in the form of sodium fluoride or sodium monofluorophosphate (MFP). The frequent use of toothpaste with a 1,100 ppm fluoride content enhances email remineralization and inhibits surface demineralization of enamel and roots. Most fluoride toothpastes contain light abrasives to remove heavier impurities and mild surface staining. These include calcium carbonate, silica gel, magnesium carbonate and phosphate salts.
Fluoride is available in three forms during brushing. First, it is available as a free ionic fluoride that can react with tooth structure, disrupt bacterial metabolism in plaque, or absorb into the oral mucosa. Second, it is available as a profluoride compound that can settle in the mouth during brushing and releasing ionic fluoride. Finally, fluoride in toothpaste can exist as an unavailable fluoride compound that does not release fluoride ions. This is due to the fluoride ion being swallowed or thrown away during spitting.
Toothpaste with high fluorine content generally contains 1.1% sodium fluoride toothpaste (5,000 ppm). This type of toothpaste is used in the same way as regular toothpaste. Application of toothpaste with high fluoride content in adults twice a day increases untreated untreated root deformity when compared with toothpaste with ordinary fluoride content.
Fluoridated toothpaste is also available in 0.454% stannous fluoride. It seems to be effective in reducing tooth hypersensitivity. In addition, brushing twice a day with stannous fluoride toothpastes can reduce gingivitis, gingival bleeding, and dental plaque.
Anti-sensitivity toothpaste with fluoride is also available for those with sensitive teeth. Some of the anti-sensitivity toothpaste with fluoride on the market contains a substance called strontium chloride or potassium nitrate that helps relieve tooth sensitivity.
Oral dusters
Rinse mouth fluoride can be applied professionally by professional dentist or home use. The most commonly used fluoride compound in oral rinse solution is neutral sodium fluoride. The fluoride mouth washings ranged from 0.05% to 0.2% (225-1000 ppm) in concentrations. Rinse fluoride with 0.05% fluoride content is used for daily flushing, while rinse with 0.2% fluoride content used for weekly flushing and in a school-based weekly flushing program. Fluoride at this concentration is not strong enough for people at high risk for tooth decay. Regular use of the mouth (230 ppm) or weekly (900 ppm) per oral rinse under supervision results in a reduction in permanent dental decay of children. After mouthurse fluoride treatment, fluoride in mouthwash is preserved in saliva which helps prevent tooth decay.
Rinse mouth fluoride is recommended for use in conjunction with other fluoride therapies, but is usually contraindicated for children under the age of 6 because they can swallow rinse and increase the risk of dental fluorosis. In areas with no fluoridated drinking water, this rinse is recommended for children.
Gel/foams
There are several types of professionally applied foam gel and foam on the market. Types of professionally applied fluoride gel include 2.0% neutral fluoride sodium and 1.23% reduced fluoride phosphate. 1.23% phosphoric acid or foam fluoride gel is used for patients without dental restorations, whereas 2.0% neutral neutral fluoride is used for patients with composites, porcelain, titanium, sealants or sensitivity.
Professionally applied gel or gel fluoride is applied through the use of a foam mouth tray held in the mouth with a soft bite. Applications usually last for about four minutes, and patients should not rinse, eat, smoke, or drink for 30 minutes after application. The reason is to let the tooth absorb fluorine into the tooth structure when it is at its highest concentration, without being disturbed. It helps repair microscopic tooth decay. There is no clinical evidence of the effectiveness of a fluoride gel/foam application one minute. Specific benefits when using foam are less necessary products during application, which result in lower fluoride doses and reduce the risk of unintentional swallowing. In addition, further research on the efficacy of fluoride foam is necessary because the evidence of its effectiveness is not as strong as that of fluoride gel and varnish.
Some gels are made for home applications with the use of a custom tray. A person's dental model can be made by a professional dentist, who then uses it to make trays, similar to sports guard trays, which are placed on top of their teeth. Patients can then use this to hold fluoride treatments against their teeth overnight or a few minutes during the day. The concentration of fluoride in this gel is much lower than that of professional products. Self-applied sodium fluoride gel/foams typically contain 0.5% fluoride and stannous fluoride gel/foam containing 0.15%.
Treatment of head and neck radiation can destroy salivary gland cells that can cause dry mouth. Patients with reduced salivary flow have an increased risk of tooth decay. The home application of a 1.1% fluoride gel with a special tray is recommended for patients undergoing or completing with head and neck radiation treatment and patients with decreased salivary flow.
Further research is needed on the effectiveness of fluoride gel in treating early tooth decay lesions.
Varnish
Fluoride varnishes have a practical advantage over the gel in ease of application and use of fluoride volume that is smaller than required for gel applications. The principle of fluoride varnish is to apply fluoride salts in very high concentrations (about 50,000 ppm) to the tooth surface. Fluoride varnish is a resin-based application designed to stay on the tooth surface for several hours. Because this varnish is located on the tooth surface, saliva dissolves fluoride salts, which in turn allows fluoride ions to be released and absorbed by the teeth and soft tissues. Then, fluoride is released back into the oral cavity of this reservoir which serves as a tooth protection against cavities. Currently, no published evidence suggests that professionally applied fluoride varnish is a risk factor for enamel fluorosis. This varnish is applied with a brush and tuned in seconds.
Fluoride varnish has been shown to be effective in reducing early tooth decay lesions in primary and permanent teeth. Application of fluoride varnish every six months is effective in preventing tooth decay in primary and permanent teeth of children and adolescents.
The slow-release device
Devices that slowly release fluoride can be implanted on the tooth surface, usually on the molar side where it is invisible and does not interfere with eating. The two main types are copolymer membranes and glass beads. These devices are effective in increasing fluoride concentrations and preventing tooth decay, but they have problems with retention rates, ie the device too often falls. A Cochrane 2018 review found insufficient evidence to determine the effects of slow-releasing fluoride glass beads in caries inhibition when compared with other types of fluoride therapy.
Lozenges
Lozenges fluoride can contain about 1 mg of fluoride, and is intended to be stored in the mouth and inhaled. The soluble candy is swallowed slowly, so the use of lozenges is a topical and systemic therapy. A 1955 study comparing the effects of fluoride reliever and fluoride pills provides clear evidence from the start that fluoride acts topically.
Medical supplements
Medical fluoride supplements in the form of tablets, suction tablets, or fluids (including fluoride-vitamin preparations) are used primarily for children in areas without fluoridated drinking water. Evidence supporting the effectiveness of this treatment for weak primary teeth. Supplements prevent cavities in permanent teeth. A significant side effect was mild to moderate tooth fluorosis. A Cochrane review also found no evidence that daily fluoride supplementation in pregnant women is effective in preventing tooth decay or causing fluorosis in their children.
References
Further reading
- Dental Portal
- Committee on Fluoride in Drinking Water, National Research Council. (2006). Fluoride in Drinking Water: A Scientific Review of EPA Standards . National Academies Press.
- government guidelines
- History of Fluoride History of fluoride therapy includes an early patent
Source of the article : Wikipedia
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