Fluoride is on the list of elements that bring beneficial physiological effects. Fluoridation, that is, the introduction of fluoride into water prevents the loss of minerals from the enamel of teeth, making them more resistant to the metabolism of caries-causing bacteria. Studies conducted by the World Health Organization show that for every dollar invested in fluoridation, $50 is saved that would somehow be earmarked for dental treatment.
In Brazil, the practice of fluoridation of public water supply began in 1953. However, fluoridation was in the 1970s that fluoridation made great progress, with participation in national and state programs, reducing the incidence of caries in the population by up to 65%.
For patients with a high cariogenic risk (high propensity for the development of caries), the use of fluoride only in water may not be sufficient to decrease the disease. The topical applications of fluoride performed in the office present a higher concentration of fluoride than that present in water, in toothpastes and mouthwash. Periodic application of fluoride, whether in children or adults, helps to decrease the risk of decayed teeth.
Fluor and tooth remineralization
The presence of fluoride ions increases the formation and precipitation of fluorapatite, calcium and phosphate present in saliva on the tooth structure. This insoluble precipitate replaces soluble salts that have been lost due to demineralization caused by the microbial attack. This precipitation process results in a more resistant enamel to acid substrates from caries bacteria. Fluoride does not act only on enamel. At low concentrations, fluoride presents antimicrobial activity, inhibiting bacterial adhesion and preventing carbohydrate storage, which limits microbial metabolism between host meals.
How does fluoride prevent caries?
Fluoride acts in the reduction of bacterial metabolism, inhibits the loss of minerals from tooth enamel and stimulates the remineralization of areas already affected and weakened by the action of caries.
What is the topical application of fluoride?
Topical fluoride application (ATF) is a preventive procedure that aims to strengthen teeth that present medium and high risk of caries. The application can be done in the form of gel or foam, through adjustable trays, leaving fluoride in close contact with the dental surface in a period of 2 to 4 minutes. Fluoride can also be applied under the teeth in the form of varnish. This form of application is more recommended for very young patients who do not tolerate the use of trays.
What are the factors to consider in the need for fluoride application?
Topical fluoride application should be performed considering several factors:
– The patient’s age: Fluoride does not present any restriction regarding the patient’s age, and can be applied at all ages. Application in children and adolescents is usually more frequent due to high intake of sugary foods and beverages and poor oral hygiene. However, this practice has been very common in adults as well.
– Diet: Patient with diets rich in sucrose, sugars and industrialized foods increase the risk of developing dental caries.
– Oral hygiene: Patients with absence or lack of oral hygiene care, such as correct brushing, flossing and routine dental prophylaxis, have greater risks for the development of caries.
Is fluoride safe?
Fluoride used for the prevention and control of caries has been effective and safe for many decades. However, products containing excess fluoride should be kept out of the reach of children. Excess fluoride can cause fluorosis.
What is fluorosis?
Fluorosis occurs due to excessive fluoride exposure, compromising the development of permanent teeth and causing whitish spots and horizontal stripes. In more severe cases, teeth affected by fluorosis may present deficiency in enamel and dentin formation, becoming weaker. Brown spots may also be present. The development and degree of fluorosis are multifactorial, depending on the amount of fluoride ingested, how long it was ingested and during which period of tooth development.
What are the effects of fluoride rinses?
The required amount of fluoride is already present in toothpaste, so the rinse acts only as a complement. In no way should toothpaste be replaced with any type of mouthwash. They are not indicated for infant patients as they are easily swallowed and can cause serious damage to teeth and intestinal flora. Some rinses with a higher fluoride concentration may be indicated for the treatment of tooth sensitivity. They may also be indicated for patients who are undergoing orthodontic treatment composite veneer melbourne.
Should fluoride be applied periodically?
Yes. What will determine the periodicity of fluoride applications will be the cariogenic risk presented by the patient.
What determines the cariogenic risk of each patient?
These are some of the factors that determine the risk of developing caries:
– Poor oral hygiene;
– Large number of restorations already present;
– The presence of cavities;
– Diet;
– Eating disorders;
– Consistent and excessive use of alcohol and chemicals;
– Some medicines;
– Radiotherapy;
– Decreased salivary secretion;
– Enamel defects;
– Lack of control of periodic cleanings.
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Can adult patients also benefit?
Yes. There is no contraindication in relation to the patient’s age and fluoride application. Patients who have a high cariogenic risk, poor hygiene, and poorly balanced diet can greatly benefit from fluoride application, reducing the risk of caries. Root exposure in adult patients with bone loss and gingival retraction is also very common. Due to the fact that the roots are not covered by a layer of enamel, as in the crown, dentin tissue is more susceptible to care lesions. In such cases, topical application of fluoride may also help.
Suplementos de flúor são necessários?
No. Fluoride supplementation, whether in tablets or drops, should only be prescribed for cases where there is no fluoridation in the water supply system. Thus, there is no indication or need for use in large cities in Brazil. Make sure your city has fluoridation in the water supply system.
Do fluoride supplements during pregnancy and breastfeeding bring any benefit to the baby?
There is no scientific basis to prove the need to increase fluoride intake during pregnancy or during breastfeeding in order to bring benefits to the oral health of the baby. To date, scientific evidence is insufficient to prove that fluoride supplements during this period may decrease the incidence of future caries.
Should children’s toothpaste contain fluoride?
Due to the lack of adequate motor coordination, toothpaste indicated for infant patients should contain ppm – a smaller amount of fluoride when compared to the amount present in conventional toothpastes – or does not contain any fluoride. This is because children have greater ease in swallowing toothpaste. Continuous ingestion may lead to fluorosis and stomach pains. Brushing should always be supervised by parents until the child develops optimal motor coordination so as not to swallow toothpaste. Visit Jacaboson Dental in Melubourne.
