Tooth decay is an infectious and multifactorial disease that affects most people in developing countries. Fluoride is the ionic form of fluorine, which is the thirtieth richest element in the earth's crust. The main source of fluoride in nature is water. Other important sources of fluoride are tea, seafood containing edible bones or shells, medical supplements, and fluoride toothpastes. A cup of tea provides 0.10-0.12 mg of fluoride. Other plants also contain different amounts of fluoride depending on the characteristics of the soil in which they grow. Meat, offal (liver, kidney), spinach, apples, eggs, chicken, rice and oats also contain fluoride. There is a total of 2-3 g of fluoride in the tooth and bone structure. There is approximately 0.3 mg of fluoride in 100 ml of blood. The safe amount of fluoride to take is 0.7 mg per day for babies, 3 mg per day for adult women and 4 mg per day for adult men. Fluoride reduces the incidence of tooth decay and slows or reverses the progression of existing cavities. Although pit and fissure sealants, meticulous oral hygiene, and appropriate dietary practices contribute to caries prevention and control, the most effective and widely used approach involves the use of fluoride.
Fluoride, which is recognized for its usefulness in preventing dental caries, is administered systemically or topically. is implemented. Topical fluoride applications include fluoride toothpaste, fluoride mouthwashes, fluoride gels, fluoride varnishes and dental filling materials that release long-term fluoride. Systemic fluoride applications include fluoridation of drinking water, fluoride salts, fluoride milk, fluoride fruit juices, fluoride tablets, fluoride drops and fluoride candies.
Initially, it was thought to be beneficial when fluoride was given systemically during tooth development, but more Later research showed that topical effects were more advantageous in the prevention or treatment of dental caries and began to replace systemic fluoride. Fluoridation of water was once heralded as one of the best public health methods of the twentieth century. Because this practice is not feasible or cost-effective in many areas, especially rural areas, researchers are looking at ways to add fluoride to the general population, such as adding fluoride to milk and table salt. They researched the methods of love. Recently, major concerns about the toxicity that may occur with excessive fluoride intake have increased worldwide, and as a result, several countries have banned water fluoridation.
Toothpaste
Nowadays, fluoridated Toothpaste is the most common method used to maintain a consistently low fluoride level in the oral environment. In this way, it is thought to play an important role in reducing tooth decay in industrialized countries in recent years.
Since young children cannot spit effectively, it is said that they can swallow 80-100% of the fluoride in the paste with each brushing. At the same time, since it may lead to excessive fluoride intake in young children, tasteless or slightly minty sweet pastes are recommended rather than using toothpaste containing fruit or sugar-like sweeteners. If sweetened pastes are to be used, it is recommended to apply the paste to the brush under family supervision. Similarly, it has been recommended that toothpastes containing 1,500 ppm or more fluoride not be used by young children because they may lead to excessive fluoride intake. Guidelines on the use of fluoride toothpaste for young children vary from country to country. The biggest differences between countries are in the age at which fluoride toothpaste should be used, the fluoride concentration, and the recommendations regarding the placement of toothpaste on the brush.
In systematic reviews of studies, it has been stated that the use of fluoride toothpaste in children aged 24 months and under may cause fluorosis. It is said that toothpastes with fluoride higher than 1000 ppm may cause fluorosis in children under 5 years of age. For this reason, in the guidelines that recommend the use of toothpaste containing 1000 ppm F to reduce this risk, the amount of paste to be used is 'swab'. It has also been noted that it is important to supervise children while brushing to ensure proper use of toothpaste. It is recommended that children under 6 years of age should not be encouraged to use sweetened toothpastes containing 1500 ppm or more fluoride.
Fluoride Varnish
Fluoride v Dentistry is a dental treatment that helps prevent, slow down, or prevent the progression of tooth decay. Varnishes are usually applied with small brushes or syringes. 5% NaF (22000 ppm F- ion) is used in varnishes. A single dose of 0.25 ml of fluoride varnish application containing 22,600 ppm F has been reported to contain 5.65 mg of fluoride ions, which is well below the possibly toxic dose (PTD) for 5 mg/kg body weight (O'Mullane et al., 2016).
According to the results of a study investigating fluoride pharmacokinetics 12 to 15 months after 5% sodium fluoride varnish application, the American Academy of Pediatrics (AAP) reported that fluoride varnish application is safe for young children (Milgrom et al., 2014).
Garcia et al. In 2017, 2424 children aged between 0 and 5 who had erupted teeth were followed for 3 years, and a total of 10,249 fluoride varnish applications were applied to the children during this period. According to the results of the study, it was stated that fluoride varnish did not have any treatment-related side effects in young children and that it was an effective method for caries prevention in young children.
Lockner et al., in 2017, reported the application of fluoride varnish and fluoride in children aged 3-4 years. According to the results of their study examining urinary fluoride excretion after the use of toothpaste, they found that using a limited amount of fluoride toothpaste after varnish application would reduce fluoride exposure.
In countries with high fluoride water such as Australia, Ireland and the United States, fluoride varnish is used only for high caries risk. In countries with limited or no water fluoridation, such as England and Scotland, the use of fluoride varnish has been recommended for all children and young adults. The frequency of application has increased for those at high risk of caries. O'Mullane et al., 2016).
In Pain's (2017) article titled 'Damages of Fluoride to the Gastrointestinal System', it was stated that drinking water containing 1 ppm fluoride is normally found in the blood. It has been stated that it has a concentration 200 times higher than the existing ionic level and can sometimes cause stomach irritation and pain. Saying it's time for a comprehensive global ban on water fluoridation In a study conducted by Trivedi et al. in 2007, the effect of water with high fluoride content on the intelligence of school children in India was examined. According to this study, the biomechanism of F's action in reducing IQ is not clear. However, there is evidence that it may involve changes in membrane lipid and decreased cholinesterase activity in the brain. However, in this study, fluoride levels in drinking water varied between 2 and 5.5 mg/L. As it is known, fluoride levels in drinking water vary depending on the region you live in. If we talk about Izmir, the province where I am located, according to IZSU's water quality report, the fluoride rate is 0.064 mg/L.
Fluoride application is recommended in cases where fluoridation is not carried out in water resources and the fluoride level in drinking water is below 0.7 ppm. . It has been stated that high-risk children can be given appropriate fluoride support, taking into account the fluoride they receive from the environment.
Yu et al. (1996) stated that they showed changes in neurotransmitters and receptors in the human fetal brain from the area of endemic fluorosis. The endemic fluorosis region mentioned in the study is a region in China and the fluoride content of natural drinking water is very high.
In summary, these studies were conducted in regions where the fluoride rate in drinking water is very high.
In Europe. If we examine the fluoride bans
Belgium
Belgium banned fluoride supplements with the thought that excessive use of fluoride could increase the risk of osteoporosis and damage the nervous system.
According to Nutraingredients.com: They stated that brushing teeth with fluoride toothpaste is sufficient and that other fluoride supplements are not needed.
They stated that topical fluoride applications are sufficient to protect against caries and that there is no need for systemic fluoride applications. .
France
France's health products regulatory agency has stopped the sale of products containing fluoride salts for the treatment of osteoporosis. The effectiveness of fluoride in treating osteoporosis has proven ineffective compared to alternative treatments and has been said to carry a risk of fluorosis in the long term.
Ireland
It is recommended to reduce the levels of fluoride added to Irish water supplies. According to Irishhealth.com, dosage reduction has been recommended due to greater intake by children and adults today from other sources, particularly through regular use of toothpaste.
In March 2018 UK health monitoring report on fluoridation.
Tooth decay is a major health problem worldwide and is still a major problem in the UK. Although preventable, it is one of the most common causes of hospitalization in children.
Dental treatment under general anesthesia (GA) in children with fluoridation has a small but real, life-threatening risk of complications, which is why the number of dental procedures performed under GA of this magnitude is
This reduction is also likely to have a significant impact on the costs of dental care provision due to the higher costs associated with hospital admission.
Public Health England, fluoride concentration and hypothyroidism. It is investigating whether primary care data sets can be used to investigate a possible relationship between.
According to the Guidelines Published by the American Dental Association:
Fluoride is nature's caries fighter. It occurs naturally in varying amounts in water sources such as rivers, lakes, and even oceans. Fluoride also occurs naturally in some amount in certain foods and beverages, but levels vary widely. Fluoride is also added to some dental products, such as toothpaste, to help protect teeth from cavities.
How does fluoride protect teeth?
Before teeth erupt into the mouth, fluoride from foods, beverages and dietary supplements is added. It joins the structure of the tooth enamel (the hard surface of the tooth), making it stronger. The strengthened enamel structure becomes more resistant to tooth decay. This effect is "systemic" protection.
After teeth erupt into the mouth, fluoride helps remineralize weakened, decaying tooth enamel and reverses the early signs of tooth decay. Clean your teeth with fluoride
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