Name: Jaden A. Santos Section & Subject: Sec B, Dental Materials Lecture Research Paper on Fluorides in Dentistry Introduction to Fluoride It has been demonstrated that fluoride plays a crucial role in ensuring that populations achieve and maintain good oral health. The equilibrium between demineralization and demineralization at the surface of the tooth is impacted at the atomic level, moving it back in favor of demineralization. Fluoride achieves this through a number of processes, including lowering salivary solvating power towards tooth minerals, lowering apatite phase solubility, and enhancing the mineralization process' crystallization kinetics. Through the reduction of their enzyme activity, it might also have an impact on the bacterial populations that reside in the oral biofilms. Fluoride achieves this through a number of processes, including lowering salivary solvating power towards tooth minerals, lowering apatite phase solubility, and enhancing the mineralization process' crystallization kinetics. Through the reduction of their enzyme activity, it might also have an impact on the bacterial populations that reside in the oral biofilms. Fluoride is added to drinking water for huge populations all over the world, and at the amounts used, it is both safe and effective, as recognized by several public health organizations across the world. Fluoride can be given to people both individually and as part of a public health initiative, primarily through the residential water supply but also by adding it to table salt or milk, Tressaud, A., & Haufe, G. (2008). Mechanism of Action of Fluoride in Preventing Caries According to Jürgensen, N. and Petersen, P.E. (2013), the main contributors to the burden of dental caries worldwide are excessive sugar consumption and insufficient fluoride exposure. Fluoride use represents a significant advance in public health. In communities where the concentration of fluoride is below the ideal levels to have a cariostatic effect, the controlled addition of fluoride to drinking water supplies started in the 1940s, and since then, extensive research has confirmed the successful reduction in dental caries in many countries. Fluoridated salt was first produced industrially in Switzerland in 1955, and its use quickly spread to other nations and regions of the globe with comparable success as water fluoridation. Plans have been formed in nations all over the world based on integration with school health and nutrition programs because milk fluoride has also been reported to be effective in preventing dental caries, particularly in children. Fluoridated milk, salt, and water have been dubbed automatic systems for preventing dental cavities because they don't require any effort on the part of the consumer. Since toothpastes are so expensive, poor population groups have been prevented from using this preventive measure, despite the fact that fluoride in toothpaste has been available for decades and is thought to be a major factor in the decline in dental caries observed among people in industrialized countries. Fluoride can adsorb to the surface of apatite crystals when it is present at low, persistent amounts (sub-ppm range) in oral secretions during an acidic challenge, preventing demineralization. Fluoride residues in the solution will cause it to become extremely supersaturated in relation to fluorhydroxyapatite when the pH is restored, hastening the remineralization process. The enamel will become more resistant to future acidic challenges because the mineral generated under the nucleating action of the partially dissolved minerals will then preferentially include fluoride and exclude carbonate. Additionally, topical fluoride has antibacterial properties. Dental plaque contains fluoride concentrations that have biological effects on key S virulence factors. mutans in vitro, including acid generation and glucan synthesis, but it is yet unclear what this means for the organism in vivo. When fluoride is absorbed into these teeth before they erupt, evidence also supports fluoride's systemic mechanism of caries inhibition in the pit and fissure surfaces of permanent first molars, Buzalaf, M. A., Pessan, J. P., Honório, H. M., & Ten Cate, J. M. (2011). Fluoridated Toothpastes Available in the Market As stated by Tenuta, L. M., & Cury, J. A. (2013), brushing with fluoride toothpaste is an efficient approach to increase the availability of fluoride in the oral cavity to prevent demineralization and boost remineralization of enamel and dentine, which is far more successful than mechanical biofilm removal. Numerous laboratory and clinical research that have helped to create efficient antidotes and comprehend their mechanisms of action have approximated the effects of fluoride toothpastes. The availability of fluoride in toothpaste formulations, its bioavailability in saliva and traces of disturbed biofilm, its reaction with the dental substrate to form loosely bound reservoirs, and the eventual reduction of mineral loss and increase in mineral and fluoride content of caries lesions have all been the focus of these studies. For populations at high risk of developing caries, brushing with fluoride toothpaste had a statistically significant impact on mean decayed, missing, and filled primary tooth surfaces and decayed, missing, and filled primary teeth (standard mean difference [95 percent confidence interval CI], 0.25 [0.36 to 0.14] and 0.19 [0.32 to 0.06], respectively). The impact of using toothpastes with various fluoride concentrations on caries varied. When using fluoride toothpaste for the first time after 24 months, the probabilities of developing fluorosis either decreased (odds ratio [OR] [95 percent CI] = 0.66 [0.48-0.90]) or remained the same (OR [95 percent CI] = 0.92 [0.71-1.18]). Fluorosis risk decreased with consumption that started after 12 or 14 months of age (OR = 0.70 [0.57-0.88]). Clinical studies have shown that fluoride toothpastes with good formulations can control and prevent dental cavities. They might potentially contribute to the aetiology of dental fluorosis as a risk factor. This evaluation takes into account the evidence that is currently available to support the proper use of fluoride toothpaste to maximize benefits and reduce risks. Fluoride toothpaste's ability to prevent cavities is significantly influenced by three variables: concentration, brushing frequency, and post-brushing rinse behavior. According to the research, toothpastes with low fluoride concentrations (600 ppm F) offer less caries protection than those with average (1000 ppm F) or high (1500 ppm F) concentrations. However, extremely young children (under 7 years) at minimal caries risk, especially if residing in fluoridated areas, should use low-fluoride toothpastes. Higher fluoride concentrations should be used for other young children. While rinsing with a lot of water should be avoided, twice-daily brushing should be encouraged. The effectiveness of toothpaste in small doses is equivalent to that in big doses. Only young children are at risk for fluorosis since it is linked to consuming high doses of fluoride during tooth growth. The amount utilized, more so than its concentration, determines how variable the fluoride dose received is. Parents should be instructed to use only a pea-sized amount of toothpaste and to urge spitting out any excess to reduce the risk of fluorosis. The advantages can be maximized and the hazards of fluorosis can be decreased by using fluoride toothpastes properly. Dental Materials with Fluoride As a biofilm-sugar dependent condition, caries causes the gradual deterioration of the mineral structure of any tooth surface, whether it is intact, sealed, or restored, where biofilm is still present and is frequently exposed to sugar. The way fluoride works to prevent cavities in dental materials is similar to how it works in dentifrices and other fluoride delivery methods. Fluoride-releasing substances cannot prevent dental biofilm from growing on surfaces next to them or stop dental biofilms from producing acid. On tooth surfaces near dental materials, the fluoride produced delays the spread of caries lesions. In-depth study has been conducted for many years on substances that can release ions like calcium and fluoride, which are essential for the remineralization of dentin and enamel. When it comes to fluoride, one of various metal fluorides or hexafluorophosphate salts has typically been the source, while calcium has most frequently come from some kind of calcium phosphate. Using the sol-gel process, fluoride-containing bioactive glass (BAG) serves as a single source of calcium and fluoride ions in aqueous solutions. The release of fluoride ions prior to fluoride replenishment was comparable for the BAG 61 and BAG 81 composites after 2 hours as well as after 22 hours. The BAG 81 composite substantially produced more fluoride ions at the four consecutive time intervals, one before and three after fluoride recharge (p 0.05). Although the BAG 81 composite was recharged more than the BAG 61 composite, both composites were recharged by exposure to 5000 ppm fluoride. Each of the 2 and 22 h time periods, the BAG 61 composite released significantly higher calcium ions before fluoride recharging. The release of calcium at the four following time intervals for the two composites was not statistically different (p > 0.05) after that. The two main causes of restoration failures are secondary caries and restorative fracture. Release of fluoride ions (F) helps prevent tooth decay. After a sucrose rinse, the pH of the plaque can drop to a cariogenic pH of 4-4.5. When these ions are most required to prevent caries, at an acidic, cariogenic pH, the restoratives studied were able to significantly boost the F release. However, these F-releasing restoratives' mechanical qualities drastically deteriorated in immersion. It is necessary to make efforts to create F-releasing restoratives with high levels of sustained F release and better mechanical property durability for substantial stress-bearing restorations. References: Buzalaf, M. A., Pessan, J. P., Honório, H. M., & Ten Cate, J. M. (2011). Mechanisms of action of fluoride for caries control. Fluoride and the Oral Environment, 97-114. https://doi.org/10.1159/000325151 Cury, J. A., De Oliveira, B. H., dos Santos, A. P., & Tenuta, L. M. (2016). Are fluoride releasing dental materials clinically effective on caries control? Dental Materials, 32(3), 323-333. https://doi.org/10.1016/j.dental.2015.12.002 Davis, H. B., Gwinner, F., Mitchell, J. C., & Ferracane, J. L. (2014). Ion release from, and fluoride recharge of a composite with a fluoride-containing bioactive glass. Dental Materials, 30(10), 1187-1194. https://doi.org/10.1016/j.dental.2014.07.012 Jürgensen, N. and Petersen, P.E. (2013): Promoting oral health of children through schools: Results from a WHO global survey 2012. Community Dental Health 30, 204– 218. Moreau, J. L., & Xu, H. H. (2010). Fluoride releasing restorative materials: Effects of pH on mechanical properties and ion release. Dental Materials, 26(11), e227-e235. https://doi.org/10.1016/j.dental.2010.07.004 Tenuta, L. M., & Cury, J. A. (2013). Laboratory and human studies to estimate Anticaries efficacy of fluoride toothpastes. Monographs in Oral Science, 108-124. https://doi.org/10.1159/000350479 Tressaud, A., & Haufe, G. (2008). Fluoride in Dentistry and Dental Restoratives. In Fluorine and health: Molecular imaging, biomedical materials and pharmaceuticals (pp. 333-378). Elsevier. Wright, J. T., Hanson, N., Ristic, H., Whall, C. W., Estrich, C. G., & Zentz, R. R. (2014). Fluoride toothpaste efficacy and safety in children younger than 6 years. The Journal of the American Dental Association, 145(2), 182-189. https://doi.org/10.14219/jada.2013.37