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.
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