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Umbilical cord fluoride serum levels may not reflect fetal fluoride status.

OBJECTIVE: To evaluate the reliability of fluoride levels in the umbilical cord as reflecting neonate fluoride status. DESIGN: Prospective study of fluoride levels of pregnant women at term and their neonates. SETTING: Delivery room and maternity unite of Hadassah Hospital Mount Scopus. PATIENTS: Fluoride serum levels were determined in the sera of 20 women with normal pregnancies at term, during delivery, in the corresponding mixed cord sera and neonatal sera at 24 hours after delivery. RESULTS: The mean maternal fluoride serum level was 0.0303 microgram/ml (SD 9.015), mean cord fluoride serum level 0.0183 microgram/ml (SD 0.012), and mean neonatal fluoride serum 0.0380 microgram/ml (SD 0.016). CONCLUSION: The significantly (p < 0.001) low mixed cord serum levels of fluoride as compared with neonatal and maternal serum levels may be explained by placental sequestration of fluoride. It is suggested that cord serum fluoride levels to not reflect fetal fluoride status.

Female↗

Neutron activation analysis of fluoride release after treatment with a fluoride varnish in vitro.

OBJECTIVE: To use neutron activation analysis to study a new type of cariostatic material, fluoride varnish, in terms of its anti-caries mechanism and its release in vitro. MATERIALS AND METHODS: Twenty enamel specimens were measured for baseline fluoride content using neutron activation analysis. The enamel specimens were then fluoridated with 1.5% sodium fluoride varnish for 24 hours, and their enamel fluoride content was measured again with neutron activation analysis. RESULTS: The baseline fluoride content in the enamel specimens was 161.7 micrograms/g; after fluoridation, the fluoride content in the enamel specimens increased to 277.8 micrograms/g, or about 1.7 times. CONCLUSION: It is evident that this sodium fluoride varnish can significantly increase enamel fluoride content. The neutron activation analysis is a good method for fluoride measurement in vitro.

Cariostatic Agents↗

Dental hygienists' knowledge and opinions about fluorides and fluoridation.

This article reports results of a study of 563 practicing Minnesota and Wisconsin dental hygienists' knowledge and opinions about fluorides and water fluoridation. Two independent samples were selected randomly from the populations of licensed dental hygienists residing in the two states. Data were collected using a pretested, 42-item, mailed questionnaire. An 84 percent response was achieved with two followup reminders. These data provide baseline information about the caries prevention knowledge and attitudes of practicing dental hygienists in two states. Respondents from both states held similar levels of knowledge about fluorides and opinions about decision making on fluoridation. Fluoride topics, especially water fluoridation, were not receiving high priority in patient education, although nearly all believed that dental hygienists should promote water fluoridation actively. Two-thirds of respondents from both states believed fluoridation decisions should be made by health authorities, rather than by elected officials or through public vote. Greater attention to patient education about fluoride and community water fluoridation is needed by dental hygienists.

Adult↗

Effects of two fluoride gels on fluoride uptake and phosphorus loss during artificial caries formation.

Blocks of human enamel were cycled through a demineralization--F-treatment-remineralization procedure and then analyzed for fluoride and the presence of caries-like lesions. Treatments with a sodium fluoride gel (5000 ppm F) increased the enamel fluoride concentration to 6500 ppm F, whereas a stannous fluoride gel (1000 ppm F) increased enamel fluoride to about 1200 ppm F. Although a control treatment (water) allowed caries-like lesions to form, as observed by microradiography, no lesions were found in either of the fluoride-treated groups. When the experiment was repeated with radioactive teeth, mineral loss, as determined by release of 32P, was again greatest in the water-treated control group, but some loss was observed in the fluoride treatment groups. The least loss was found in the sodium fluoride group. It was concluded that the fluoride treatments not only increased enamel resistance but also enhanced remineralization so that calcium phosphate was replaced during the subsequent remineralization phase. Because of the probability that stannous ions were deposited during the stannous fluoride treatments, some of the apparent calcium phosphate re-deposition in this group was probably stannous compounds.

Absorptiometry, Photon↗

Fluoride release/recharge from restorative materials--effect of fluoride gels and time.

This study examined the differences in fluoride release and recharge among four restorative materials following treatment with APF or neutral fluoride gel for one or four minutes. Specimens were immersed in 2 mL of deionized water, while fluoride release was measured at 24-hour intervals for 15 days using an ion-selective electrode and analyzer. The materials were then treated with the fluoride gels. The fluoride release was measured for 15 days. ANOVA (p<0.05) showed higher fluoride release for Ketac-Fil before fluoride application and for Vitremer and Fuji II LC after application of APF gel. APF gel yielded higher fluoride release when compared to neutral gel, regardless of the material. Fluoride recharge and release was greater after the four-minute APF gel application, with no difference between the times of application for the neutral gel (p>0.05), except for Ketac-Fil. The pattern of release before and after application of the gels was similar and was higher at day 16 compared to day one for the APF gel for resin materials, with higher release at day 15 compared to the initial for Fuji II LC and Vitremer. It was concluded that RM-GICs were the most effective materials with regards to fluoride release after application of APF gel for four minutes.

Acidulated Phosphate Fluoride↗

[Effects of different quantity of fluoride toothpaste on fluoride intake by preschool children].

OBJECTIVE: This study was to investigate the influence of different quantity of fluoride toothpaste(1000 microg/g)on the intake level of fluoride among three children age groups of preschool children,to explore the rational and security quantity of fluoride toothpaste in preschool children. METHODS: Urinary fluoride excretion of 24-hour urinary samples was measured by fluoride ion electrode among three age groups of preschool children,serving 24-hour urinary fluoride excretion before using fluoride toothpaste as self-control. RESULTS: There were statistically significant differences in 24-hour urinary fluoride excretion among four different quantity toothpastes (P<0.01),and among three age groups (P<0.05). CONCLUSION: Fluoride intake level was influenced by the accidental swallowing of fluoride toothpaste among preschool children. So children under 6-year-old should decrease quantity of fluoride toothpaste,no more than a small pea (about 0.25g).

English Abstract↗

The effect of topical fluoride treatment on enamel fluoride uptake and the tensile bond strength of an orthodontic bonding resin.

Enamel demineralization occurring adjacent to directly bonded orthodontic attachments is of great concern to orthodontists. The topical application of fluorides to enamel surfaces before acid etching and the bonding of the attachments is not recommended by many investigators. The objective of this study was to determine the enamel fluoride acquired from various topical fluoride agents and to determine the effect of the acquired fluoride on the tensile bond strength of an orthodontic bonding system. Fifty extracted maxillary central incisors were mounted in cups and the facial surfaces of the crowns were polished on 600-grit silicon carbide paper. Enamel microbiopsies were performed just off the midpoint of each tooth. Ten teeth served as controls and received no topical fluoride treatment, while a similar number were treated with either APF, SnF2, Duraphat, or Fluor Protector. The teeth were suspended in synthetic saliva 4 minutes after fluoride application. The topical fluoride agents were removed after 24 hours and the teeth were again suspended in synthetic saliva at 37 degrees C for 7 days. Enamel biopsies were again performed just off the midpoint of each tooth on the side not previously biopsied. The enamel surfaces were etched for 1 minute and the tensile bond strength of Concise orthodontic bonding system to the etched enamel surfaces was determined. The enamel surfaces acquired significantly different amounts of fluoride from the topical fluoride agents, but the bond strengths to these surfaces were not significantly different. The results of this in vitro study suggest that the application of topical fluoride agents to enamel surfaces 7 days before the bonding of orthodontic attachments will not have an adverse effect on bond strength.

Acid Etching, Dental↗

Fluoride profiles in premolars after different durations of water fluoridation in Ho Chi Minh City, Vietnam.

In order to evaluate the uptake of fluoride (F) into tooth structures following water fluoridation in Ho Chi Minh City, F concentrations were measured from the enamel surface through the enamel-dentine junction (EDJ) to dentine close to the pulp in premolars. Calcification had been completed in all the teeth before fluoridation. Samples were obtained from fluoridated areas of the City ([F]: 0.7 parts/10(6)) after 3 years (eight samples), 6 years (eight samples) and 8 years (nine samples). Samples were also taken from regions outside the fluoridated water supply of the City in 1998 after 8 years of water fluoridation. An abrasive microsampling method was used to determine the profiles of fluoride and phosphorus concentrations. In enamel surfaces, F concentrations tended to increase with increasing periods of fluoridation. In dentine close to the pulp, F concentrations also increased statistically significantly with the increasing duration of fluoridation of water (between 6 and 3 years: P=0.006; between 8 and 3 years: P=0.001; between 8 years and 8 years without F: P=0.0001). It was concluded that F concentrations in enamel and dentine had tended to increase gradually with the duration of water fluoridation in Ho Chi Minh City. The increase was most obvious in dentine near the junction with the pulp.

Adolescent↗

A method for determining the distribution of fluoride, calcium and phosphorus in human dental plaque and the effect of a single in vivo fluoride rinse.

A new sampling method, capable of sampling plaque from its surface to its interior for quantitative studies, was modified to meet some of the requirements for the determination of the fluoride and mineral (Ca and P) profiles within dental plaque formed in vivo. Plaque samples were repeatedly collected from the same individual, using special devices, before a single fluoride rinse (900 parts/10(6) fluoride) and 10 min and 24 hr after rinse. The method allowed examination of fluoride, calcium and phosphorus distribution along the entire thickness of plaque. Fluoride content significantly increased throughout the sample 10 min after rinsing, indicating the fluoride had rapidly penetrated into the plaque. Although the elevated fluoride concentrations diminished almost to baseline with 24 hr, a high correlation was found between fluoride and minerals in each plaque fraction. It is concluded that this technique will be useful for evaluating the fluoride and mineral behaviour in the saliva/plaque and plaque/enamel interfaces, and the anti caries efficacy of fluoride applications.

Calcium↗

Should the drinking water of Truro, Nova Scotia, be fluoridated? Water fluoridation in the 1990s.

An epidemiological assessment of differences in caries and fluorosis prevalences between children in Truro (< 0.1 ppm) and Kentville (fluoridated at 1.1 ppm in 1991), Nova Scotia, Canada, was completed in 1991. Out of a total of 429 children, in grades 5 and 6, in the two towns in 1991, 219 (51%) were examined. Parents answered a self-administered questionnaire investigating the sources of drinking water used by the children since birth, residence history, use of fluoride supplements, dentifrices, and other fluoride products during the first 6 yr of the life. The examination criteria differentiated between non-cavitated and cavitated carious lesions. Dental fluorosis was measured using the TSIF index. Examiner agreement was excellent. Of the children examined, 80 (36.5%) drank water (fluoridated or non-fluoridated) from municipal water systems during the first 6 yr of life. The children were assigned into five groups based upon residence history and exposure to fluoridated water during the first 6 yr of life. The percentage difference in mean DMFS scores between children in the fluoridated and non-fluoridated groups is 17% (delta DMFS1 = 0.7) when non-cavitated carious lesions are included and 39% (delta DMFS2 = 1.1) when they are excluded. The differences are not statistically significant. The significant risk factors associated with the DMFS1 and DMFS2 scores identified by a stepwise multiple regression analysis are: education level of the father, gender, and number of years of reported use of toothpaste during the first 6 yr of life. Dental fluorosis (mainly TSIF score of 1) was present in 41.5% and 69.2% of the children in the non-fluoridated and fluoridated groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

Fluoride supplements and caries in a non-fluoridated child population.

In Norway, there is no water fluoridation and little naturally occurring fluoride in drinking water. Fluoride toothpaste is used by 95% of the population and there is a long tradition of use of fluoride supplements. The purpose of this study was to analyse whether children who used fluoride toothpaste regularly and complied with the recommendations for use of fluoride supplements had less caries than other children at the age of 8 years. Most fluoride supplements sold in Norway are lozenge-type tablets, which allow for extended enamel exposure to fluoride. All children (n = 551) born in 1988 living in a suburban community in Norway were invited to participate. In those who participated (n = 470), caries was registered clinically and radiographically and parents provided data on use of supplements. Thirty-eight percent of the children had used fluoride supplements regularly during the period 0.5 to 4.0 years of age and 66% used supplements regularly at the age of 6 to 8 years. Multivariate analyses showed that the children complying with the recommendations for use of fluoride supplements during the period 0.5 to 4.0 years of age had lower caries experience (dmfs) and fewer decayed surfaces (ds) in primary teeth than other children. No significant associations were found between supplement use in childhood and caries prevalence (DMFS) or number of decayed surfaces (DS) in permanent teeth at the age of 8 years. Supplement use from 6 to 8 years of age was not associated with caries occurrence either in primary or in permanent teeth. Both mother's education and the quality of dental hygiene were inversely associated with caries occurrence.

Analysis of Variance↗

Total fluoride intake and implications for dietary fluoride supplementation.

This paper reviews the history and validity of recommended "optimal" levels of systemic fluoride intake and the available information on levels of fluoride intake in young children from foods and beverages (including water), dentifrices, dietary fluoride supplements, mouthrinses, and gels. Most of the studies emphasize the substantial variation in ingestion among individuals. Often, a substantial proportion of individuals received fluoride well beyond the mean exposure reported in the study. Limitations in the existing data make it difficult to determine the total distribution of fluoride intake from all sources. Therefore, hypothetical combinations of possible daily fluoride intake from the three main sources (diet, dentifrices, and supplements) are presented for those aged 6, 12, 24, and 36 months, with associated mean intake per kg body weight. Findings suggest that some children exceed the "optimal" level of fluoride intake from single sources alone, while others can from a combination of sources. Moreover, if current recommended "optimal" levels, which have been derived on an empirical basis, are actually lower than what has been quoted in the literature, then more children could be ingesting excessive amounts of fluoride, which could increase their risk of developing objectionable dental fluorosis. The variation and complexity of fluoride ingestion from all sources should be considered in the evaluation of recommendations for use of dietary fluoride supplements.

Adolescent↗

The effects of age and fluoride exposure on fluoride, citrate and carbonate content of human cementum.

A study was conducted to determine the values of several chemical components of dental cementum. Extracted teeth from continuous residents of low, optimal, and high natural fluoride areas were selected to determine the effects of fluoride exposure and age on the fluoride, citrate and carbonate content of cervical and apical areas of sound and periodontally diseased human cementum. 1. For normal cementum the mean fluoride content of all 18 groups was 0.443 plus or minus 0.04%on an ash basis and 0.253 plus or minus 0.02% on a dry weight basis; the mean citrate content was 1.52 plus or minus 0.10% on an ash basis and 0.86 plus or minus 0.06% on a dry weight basis; the mean carbonate content was 4.95 plus or minus 0.39% on an ash basis and 2.79 plus or minus 0.22% on a dry weight basis. 2. For diseased cementum the mean fluoride content of all 12 groups was 0.575 plus or minus 0.03% on an ash basis and 0.342 plus or minus 0.02% on a dry weight basis; the mean citrate content was 1.19 plus or minus 0.07% on an ash basis and 0.71 plus or minus 0.05% on a dry weight basis; the mean carbonate content was 5.95 plus or minus 0.47% on an ash basis and 3.50 plus or minus 0.28% on a dry weight basis. 3. There is a general increment in fluoride content of normal cervical and apical cementum, both with age and fluoride exposure. For diseased cementum this held true for fluoride exposure but not age. 4. The mean fluoride content of cervical cementum is greater than that of apical cementum for both normal and diseased groups. For citrate and carbonate no definite statistical differences were noted between cervical and apical areas. 5. The diseased cementum has a significantly higher mean fluoride content, a significantly lower citrate content, and a slightly, but not statistically significant, higher carbonate content than normal cementum. 6. Unlike bone, no inverse fluoride/citrate or fluoride/carbonate relationship was observed. 7. For both normal and diseased groups the carbonate content of cementum of individuals over age 40 tended to be lower than for individuals 20-40 years of age.

Adolescent↗

Fluoride analysis of foods for infants and estimation of daily fluoride intake.

The mean daily fluoride intake in infants was estimated on the basis of their intake of commercial foods for infants in Japan and evaluated in order to establish the effectiveness and safety criteria for water fluoridation, which is practiced as a preventive measure for dental caries suitable in life stages from children to the elderly. Based upon the intakes of foods for infants, the mean daily fluoride intake was estimated to be 0.166 mg in infants aged 3-4 months, 0.202 mg in those aged 5-6 months, and 0.266 mg in those aged 7-8 months. The mean daily fluoride intake per kg of body weight at these ages was in the range of 0.023-0.029 mg/kg, which was about half of the standard daily fluoride intake for infants and children advocated by Ophaug et al., as 0.05-0.07 mg/kg. From our results, the daily fluoride intake of infants from foods in Japan is estimated to be equivalent to or lower than the values of previous reports in non-fluoridated areas. Consequently, our data support the argument that water fluoridation and the appropriate use of fluoride for dental caries prevention in Japan are needed on the basis of scientific criteria in terms of fluoride exposure related to food intake during tooth formation.

Animals↗

On the role of calcium fluoride in the cariostatic mechanism of fluoride.

The literature concerning the formation and stability of CaF2 in the oral environment is reviewed. In early work the CaF2 formed during topical application with fluoride was assumed to be beneficial. It was suggested that it could protect the enamel surface directly or provide free fluoride ions for subsequent incorporation into the hydroxyapatite lattice. However, McCann claimed, in 1968, that CaF2 is soluble in saliva (12-15 mg/l), that it would be rapidly lost in the oral cavity, and that the clinical effect of fluoride was related to formation of firmly bound fluoride only. In this period many authors reported total loss of CaF2 during 24 h after a topical application of fluoride. It has now been shown in several laboratories that calcium fluoride is stable in saliva at neutral pH owing to surface adsorption of HPO2-4 to the crystal surface and formation of a solubility-limiting phase. Extended exposure of saliva can cause formation of a fluorapatite layer on the CaF2 crystals, restricting their dissolution further. Low pH (pH less than 5) causes loss of the solubility-limiting adsorbed HPO2-4 and a slow dissolution of CaF2. The CaF2 crystals may thus serve as pH-controlled reservoirs of fluoride ions on the enamel or in plaque and release fluoride during caries challenges. It is suggested that calcium fluoride is an essential phase explaining important aspects of the mechanism of topically applied fluoride, contrary to what was assumed in the past.

Calcium Fluoride↗

Effects of fluoride on bone in Finland. Histomorphometry of cadaver bone from low and high fluoride areas.

In three different areas of Finland, fluoride in bone and its effect on the histomorphometry of trabecular bone was studied. Bone samples were taken from cadavers from a low-fluoride area (fluoride concentration under 0.3 ppm), an area with fluoridated drinking water (1.0-1.2 ppm) and a high-fluoride area (over 1.5 ppm). The fluoride content in trabecular bone was greatly increased in the high-fluoride area, and it was also higher in the fluoridated-water area than in the low-fluoride area. Histomorphometric bone changes were markedly increased when the fluoride content in water exceeded 1.5 ppm.

Adult↗

[Release of fluoride by fluoridated amalgams and its incorporation by dental enamel].

Liberation of stannous fluoride incorporated in the alloy powder before amalgamation was demonstrated for all the amalgams tested in this study. This liberation was observed for stannous fluoride concentrations of 0.5% and 1%. Clear differences were noted in relation to the type of amalgam studied. Through the use of a non destructive method (activation with charged particles) it was possible to measure the fluoride concentration in enamel before and after the contact with the fluoridated amalgam. This analysis demonstrated that the fluoride liberated from the amalgam was trapped by enamel in contact with alloys containing 0.5% or 1% of stannous fluoride. The enrichment in fluoride was very important in the first weeks and remained high after four months. No significant difference appeared between alloys fluoridated at 0.5% and 1%. The dissolution of calcium fluoride through a KOH treatment showed that the amount of stable fluoride (fluorapatite) formed was important.

Calcium Fluoride↗

[Dietary ingestion of fluoride and caries prevalence in preschool and school children in cities with different fluoride content in the drinking water and diet].

The consumption of dietary fluoride and its relationship with dental caries prevalence was determined in 780 preschool children and 802 school children from quique, Arica, Santiago and San Antonio, where drinking water has different fluoride concentration. Dietary fluoride was determined from dietary records and fluoride content of foods. The fluoride consumption from drinking water was calculated by Galagan and Vermillion formula. The total fluoride consumption was obtained. The dental caries prevalence was established by the evaluation of dental caries index in deciduous (dmft) and permanent (DMFT) dentition. Significantly lower DMFT values were founded in cities with lower fluoride levels in drinking water. The exception was San Antonio, where high dietary fluoride explained the lower DMFT values relative to Santiago. Our results suggest that not only fluoride in water but also the consumption of fluoride rich foods has a significant impact on the prevalence of caries.

Adolescent↗