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PubMed1988

Effects of a sodium fluoride solution and a varnish with different fluoride concentrations on enamel remineralization in vitro.

To study the efficacy of sodium fluoride varnishes and a NaF solution in remineralization of enamel, 120 slabs of non-carious human enamel enamel were presoftened for 6 h and randomly divided into six groups. The slabs were stored in synthetic saliva for 9 days, except for a daily 30-min immersion in 0.1 M lactic acid-NaOH buffer. During the 9-day period, one group of the slabs received no treatment, and the rest were treated once or three times with 2.3% or 1.1% sodium fluoride varnish Duraphat, or nine times with a 0.1% NaF solution. Finally, the slabs were demineralized for 1 h, and the amount of dissolved Ca and F was determined. Microhardness of enamel was determined initially, after presoftening, after the 9-day period, and after the 1-h demineralization. All fluoride treatments prevented enamel softening almost completely during the 9 days, but the control slabs softened markedly. Fluoride varnishes were more effective than NaF solution. Three applications of 2.3% Duraphat were slightly more effective than any of the other varnish treatments, but one treatment with 2.3% varnish was not more effective than treatments with 1.1% varnish. Enamel treated three times with 1.1% varnish showed the greatest acid resistance during the 1-h demineralization. The results suggest that the efficacy of the varnish was not proportional to the fluoride concentration but rather to the number of applications. Fluoride uptake by enamel was greatest with the most concentrated varnish. Enamel solubility was not, however, directly proportional to the fluoride content of enamel.

Dental Caries↗
PubMed1989

Bactericidal concentrations of chlorhexidine-digluconate, amine fluoride gel and stannous fluoride gel for subgingival bacteria tested in serum at short contact times.

In vitro inhibitory and bactericidal concentrations in serum of chlorhexidine-digluconate, amine fluoride gel, stannous fluoride gel, stannous fluoride, metronidazole and amoxicillin were determined against Bacteroides gingivalis, Bacteroides intermedius, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans and Capnocytophaga sputigena. The minimal inhibitory concentration was assessed by the agar dilution technique. The killing curves and minimal bactericidal concentration of the antimicrobial agents in inactivated bovine serum were determined after 5, 10, 20 and 60 minutes contact time. The minimal inhibitory concentration varied amongst the tested bacteria. A concentration of 128 micrograms/ml chlorhexidine digluconate, 20 mg/ml amine fluoride gel, 1 mg/ml stannous fluoride, 128 micrograms/ml metronidazole and 4 micrograms/ml amoxicillin inhibited the growth of the tested species. The minimal bactericidal concentration in serum for B. gingivalis, B. intermedius, F. nucleatum, A. actinomycetemcomitans and C. sputigena after 10 min contact time was 5 mg/ml for chlorhexidine digluconate and 100 mg/ml for amine fluoride gel. A concentration of 200 mg/ml stannous fluoride gel in serum was bactericidal for the tested species after 10 min contact time, with exception of F. nucleatum.

Actinobacillus↗
PubMed1995

Fluoride supplement use by children in fluoridated communities.

OBJECTIVES: The purpose of this study is to describe patterns of inappropriate fluoride supplementation among a sample of Connecticut schoolchildren living in optimally fluoridated areas. METHODS: Fluoride exposure histories were obtained via a written questionnaire with a response rate of 89 percent and an overall reliability of 87 percent agreement. RESULTS: A total of 575 subjects lived the entire first eight years of life in a fluoridated community. Of these, 26.1 percent had a history of inappropriate supplementation sometime during that period, including 31.8 percent of subjects with mild to moderate fluorosis and 22.8 percent of subjects without fluorosis. There were no significant supplement history differences related to current age, sex, or socioeconomic status. Overall, 71 percent of these subjects used only vitamins with fluoride, while only 14 percent were reported to have used fluoride supplements alone. Sixty-eight percent of the subjects who were supplemented while breast feeding, continued supplementation after cessation of breast feeding. CONCLUSIONS: These findings reinforce the need for health professionals to be targeted more aggressively at the school, residency, and private practice levels to better promote a full understanding of the proper utilization of fluoride supplements.

Adolescent↗
PubMed2000

Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants.

BACKGROUND: Although the predominant beneficial effect of fluoride occurs locally in the mouth, the adverse effect, dental fluorosis, occurs by the systemic route. The caries attack rate in industrialized countries, including the United States and Canada, has decreased dramatically over the past 40 years. However, the prevalence of dental fluorosis in the United States has increased during the last 30 years both in communities with fluoridated water and in communities with nonfluoridated water. Dental fluorosis is closely associated with fluoride intake during the period of tooth development. METHODS: We reviewed the major changes in infant feeding practices that have occurred since 1930 and the changes in fluoride intakes by infants and young children associated with changes in feeding practices. RESULTS AND CONCLUSIONS: Based on this review, we conclude that fluoride intakes of infants and children have shown a rather steady increase since 1930, are likely to continue to increase, and will be associated with further increase in the prevalence of enamel fluorosis unless intervention measures are instituted. RECOMMENDATIONS: We believe the most important measures that should be undertaken are (1) use, when feasible, of water low in fluoride for dilution of infant formulas; (2) adult supervision of toothbrushing by children younger than 5 years of age; and (3) changes in recommendations for administration of fluoride supplements so that such supplements are not given to infants and more stringent criteria are applied for administration to children.

Adult↗
PubMed1990

Diurnal fluoride concentration in whole saliva in children living in a high- and a low-fluoride area.

Salivary fluoride concentrations were investigated in 12-year-old children living in areas with low (0.1 ppm) or high (1.2 ppm) fluoride concentration in the drinking water. Unstimulated whole saliva was collected from 27 children from the respective areas every 2nd hour for 46 h except during sleep. The mean salivary fluoride concentration was 0.32 +/- 0.013 mumol/l (n = 419) in the low-fluoride (LF) area and 0.87 +/- 0.047 mumol/l (n = 401) in the high-fluoride (HF) area. No significant rhythm could be found for the diurnal variations in the mean or individual salivary fluoride concentrations. However, in the HF area the individual salivary fluoride concentrations fluctuated widely and randomly.

Analysis of Variance↗
PubMed1990

Estimation of fluoride absorption from swallowed fluoride toothpastes.

Eight adults ingested five different toothpastes with and without 1,000 ppm (1 microgram/g) fluoride added as NaF or Na2PO3F. The systemic fluoride absorption was estimated by by comparing the areas under salivary fluoride concentration curves produced after the toothpaste ingestion. Of the toothpastes investigated--chalk, dicalcium phosphate dihydrate, silica or alumina with sodium monofluorophosphate, and silica with sodium fluoride--the fluoride absorption was found to be statistically significantly lower only from the dicalcium phosphate dihydrate toothpaste. Measuring changing fluoride levels in saliva appears to be an acceptable non-invasive technique for following systemic fluoride absorption.

Absorption↗
PubMed1985

Prevalence of dental fluorosis after fluoride-gel treatments in a low-fluoride area.

The goal of the present investigation was to study whether periodic use of fluoride-gel treatments resulted in an increased prevalence of dental fluorosis. 269 children, from 14 to 16 years of age, who had received semi-annual or quarterly fluoride-gel treatments were examined for possible fluoride-induced enamel changes. Further, in order to determine the amount of fluoride retained during the gel treatment, the expectorate was analyzed in 18 younger children presently participating in the prophylaxis program. It was found that the retention of fluoride averaged 7.3 mg per treatment (up to 0.5 mg fluoride per kg body weight). An increased prevalence of dental fluorosis was not observed, even after up to five yearly treatments were given during tooth formation periods. The background prevalence of dental fluorosis in a low-fluoride area in Denmark is described.

Adolescent↗
PubMed1989

Studies on fluoride concentrations in human submandibular/sublingual saliva and their relation to flow rate and plasma fluoride levels.

Submandibular/sublingual saliva and blood were collected from five subjects after ingestion of 1 mg fluoride as NaF. An individual collection device, made from a silicone impression material, was used to collect the saliva in 10-minute samples, before and during 2 hr after the fluoride intake. In two separate experiments on each individual, submandibular/sublingual saliva was collected continuously at different flow rates: without stimulation and with gustatory stimulation. Blood was also collected at intervals throughout the experiments. The concentration of fluoride in the submandibular/sublingual saliva was less than that in the plasma but independent of salivary flow rate. The ratio between the saliva and plasma fluoride concentrations at the peak of the mean plasma fluoride concentrations was 0.55 +/- 0.13 and 0.69 +/- 0.11 in the experiments on unstimulated and stimulated salivary, flow rate, respectively. The total amount of the ingested fluoride dose that was excreted through the submandibular/sublingual glands during 130 min was highly correlated with the salivary flow rate. The fraction of the ingested fluoride dose excreted in 2 hr was 0.04 +/- 0.02% in the unstimulated saliva and 0.15 +/- 0.09% in the stimulated saliva.

Fluorides↗
PubMed2002

Fluoride uptake, retention, and remineralization efficacy of a highly concentrated fluoride solution on enamel lesions in situ.

Repeated topical application of concentrated fluorides is known to reduce caries. Little is known about fluoride retention and remineralization in incipient caries lesions following a single application. We investigated fluoride and the remineralization kinetics of a single application of elmex fluid (GABA International AG, Münchenstein, Switzerland; 10,000 ppm F) in initial enamel lesions. In this double-blind, placebo-controlled, randomized, crossover in situ study that conformed to good clinical practice, volunteers received intra-oral removable appliances carrying demineralized enamel samples after application of elmex fluid or placebo. After 5 min, 1, 2, 3, and 4 weeks in situ, KOH-soluble fluoride (KOHF), structurally bound fluoride (SBF), mineral gain, and lesion depth reduction were measured. Elmex fluid promoted higher KOHF and SBF at all times, decreased KOHF with time, increased SBF up to 3 weeks, and registered a higher mineral gain than placebo. Volunteers with higher stimulated salivary flow rates had lower fluoride uptake, but higher mineral gain. In conclusion, a single application of highly concentrated fluoride solution increases remineralization.

Adolescent↗
PubMed2000

Dental hygienist and patient comparisons of fluoride varnishes to fluoride gels.

PURPOSE: The purpose of this study was to evaluate a fluoride varnish and compare it to fluoride gels in categories including taste, comfort, efficiency, discoloration, moisture control, safety, and ease of application. METHODS: Methods. Twenty-five licensed dental hygienists and 148 patients completed questionnaires comparing fluoride varnish to fluoride gel for the following categories: taste, comfort, efficiency, discoloration, moisture control, and safety. Responses were analyzed using descriptive statistics and a chi-square test. RESULTS: The 25 dental hygienists rated fluoride varnish (Duraphat) superior to fluoride gels in all categories. Eighty-three (56.5%) of the 148 patients reported the varnish application to be more comfortable than gel while 29 (20%) found it the same. In taste comparison, 90 (71.4%) preferred the varnish, while 16 (12.7%) rated it the same. The time required was reported as better for the varnish technique by 59 (50.4%) and equal to the gels by 32 (20.3%). Discoloration of the teeth by the varnish was found not noticeable or not objectionable by 66 (49.3%) and somewhat objectionable or too noticeable for comfort in public by 68 (50.7%). However, 85 (64.3%) reported that they would choose to have the varnish treatment while 33 (25%) would not. Dental hygienist responses on questions 1-4 relative to the number of years in practice were not found to be significantly different. CONCLUSION: The patients and dental hygienists in this study preferred fluoride varnishes to gels. However, since some patients objected to the temporary discoloration, varnishes may not be suitable for everyone.

Attitude of Health Personnel↗
PubMed1990

Differential activation of rabbit femoral arteries by aluminum fluoride and sodium fluoride.

The effect of fluoride (NaF; 10 mM sodium fluoride plus deferoxamine to chelate contaminating aluminum) and fluoride plus aluminum fluorides (AlF; 10 mM sodium fluoride plus 20 microM aluminum chloride) on activation of rabbit femoral arteries was investigated. AlF and NaF produced large increases in stress (force/muscle cross-sectional area), but temporal changes were dissimilar, as were other indices of muscle activation. Stress produced by NaF developed slowly and only after a long delay of about 15 min, whereas stress produced by AlF developed rapidly after a delay of only about 5 min. NaF-induced contractions were more sustained than AlF-induced contractions. Both AlF and NaF increased the level of cross-bridge phosphorylation and the velocity of muscle shortening, but at comparable stresses, AlF produced greater increases than did NaF. AlF produced a large increase in lP production, whereas NaF produced a small increase. Also, AlF-induced stress was largely insensitive to inhibition by the calcium channel blocker, nifedipine (1 microM), whereas NaF-induced stress was largely inhibited by nifedipine. However, in tissues depleted of calcium, both agents produced potent contractions when CaCl2 was added back to the tissues (EC50 values for AlF, NaF, histamine, phenylephrine and KCl were, respectively, 0.057, 0.085, 0.11, 0.11 and 0.23 mM). AlF, but not NaF, strongly desensitized arteries to phenylephrine, causing a 73% reduction in the ability of phenylephrine to achieve maximum steady-state stress. These data suggest that fluoride contracted rabbit femoral arteries by stimulating L-type calcium channels, and that aluminum fluoride stimulated phospholipase C, producing additional muscle activation.

Aluminum↗
PubMedDate not supplied

Use of fluoride supplementation by children living in fluoridated communities.

As part of a case-control study that investigated risk factors of enamel fluorosis, a fluoride/residency history was obtained covering the first six years of life by means of a mailed questionnaire, with a reliability factor of 90 percent. Of the 677 participating seventh-grade and eighth-grade children, demonstrating either mild-to-moderate dental fluorosis (fluorosis cases) or were fluorosis-free (fluorosis controls), 11 percent (N = 74) had lived in a fluoridated community for at least a year during their first six years of life. Forty percent of the fluorosis cases and 22 percent of the fluorosis controls were reported to have taken fluoride supplements during their residency in a fluoridated community, with 79 percent of the supplementation for both groups in the form of vitamins with fluoride. Further, these children had resided in more then twenty cities across ten states, and therefore do not represent just a localized problem. Such findings indicate that fluoride supplements had been incorrectly prescribed for a sizeable percentage of children residing in fluoridated areas; they also suggest an explanation for the recent increased prevalence of fluorosis in similar age-groups in some fluoridated areas. Given that the recent literature does not show that the appropriateness of supplemental prescription practices has improved for post-1975 birth cohorts, these findings suggest the need for enhanced professional education and monitoring to ensure that this occurs.

Administration, Oral↗
PubMed1989

Fluorides and the prevention of dental caries. Part II: The case for water fluoridation.

The evidence is very strong that fluoridation of water, and fluorides in other forms, are the prime reasons for the enormous reduction in decay that has occurred over the past 25-30 years. These advantages must be retained. This can be done most effectively and most economically through a continuation of water fluoridation and the use of fluoride toothpaste. In nonfluoridated areas, professionally applied topical fluorides will continue to be needed, particularly within the School Dental Service, and in those adolescent and adults where the history and clinical picture suggest the individual is at risk. Without fluoride acting to enhance the resistance of the mouth, decay would certainly rise. Although advocacy for a sound diet and the use of fissure sealants is encouraged as part of caries preventive programmes, these alone will not provide adequate protection across the whole community. Fluoridation of public water supplies continues to be endorsed.

Costs and Cost Analysis↗
PubMed1977

[Natural fluorides. The distinction between technically produced and naturally occurring fluorides in caries prophylaxis].

In the controversial discussion of the bio-availability of fluoride in caries prophylaxis by fluoridation, fluorides coming from the geochemical circulation to the biochemical circulation are sometimes differentiated from synthetic fluorides introduced into fluoride medication. The question as to whether such a differentiation is essential can be answered from the physical-chemical point of view. This requires a wide field of scientific research starting with geochemistry and the knowledge of fluoride deposits, sedimentology, hydrology, technology of inorganic and organic fluorine compounds, thermodynamics of dissolved fluorides, up to biocrystallography and biochemistry of fluorine.

Biological Availability↗
PubMed1989

[Uptake and release of fluoride in enamel surface after fluoridation].

After one single application of a sodium monofluorophosphate or sodium fluoride solution (1%) in an in vitro study, the incorporation of fluoride into enamel platelets was determined. Compared with sodium fluoride the increase in the fluoride concentration following the application of sodium monofluorophosphate was significantly lower, whereas the loss of fluoride after four weeks of rinsing with an artificial saliva solution was markedly reduced. The duration of fluoride incorporation may be one of the factors governing the clinical equivalence of both substances. To determine the amount of enamel in which the fluoride content was measured, the elements calcium and phosphor were determined with the aid of nuclear emission spectrometry and compared with photometric phosphate measurements. All three methods produced identical results.

Dental Enamel↗
PubMed1982

[Elimination of fluoride in urine during fluoridation of salt and drinking water].

From 552 ambulatory gynecological patients in different parts of Switzerland the urinary excretion of fluorine was measured. The patients were classified into 4 groups according to origin: (1) 84 women were from the Canton Basel-Stadt. In this city water has been fluoridated since 1962; (2) 139 women from Canton Glarus. In this area a pilot study was under way using table and baker's salt, to both of which 250 mg F/kg had been added; (3) 128 women from Canton Aargau who were using a low dose fluoridated salt (90 mg F/kg); (4) 201 patients from Cantons Aargau and Tessin respectively who were consuming neither fluoridated water or salt acted as controls. Quantitation of ionized fluorine in urine was performed by means of the fluoride ion sensitive electrode in afternoon urine samples, thus eliminating the influence of sex difference and diurnal rhythm in fluorine excretion. The molar urinary fluorine concentration was related to the corresponding urinary creatinine concentration and expressed as mumol F per mmol creatinine. The fluoridation of salt or water was considered ideal when the excretion factor amounted to 6.29 mumol X mmol-1. The most important finding was that the Glarus females excrete higher levels of fluorine than the patients from Basel, though the difference was no significant. The fluoridation of salt with 90 mg F/kg is followed by an increase of the excretion factor from 2.58 to 3.65 mumol X mmol-1. It could also be demonstrated that in Canton Glarus, where salt with higher fluorine content is used, the excretion coefficient remains below the level believed to be toxic in the long run. It is concluded that salt fluoridation with 250 gm F/kg is safe. Furthermore, the excretion of fluorine in the control group seems to confirm that fluorine is a trace element of ubiquitous occurrence even excreted in urine of individuals who deliberately avoid fluorine as an additive to table salt or water.

Creatinine↗
PubMed1995

[Relationship between bone fluoride content, pathological change in bone of aborted fetuses and maternal fluoride level].

Relationship between bone fluoride content, pathological change in bone of aborted fetuses and maternal fluoride level was studied in 46 pregnant women and their inducedly-aborted fetuses. Results showed fluoride content in fetal femur averaged 368.2 micrograms/g, and 41.4% of the bone with pathological change. Fluoride levels in maternal urine and amniotic fluid and fluoride content in fetal femur and pathological change in fetal femur appeared a positive correlation between them. Femur fluoride content and pathological change of bone in fetuses born to mothers with mottling teeth were significantly greater than to those without them. Pathological change in fetal femur presented dose-response relationship with their bone fluoride content. When the latter reached greater than 500 micrograms/g, pathological changes occurred in 90% of the bone.

Adult↗
PubMed1996

Bioavailability of fluoride administered as sodium fluoride or sodium monofluorophosphate to human volunteers.

This paper reports a reassessment of the bioavailability of fluoride from monofluorophosphate (MFP, CAS 10163-15-2). It was prompted by recent work from this laboratory reporting that, following an oral dose of MFP, a fraction of the drug appears in plasma bound to globulins forming a previously undetected compartment of non-diffusible fluoride. The presence of protein-bound MFP in plasma after the intake of this drug hinders its straightforward comparison with NaF (CAS 7681-49-4). After an oral of NaF, all plasma fluoride is diffusible. After intake of MFP, on the other hand, plasma contains diffusible fluoride and protein-bound fluoride during the 6-8 h following intake. The area under the curve of total plasma fluoride for MFP (1540 +/- 117 mumol.min/l) doubles that of NaF (811 +/- 52 mumol.min/l p < 0.001). On this basis, in agreement with findings previously reported for the rat, it is concluded that the bioavailability of fluoride for MFP doubles that of NaF.

Adult↗