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PubMed2006

Removal of fluoride from aqueous phase by biosorption onto algal biosorbent Spirogyra sp.-IO2: sorption mechanism elucidation.

This communication presents results pertaining to the adsorptive studies carried out on fluoride removal onto algal biosorbent (Spirogyra IO2). Batch sorption studies were performed and the results revealed that biosorbent demonstrated ability to adsorb the fluoride. Influence of varying the conditions for removal of fluoride, such as the fluoride concentration, the pH of aqueous solution, the dosage of adsorbent, the temperature on removal of fluoride, and the adsorption-desorption studies were investigated. Sorption interaction of fluoride on to algal species obeyed the pseudo first order rate equation. Experimental data showed good fit with the Langmuir's adsorption isotherm model. Fluoride sorption was found to be dependent on the aqueous phase pH and the uptake was observed to be greater at lower pH. Maximum fluoride sorption was observed at operating 30 degrees C operating temperature. Adsorption-desorption of fluoride into inorganic solutions and distilled water was observed and this indicated the combined effect of ion exchange and physical sorption phenomena. Significant changes in the FT-IR spectra was observed after fluoride sorption which is indicative of the participation of surface function groups associated with hydrogen atoms in the carboxylic groups in sorption interaction. From X-ray photoelectron spectroscopy (XPS) analysis a marginal increase in the area for the binding energy peak at 287.4eV was observed which could be due to the formation of -C-F- bonds. Thermogravimetric (TGA) analysis of the fluoride loaded sorbent showed that the biosorbent underwent three steps decomposition process when heated from 25 to 100 degrees C. The maximum weight loss was observed to be between 200 and 400 degrees C and 700 and 800 degrees C.

Adsorption↗
PubMed2006

Effect of fluoride intoxication on endometrial apoptosis and lipid peroxidation in rats: role of vitamins E and C.

Fluoride is a strong, hard anion and cumulative toxic agent. The effect of fluoride intoxication on lipid peroxidation in endometrial tissue and the protective effects of combinations of vitamins E and C in rats were studied. Additionally, the apoptotic changes in endometrial tissue were examined. Experimental groups were as follows: control group; a group treated with 100 mg/l fluoride (F group); and a group treated with 100 mg/l fluoride plus vitamins E and C (F+Vit group). The F and F+Vit groups were treated orally with fluoride for 30 days. Vitamins E and C were injected simultaneously at doses of 50 mg/kg day i.m. and 20 mg/kg day body weight i.p. Extensive formation of DNA strand breaks, the typical biochemical feature of apoptosis, was detected with the use of the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick and labeling (TUNEL) method. Malondialdehyde (MDA) levels were determined in uterine tissue of rats. Fluoride caused a significant increase in MDA levels (an important marker of lipid peroxidation) in the fluoride group compared with the controls (p<0.05). Vitamins E and C significantly reduced the fluoride-induced lipid peroxidation in the F+Vit group compared with the F group (p<0.05). Diffuse apoptosis in glandular epithelium and stromal cells was found in endometrial tissues of F treated rats by TUNEL method. The severity of these lesions was reduced by the administration of vitamins. From these results, it can be concluded that subchronic fluoride administration causes endometrial apoptosis, and lipid peroxidation may be a molecular mechanism involved in fluoride-induced toxicity. Furthermore, treatment with a combination of vitamins E and C reduced endometrial apoptosis caused by fluoride.

Administration, Oral↗
PubMedDate not supplied

Fluoride profiles in dental calculus from Japanese, Chinese and British residents.

Whether the fluoride concentrations and profiles differ in human dental calculus obtained from different countries was investigated. A total of 203 dental calculus deposits on 203 permanent teeth from residents (mean age, 52.1 years) of Nagoya (Japan), Shanghai (China), Leeds (Great Britain) and the Wuhan mountainous area (China, fluoridated area) were analysed. An abrasive microsampling procedure was used to examine fluoride distribution. There were five types of fluoride profiles in dental calculus in each area/country (designated types L, J, U, T, W). In supragingival calculus, type L (highest in the outermost layers) and type J (highest in the innermost layers) both had significantly higher values than type U (high in the surface and innermost layers) but were relatively identical. In subgingival calculus, type W (high in the outermost, mid and innermost layers) was characteristics. Calculus from the Wuhan mountainous area (fluoridated) had the highest fluoride concentration, followed by Leeds (non-fluoridated), and Nagoya and Shanghai (non-fluoridated) calculus had the lowest. Fluoride concentrations in supragingival calculus were higher in teeth extracted because of periodontal diseases than dental caries. It is concluded that fluoride concentrations and distribution in dental calculus differ from country to country, probably due to different fluoride environments.

Adult↗
PubMed1998

The effects of fluoride concentration and the level of cariogenic challenge on caries development in desalivated rats.

Dental caries is an infectious and transmissible disease that continues to affect the majority of people. The presence of carbohydrate, mainly sucrose in the diet, is an important factor in its occurrence. The amount of fluoride required for optimal protective effect where there is a high caries challenge is unclear. Differences in the intensity of cariogenic challenge, for whatever reason, may play a part in determining fluctuations in the effectiveness of fluoride. The purpose of this study was to evaluate the effect of different concentrations of fluoride on the development of caries and explore the cariostatic effect of fluoride under various levels of cariogenic challenge. The study comprises two experiments. In experiment I, 60 desalivated Sprague Dawley rats infected with Streptococcus sobrinus were offered the following to drink for 21 days: group (1), sterile distilled water (SDW); (2) 10 parts/10(6) F SDW; (3) 20 parts/10(6) F SDW; (4) 30 parts/10(6) F SDW; (5) 40 parts/10(6) F SDW. In experiment II, eight groups of 9 rats were placed in a König Höfer programmed feeder and were exposed to different levels of cariogenic challenge through varying frequency of eating and offered water containing 10 parts/10(6) F. In experiment I, exposure to 20, 30 and 40 parts/10(6) F reduced caries development significantly: fluoride, at 10 parts/10(6), reduced the severity of the carious lesions. In this model of severe cariogenic challenge, the results suggest that elevated concentrations of fluoride might be effective in patients at high caries risk. In experiment II, fluoride reduced the incidence and severity of smooth-surface caries in all groups. The protective effect of fluoride decreased as the number of exposures to sugar increased. It is concluded that the effectiveness of fluoride is influenced by the level of cariogenic challenge and that consideration should be given to adjusting the level of fluoride exposure based on perceived caries risk, and that there is a maximum therapeutic effect of fluoride beyond which no additional protection can be expected.

Animals↗
PubMed1998

Effect of acetic acid on the fluoride release profiles of restorative glass ionomer cements.

OBJECTIVES: This study investigates the fluoride release of glass ionomers in an acetic acid solution in order to substantiate a model according to which the short-term release results from an elution of loosely bound fluoride and the long-term release from an erosive leaching of the glass particles in the bulk of the cement. METHODS: Individual fluoride release profiles of five specimens of 10 acid-base setting restorative glass ionomers were obtained by determining the amounts of fluoride released by each sample at 37 degrees C in consecutive elutions for up to 140 days with 25 ml of a 0.01 mol/l acetic acid solution with pH = 4. Differences in the fluoride release profiles were determined with a Multivariate Data Analysis on the basis of a Principal Component Analysis. RESULTS: The fluoride release profiles of the 10 glass ionomers can be classified into five distinct groups which are characterized by a cumulative fluoride release described by the equation [F]c = [F]l t/(t + t1/2) + beta square root of t. The parameters ([F]l, t1/2) and beta are characteristic for the materials in the groups, and refer to the short-term and long-term fluoride release, respectively. The acidic solution enhances both processes compared to an elution in water, the effect being more pronounced for the long-term release. SIGNIFICANCE: The fluoride release mechanism is intrinsically the same as determined for elutions in water. The increased amount of fluoride released under acidic conditions, especially in the long term, corroborates that an erosive leaching of the glass particles in the bulk of the cement accounts for the long-term fluoride release.

Acetic Acid↗
PubMed1998

The uptake and release of fluoride by ion-leaching cements after exposure to toothpaste.

OBJECTIVES: The cariostatic action associated with the glass-ionomer cement (GIC) is usually attributed to its sustained release of fluoride. However the ability of the GIC to act as a fluoride reservoir, taking it up from an external source (e.g. toothpaste, mouthwash) and subsequently releasing it over time, may also be a contributory factor. This study investigated the reservoir effect of various recently introduced ion-releasing cements: two resin-modified glass-ionomer cements (Fuji II LC, Vitremer), a compomer (acid-modified composite resin) (Dyract), and a recently introduced conventional glass-ionomer (Fuji IX). METHODS: Specimens were exposed to a fluoridated toothpaste after 28 and/or 58 days. The release of fluoride into the storage water, both before and after exposure, was monitored using a differential electrode cell. RESULTS: There was no significant difference in the fluoride releases from Vitremer and Fuji II LC. These materials released significantly more fluoride than Fuji IX and Dyract. All the materials released more fluoride on the day after exposure to an external fluoride source compared with the day before exposure. Release rates returned to baseline within 3 days. Within the time periods of the study, only the uptake/re-release of Fuji IX was adversely affected by late exposure. All the materials showed an enhanced uptake and release on repeated exposure to the external fluoride source. CONCLUSIONS: All the materials under test (Dyract, Fuji II LC, Vitremer and Fuji IX) released significant amounts of fluoride and reacted positively to exposure to an external fluoride source.

Cariostatic Agents↗
PubMed2000

Temporal and geographical variation in skeletal fluoride content of roe deer (Capreolus capreolus) from industrialized areas in Germany.

In order to study temporal and spatial variation of environmental fluoride levels, we analyzed the mandibular bone fluoride content of 157 roe deer (age range: 1-11 years) from two industrialized regions (Ruhr area: n = 76, sampling period 1955-1998; area W of Cologne: n = 81, sampling period 1983 1998) in the federal state of North Rhine-Westphalia, Germany. Bone fluoride values (dry weight basis) ranged between 150 mg F/kg (2 year-old specimen taken in 1997) and 5724 mg F/kg (10 year-old specimen taken in 1957). In both study areas, a pronounced decline in mandibular bone fluoride concentrations occurred over the respective sampling periods. In consequence, bone fluoride content of animals (both study areas pooled) taken during the period 1990-1998 was significantly (P < 0.00001) lower than that of roe deer from the period 1955 1989, while the two animal groups did not significantly differ in age. These findings are regarded as indicative of a considerable reduction of fluoride deposition into the animals' habitats, due to effective emission control measures. Bone fluoride values for the period 1990-1998 in the roe deer from the Ruhr area significantly (P < 0.005) exceeded those of the individuals from the study area W of Cologne, while the difference in age between the two groups was not significant. In both study areas, a significant (P < 0.00001) positive correlation between age and mandibular bone fluoride content (Ruhr area: rs = 0.601; area W of Cologne: rs = 0.725) was found for animals taken during this period. The present study underscores the suitability of analyzing skeletal fluoride concentrations in wild roe deer in order to monitor the magnitude of environmental contamination by fluoride and thereby to assess the efficiency of measures taken to reduce fluoride emissions from industrial sources.

Animals↗
PubMed1998

The role of fluoride in the prevention of osteoporosis.

Osteoporosis defined as low bone mass and increased susceptibility to fracture is a reflection of the sum of peak bone mass and any bone that has been lost once peak mass has been attained. Several strategies have been applied to optimize peak bone mass and to prevent bone loss. Fluoride has greatest potential as a therapy for osteoporosis once bone has been lost. It has been demonstrated both experimentally and clinically to stimulate bone formation directly and to increase bone mass in patients who already have osteoporosis. Several bone formation/stimulation therapies are under development, and some of these have reached the stage of clinical trial. None of these therapies has been as extensively studied as fluoride, and none is sufficiently advanced in development to be clinically available in the next 3 to 5 years. Fluoride therapy for osteoporosis is already performed in many countries, and approval for use in osteoporosis in the United States is pending. The first clinical trials of NaF therapy for osteoporosis were reported by Rich and Ensinck in 1961. Since then, hundreds of reports on the successes and failures of fluoride therapy have appeared in the literature. At first glance, it seems disappointing and inexplicable that, after 40 years of research, fluoride is still considered an experimental drug in the United States. One plausible explanation is that much of the early research on this drug was suboptimal, including the author's contributions. Fluoride as a naturally occurring element is difficult to patent, and this has kept major pharmaceutical companies from investing heavily in fluoride therapy despite its obvious potential. As a result, pharmacologic and pharmacokinetics studies of fluoride are limited in scope, as are phase I and phase II human toxicology and dose-finding studies. Most early studies of large doses of plain NaF were unable to demonstrate a consistent effect on fracture rate despite a consistent and dramatic effect on bone density. Once this became obvious and as new technologies for measuring bone density became available, it became equally clear that future clinical trials would have to be performed using different formulations of fluoride and lower doses. This approach has not resulted in uniformly positive clinical trials, and one must look elsewhere for answers. The most compelling explanation is that the trials have included patients with different severity of disease, suggesting that there is point in the bone loss spectrum at which even a potent bone-stimulating agent such as fluoride is ineffective. This possibility should provoke a reappraisal of the earlier negative studies: was the failure a result of the drug or of patient selection? The answer to this question is crucial, because these failures have cast a long shadow over the safety of fluoride and are contributing more to the absence of this drug from the pharmacopoeia than any other factor.

Bone Density↗
PubMed1995

Effects of fluoride on rat vertebral body biomechanical competence and bone mass.

For more than 30 years, sodium fluoride has been a commonly used therapeutic agent for established osteoporosis because of its repeatedly documented anabolic effect on trabecular bone mass. Recent clinical and experimental studies have, however, indicated a possible detrimental effect of fluoride on bone strength. Thus, the efficacy of fluoride therapy remains a controversial issue. The aim of this study was to investigate the effect of fluoride on both vertebral bone mass and quality in rats. Twenty-nine 3-month-old, female rats were randomized into three groups. One group served as a control group, and the other two groups received fluoridated water at different doses (100 ppm and 150 ppm). The rats were followed for 90 days. Three lumbar vertebrae were obtained from each rat, and changes in bone fluoride content, bone mass and biomechanical competence were assessed. The results revealed a significant increase in bone fluoride content, ash density and trabecular bone volume after fluoride treatment. Directly obtained load values and load corrected for cross-sectional area were constant. Load corrected for ash content, which is a measure of bone quality, decreased significantly after fluoride therapy. It is concluded that the increase in bone mass during fluoride treatment does not translate into an improved bone strength and that the bone quality declines. This investigation thereby supports the hypothesis of a possible negative effect of fluoride on bone quality.

Animals↗
PubMed2005

Adenine nucleotides in snail muscles as one of biomarkers of fluoride toxicity.

The aim of this work was to determine the extent of bioaccumulation of fluorides in tissues of Helix aspersa maxima. The toxicity of fluorides administered orally on the energy balance of the snail's foot was investigated based on measurements of concentrations of adenine nucleotides and their metabolism degradation products. Quantitation of fluoride levels was done in soft tissues (foot, hepatopancreas) and shells of mature snails. Qualitative and quantitative analysis of purine compounds was performed in slices of foot from mature snails. Fluoride concentrations in pulverized shells were measured using an ion-selective electrode. Gas chromatography was used to determine fluoride concentrations in soft tissues (hepatopancreas and foot). Purines were measured in foot muscle slices with high-performance liquid chromatography (HPLC). Fluoride levels in soft tissues of the snail cannot serve as an indicator for biomonitoring purposes as no significant accumulation was observed during exposure to maximum allowable concentrations of fluoride in drinking water. Contrary to this, levels of fluoride in the shell rose significantly with this concentration of fluoride in drinking water. The effect of fluorides on energy metabolism of foot muscle was evidenced by elevated AMP levels, increased adenine nucleotide pool and reduced conversion of ADP to ATP. Exposure to rising F(-) concentrations was accompanied by decreasing values of the adenylate energy charge AEC. Determination of AMP or AEC in foot muscle of exposed snails seems to be a useful indicator of fluoride effects on metabolic activity.

Adenine Nucleotides↗
PubMed2000

Fluoride pit and fissure sealants: a review.

There are two methods of fluoride incorporation into fissure sealants. In the first method, fluoride is added to the unpolymerized resin in the form of a soluble fluoride salt that releases fluoride ions by dissolution, following sealant application. In the second method, an organic fluoride compound is chemically bound to the resin and the fluoride is released by exchange with other ions (anion exchange system). This report reviews the literature on the effectiveness of all the fluoride-releasing sealants--commercial and experimental--that have been prepared using either the former or the latter method of fluoride incorporation. There is evidence for equal retention rates to conventional sealants and for ex vivo fluoride release and reduced enamel demineralization. However, further research is necessary to ensure the clinical longevity of fluoride sealant retention and to establish the objective of greater caries inhibition through the fluoride released in saliva and enamel.

Cariostatic Agents↗
PubMed2001

High concentrations of fluoride and boron in drinking water wells in the Muenster region--results of a preliminary investigation.

In 1998, two cases of severe dental fluorosis in schoolchildren occurred in the Muenster region. These cases took place in one household, where fluoridated toothpaste, fluoridated salt, and fluoride tablets were consumed. Furthermore, the family used drinking water from its private well only. Analyses of the well water ordered by local health officials revealed very high amounts of fluoride, boron, and other electrolytes. This unusual combination of high amounts of fluoride and boron could also be found in the water of a great number of other private wells that are the only source for drinking water in this rural region of the Muensterland. Anthropogenic sources could be excluded. Because of this, the results of the water samples were collated to the specific geological situation in this area. In the Muenster region there are marl layers of the chalk era covered with quarternary sediments. The quarternary sediments are up to 10 to 20 metres thick and they usually conduct the groundwater. The marl contains high concentrations of fluoride and boron. In some places the groundwater has contact with these layers. To check the amount of fluoride and boron in the groundwater, indicator values were sought, which can give a hint of high contents of these trace elements. In this study the conductivity and acidity were identified as possible indicators of a high amount of fluoride and boron in the drinking water in this specific region. To work economically and efficiently, the drinking water should be checked for fluoride and boron on a regular basis only when these values are extraordinarily high. In the case of high concentrations, especially of fluoride, in the drinking water the persons concerned should be informed about their potential health risk, giving them the opportunity to optimise the total daily intake of fluoride.

Boron↗
PubMed1976

Effects of fluoride and ethane-1-hydroxy-1,1-diphosphonate on bone metabolism in the growing chick.

White Leghorn cockerols were fed a semipurified diet (containing fluoride at 0 to 800 ppm) from the day of hatching. The birds were also injected daily with solutions containing ethane-1-hydroxy-1,1-diphosphonate (EHDP) at concentrations ranging from 5 to 20 mg as phosphorus/kg of body weight or isotonic saline. Changes in bone mineral composition and plasma Ca, Mg and F were determined as well as alterations in bone pyrophosphatase and the amounts of bone cyclic-3',5'-adenosine monophosphate (cAMP). Since dietary fluoride in high amounts is known to stimulate new bone formation, the purpose of the study was to assess whether a potent inhibitor of mineralization, such as EHDP, might alter the response to high dietary fluoride. Although bone fluoride and magnesium were increased in relationship to dietary fluoride, the administration of EHDP had little effect on these changes at low to moderate levels of fluoride. The levels of soluble bone pyrophosphatase were not greatly influenced by changes in dietary fluoride. Administration of EHDP at 20 mg P/kg, however, typically decreased the levels of bone pyrophosphatase. Bone cAMP did not appear to be influenced by either dietary fluoride or EHDP. Using tissue culture techniques, the effects of fluoride on calcium uptake and release from embryonic chick bone were also studied. The presence of 1 mM fluoride in the medium appeared to stimulate calcium uptake and reduced calcium release from chick bone. In general, the results were in keeping with previous suggestions that the major effect of fluoride on bone is the formation of fluoroapatite and subsequent effects this may have on other metabolic alterations.

Alkaline Phosphatase↗
PubMed1989

Fluoride absorption from the gastrointestinal tract of rats.

The contribution of the stomach and the small intestine to absorption of fluoride from the gastrointestinal tract was examined in rats. Fasted adult male rats weighing approximately 350 g were given 50 micrograms of fluoride in 1 ml of water by stomach intubation, with 14C-labeled polyethylene glycol as a marker of water movement through the gastrointestinal tract. Rats were killed at intervals up to 120 min, and the stomach, duodenum, jejunum, ileum, distal ileum and cecum were rapidly clamped and removed for fluoride analysis and 14C counting. Approximately 90% of the fluoride dose was absorbed in 120 min. Peak plasma fluoride concentration occurred 10 min after intubation and began to decline after 40 min as the rate of fluoride absorption slowed. Absorption from the stomach was derived from rates of gastric emptying and remaining fluoride. Even at 10 min after intubation, when the bulk of the fluoride remained in the stomach, only approximately 25% of fluoride absorption had occurred from the stomach and 75% from the small intestine. After 120 min, 19.8% of total fluoride absorption had occurred from the stomach. Although the stomach is unquestionably a significant site for fluoride absorption, its contribution is much smaller than that of the small intestine.

Animals↗
PubMed1987

Effects of fluoride and caffeine on the metabolism and motility of ejaculated bovine spermatozoa.

Treatment of washed, ejaculated bovine sperm with 30 mM sodium fluoride immobilized the cells in a characteristically rigid form. In cells metabolizing endogenous substrates, fluoride decreased respiration by about 60%, but did not inhibit the cells' ability to produce adenosine-5'-triphosphate (ATP) via oxidative phosphorylation and did not block access to endogenous substrates. Fluoride-immobilized sperm maintained maximal ATP titers for at least 60 min, but oligomycin treatment rapidly depleted ATP, indicating that ATP synthesis and metabolism was occurring in immobilized sperm. The putative phosphodiesterase inhibitor caffeine (2.5 mM) restored motility and increased respiration in fluoride-treated sperm, but 8-bromo-adenosine-3',5'-monophosphate (8-bromo-cAMP) did not, even though 8-bromo-cAMP stimulated respiration in control (untreated) sperm. Carboxyfluorescein analysis of the intracellular pH of untreated sperm indicated a normal pH of 6.3. Fluoride addition decreased the apparent intracellular pH slightly, but this effect was attributable to dilution. Caffeine did not change internal pH in untreated or fluoride-immobilized sperm. Fluoride did not appear to affect cAMP metabolism, but caffeine increased intracellular cAMP titers by about 35% in both untreated and fluoride-inhibited sperm. However, caffeine treatment did not mimic 8-bromo-cAMP, as analyzed by electrophoresis and autoradiography of sperm proteins labeled with 32P from endogenously generated [32P]ATP. Clearly, caffeine is not stimulating motility in fluoride-treated sperm by affecting the cyclic AMP system. Fluoride also inhibited motility in digitonin-permeabilized sperm by a mechanism that may have involved magnesium depletion, but caffeine had no stimulatory effect on either untreated or fluoride-immobilized, permeabilized sperm.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1978

Acceptance, caries reduction and reported adverse effects of fluoride prophylaxis in Norway.

Water fluoridation has not been introduced in Norway, although 99% of the population receive water with suboptimal fluoride levels. Alternative methods of fluoride prophylaxis have gained wide acceptance in this country. While less than 1% of the children received fluoride tablet in 1971, sales data in 1976 indicated a daily supply of fluoride tablets to 50% of the 0-5-year-olds and to 20% of the 6-11-year-olds. Most schoolchildren have joined mass prophylactic programs with regular with regular applications of fluoride solutions. Furthermore, fluoride-containing dentifrices have become available and are increasingly used. The increased use of fluoride has been paralleled by a marked reduction in caries and restorative need. During the past 5 years, a reduction of about 45% in the number of fillings inserted in 6-17-year-old children has been noted. In some areas, a 70% reduction has been recorded. The ratio between expenses for prophylaxis and savings in cost of treatment is favorable. The Norwegian Adverse Drug Reaction Committe received 34 case reports of adverse effects ascribed to fluoride prophylaxis, from 1970 to 1977. None of the 25 follow-up studies performed, suggested fluoride to have been responsible for the reported symptoms. In Norway, the benefits of fluoride prophylaxis are becoming increasingly evident.

Adolescent↗
PubMed1999

Fluoride supplements for young children: an analysis of the literature focusing on benefits and risks.

The use of fluoride supplements to prevent caries has been advised for more than 100 years, but serious promotion of this strategy occurred only after the effectiveness of water fluoridation was established, in the late 1950s and 1960s. Although the effectiveness of fluoride supplements was apparently endorsed by many small clinical studies, closer examination of the experimental conditions of these, their methods and the analysis of their results undermined confidence in their findings. It is likely that confounding resulted in spurious conclusions in many of them. More modern, well-conducted clinical trials of supplements suggest that today, in children also exposed to fluoride from other sources such as toothpaste, the marginal effect of fluoride supplements is very small. There is evidence that fluoride lozenges, designed to maximise any local effect, may have a small caries preventive effect, particularly in deciduous teeth. Overall, poor compliance makes fluoride supplements a poor public health measure. Supplement use by young children is associated with a substantial risk of dental fluorosis. Fluorosis is an issue about which the public is becoming concerned in several countries and this concern, if translated into opposition to all fluoride use, could jeopardise the most successful caries preventive aid we have. The potential for dental fluorosis, concern about the public's reaction to this, the poor effectiveness of supplements and the public's poor compliance with their use are persuasive arguments for a radical reduction in the use of supplements by young children. Recent changes in fluoride dosage schedules and deferment of the age of commencing the use of supplements, implemented in many countries, have followed from these concerns. Supplements formulated as lozenges maximise topical exposure of enamel to fluoride and such products may offer older children and some adults a way of maintaining an elevated fluoride level in saliva at times when toothbrushing is not practical.

Cariostatic Agents↗
PubMed2004

A European perspective on fluoride use in seven countries.

OBJECTIVES: The aim of this study was to collate data on national policies for the use of fluoride in the seven European countries participating in the FLINT project. METHODS: Policies on the use of fluoride were obtained for each of the study areas. Data collected included the presence of water fluoridation and regulations governing fluoride toothpaste and fluoride supplements. RESULTS: In Ireland 74% of the population had a fluoridated water supply but in all the other countries fluoride toothpaste was the principal form of delivering fluoride, usually recommended as a dose of a pea-sized amount. Fluoride supplement use varied considerably between countries. The Netherlands had the clearest regulations covering the use of fluoride supplements and definition of at-risk individuals. Most countries, even if they recognized particular caries-risk did not define the term clearly. In Iceland all children were regarded as being at high risk of developing caries. CONCLUSION: Considerable variation exists between European countries in their policies for fluoride use and no clear definitions of high-caries-risk individuals were found. The results show that there is even a lack of coherent thought and planning within the different countries, let alone between them.

Cariostatic Agents↗