Fluoride: Impact on teeth & Fluoridation methods

Fluoride is a natural mineral that is essential for our body. It's a fundamental element for bones and teeth, but it can become dangerous if it is consumed in excess and can cause poisoning.
Fluoride has multiple effects:

Effects on teeth:

    benefit of fluoride on dental eamel
  • During the maturation of the tooth, the fluoride is fixed in the internal structure of the enamel, improving the resistance of the tooth to acid attacks, thus reducing the risk of tooth decay.
  • Fluoride acts on the surface of enamel, contributing to the maturation of the teeth. It has an action in the process of remineralization. A part of the fluoride administered orally is fixed at the tooth surface leading to remineralization of the injured sites.
  • Thanks to the antibacterial action of fluoride, it can stop and remineralize superficial caries lesion.

Effects on bacteria:

On bacteria, fluoride inhibits enzymes essential for the growth of bacteria. It has a direct action by destroying the bacterial cells.
As a RESULT: bacterial death, slow growth, inhibition of bacterial metabolism.

Top 8 fluoridation methods:

Several fluoridation methods can be used to increase the resistance of teeth against carious attacks:

Fluoridated water:

fluoridated water

Fluoridation of water with a fluorine concentration <1 mg/L (1ppm). Adopted in many countries. Very practical but does not allow respecting individual freedom of choice.
It was introduced in the USA in 1945 and gave positive results. More than 70 years of research has shown that fluoridated water is linked to decreased risk of tooth decay by 35-50%.
Water should be unfluoridated for people living near factories where the amount of fluoride in water and air EXCEEDS recommended limits.

Fluoridated salt:

fluoridated salt

Promoted by the Swiss (in 1946). The fluorides used are:

Studies initiated in the early seventies showed that fluoride, when added to salt, inhibits dental caries.
The cariostatic potential of salt fluoridation has been well proved (caries reductions up to 50%). In Europe, meaningful percentages of users have been attained only in Germany (67%) and Switzerland (85%).

Fluoridated milk:

Has no proof of effectiveness. The amount of fluorine in the milk absorbed by our body is too limited.

Fluoridated tablets or drops:

Fluoridated tablets or drops:

Important preventive potential, recognized in 1960.
Prescribed in case of absence of other sources of fluoride.
The fluoridated prescription requires an assessment of the amount of fluoride ingested by the individual in order to avoid the OVERDOSE (toxicity).

Fluoride toothpaste:

There is toothpaste cosmetics which contains a normal amount of fluoride, between 1400-1500ppm.
Pharmaceutical toothpaste which contain a large amount of fluoride intended for people who have a high risk of developing caries.

The primary benefit of using fluoride toothpaste is to reduce the risk of developing cavities and other types of tooth decay.
In addition, toothpaste contains other antiseptic and solvent elements that will complement the action of the toothbrush.

Fluoride mouthwash:

Reserved for high-risk patients with active caries.

-Daily rinsing for a small concentration.
-Weekly rinsing for a high concentration.
The mouthwash without the mechanical action of the toothbrush is not enough.
It works by protecting your teeth from acids produced by the bacterial plaque, but it's not a substitute for brushing and flossing. A fluoride rinse allow the fluoride to incorporate into the enamel, so it can help protect against cavities in people who are susceptible.
Even though a proper amount of fluoride is important for adults, it can be especially crucial for children.
Carefully watch children during use and teach proper rinsing habits to avoid swallowing.

Fluoride gel:

fluoride gel

High concentration of fluoride (powerful effect on teeth). Immediately increases fluoride in the enamel, recommended for people with high risk to develop caries.
It has the advantage of being more precise, and the risk of ingestion is low.

Fluoride varnish:

High concentration of fluoride, applied by the dentist, so the risk of ingestion is low. Adhere for a long time (a few weeks) to the surface of the enamel.

Toxicology of fluoride:

Fluoride has a toxic potential when it is absorbed in excessive amounts. There are 2 types of poisoning:

  • Acute intoxication: Rare, results from the absorption at once of an excessive amount of fluorine. The fatal dose is 48 mg/kg for adult and 5 mg/kg for child;
    For example for an adult who weighs 70 kg, the lethal dose will be: 70x48=3360 mg of fluoride.
    The symptoms are: vomiting, digestive hemorrhage, nephritis, damage to the liver or thyroid gland.
    WHAT TO DO? Provoke vomiting, absorb large amounts of milk and take the patient to an emergency service!
  • toxicology of fluoride Chronic intoxication: Ingestion of 1.5-2 mg/kg each day for long periods.
    Much more widespread. Represents a big risk for people who live in regions where fluoride exists in significant quantities in soils, water and air.
    The signs are: fluorosis (alteration of the enamel) and skeletal (thickening of the bone tissue and deformation of the framework).
The origin of intoxication is not only therapeutic (toothpaste, mouthwash, gels...). There is another natural sources:
    fluoride source Fluoride in soils: particularly abundant in the vicinity of eruptive rocks and some mineral deposits (especially phosphate).
  • Fluoride in water: Major source of fluoride ingestion, which mainly comes from the dissolution of rocks or soils covered by water.
  • Fluor in foods: In most foods (fish, tea, cereals, meat, milk ....)
"The intake of fluoride by food is estimated at 0.2 mg / day for adults, half for the child!"