Fluoride treatments
Fluoride treatments are dental care procedures aimed at preventing tooth decay by enhancing the mineral composition of tooth enamel. This process involves the application of fluoride ions, which can be ingested through various sources such as drinking water, toothpaste, and dental treatments. Fluoride helps transform hydroxyapatite, the main mineral in tooth enamel, into fluorapatite, a compound that is more resistant to acid and decay. Many municipalities in the U.S. add fluoride to their water supply at a standard concentration of 0.7 milligrams per milliliter to combat tooth decay effectively.
The use of fluoride has led to a significant reduction in dental cavities, and it is routinely included in many commercial toothpastes and gels. While fluoride treatments primarily target children and teenagers, some adults may also benefit from them during dental visits. However, caution is necessary, as excessive fluoride exposure can lead to toxicity, particularly in young children, resulting in dental discoloration or other complications. Concerns have been raised about the potential links between fluoride and bone health issues in older adults, though research findings are mixed. Overall, fluoride treatments play a crucial role in modern dental health practices, promoting stronger teeth and reducing decay risk.
Subject Terms
Fluoride treatments
Anatomy or system affected: Gums, mouth, teeth
Definition: Treatment of the teeth with a fluoride-releasing substance to help the enamel resist tooth decay
Indications and Procedures
Tooth decay involves the solubility of food during eating. Consumed carbohydrates are oxidized to organic acids, such as lactic acid, by the action of specific bacteria that adhere to the teeth. These acids dissolve tooth enamel, which mainly consists of a mineral called "hydroxyapatite" and is considered the hardest substance in the body. The protection of the enamel, and thus the inner part of the tooth, from decomposition can be achieved through fluoride treatments.
Fluoride treatment involves the ingestion of fluoride ions in drinking water, toothpaste, dental treatments, and other sources to change the nature and composition of hydroxyapatite by producing a new compound called "fluorapatite." Because it is less alkaline than hydroxyapatite, fluorapatite forms a more resistant enamel. Because of its effectiveness in preventing cavities, fluoride is added in the form of sodium fluoride or sodium hexafluorosilicate to the public water supply of many US municipalities in concentrations of 0.7 milligrams per milliliter, or just under 1 part per million. Historically, this number was as high as 1.2 milligrams; however, in 2015, 0.7 milligrams became the standard level.
Uses and Complications
As a result of this fluoridation process, a drastic reduction in dental decay has been observed. In addition, most commercially available toothpastes and gels contain fluoride in the form of sodium monofluorophosphate or sodium fluoride in concentrations of about 0.1 percent fluoride by weight. Stannous fluoride, introduced in the 1950s, has been less commonly used since the 1990s.
The recommended annual or semiannual dental cleaning by a dentist or oral hygienist removes accumulated plaque and may include further application with a fluoride substance in the form of a gel, foam, or varnish. Generally, only children and teenagers receive such a fluoride treatment, although some adults may also have it.
It must be noted that fluoride ions are toxic in large quantities. As a result, when the fluoride concentration in water is about two to four parts per million, discoloration (mottling) or damage to the teeth may occur. Study data conflict regarding whether fluoridation is associated with increased risk of osteoporosis and bone fractures in older adults. Fluoride toxicity is weight- and age-dependent, so the risks are greatest in young children.
Bibliography
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Foster, Malcolm S. Protecting Our Children’s Teeth: A Guide to Quality Dental Care from Infancy Through Age Twelve. New York: Insight Books, 1992.
National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health. "Community Water Fluoridation: Fluoridation Basics." Centers for Disease Control and Prevention, 27 Apr. 2012.
Smith, Rebecca W. The Columbia University School of Dental and Oral Surgery’s Guide to Family Dental Care. New York: W. W. Norton, 1997.
“Water Fluoridation and Cancer Risk.” American Cancer Society, 18 Nov. 2022, www.cancer.org/cancer/risk-prevention/chemicals/water-fluoridation-and-cancer-risk.html. Accessed 22 July 2023.
Wood, Debra, and Brian Randall. "Fluoride and Your Bones: A Mixed Bag." Health Library, 13 June 2012.
Woodall, Irene R., ed. Comprehensive Dental Hygiene Care. 4th ed. St. Louis, Mo.: Mosby, 1993.