Fluoridation,
is one of the most of the most effective and economical method
of protecting the tooth against decay, and is one of the greatest
achievements in the history of public health.
Like vaccination, and chlorination, this is one of
the more controversial public health measures of its time. Lets,
however try and unravel the mystery of Fluoride, solve some of
the queries and dispel some of the myths surrounding its (mis)
use.
COMMONLY
ASKED QUESTIONS
What is fluoride?
What does it do? How is it used? How safe is it? Does it do adults
any good?
These are some of the commonly asked questions people ask regarding
fluoride. I am particularly interested in answering them, as a
practicing pediatric dentist, I am asked these questions very
often by parents.
WHAT
ARE FLUORIDES?
Fluorides are a large group of chemical compounds formed when
fluorine combines with other elements. Fluorine is never found
by itself in nature. Fluorides are found everywhere- in soil,
air, and water, as well as in plant and animal life. Thats
why most foods contain some amounts of fluoride.
HOW
DOES FLUORIDE WORK?
The hardest substances in the body are bones and teeth. When the
teeth are forming, the minerals needed are brought to the jaw
and deposited in the tooth buds by the blood stream. When one
of these minerals, fluoride, is in adequate supply, it is incorporated
into the enamel of the tooth, and the resulting mineral structure
is stronger than it would be without the fluoride. As a result,
the enamel will be more resistant to attack by the acids that
form in the mouth and set the stage for decay.
Its important, then, to get fluoride to the
teeth when they are mineralizing. That means from birth, when
the primary teeth are forming, right through the development of
the adult molars and even later.
THE
FLUORIDE RESERVOIR
Years ago it was believed that the fluoride incorporated in the
teeth at the time they formed was the most important in terms
of future resistant to cavities. The theory was that if fluoride
was an integral part of the tooth structure, the tooth would be
less susceptible to decay for a lifetime.
Now weve revised our thinking about that.
Recent research has shown that the major action of
fluoride takes place not inside the tooth, but at its surface,
when the fluoride comes in contact with saliva and plaque. Fluoride
from all sources is stored in the mouth-and on the teeth, in the
plaque, in saliva and the soft tissues, ready for action. THIS
is your fluoride reservoir.
Normally, there is an on going exchange of minerals
between the enamel and the saliva. But when you eat, decay-causing
bacteria in your mouth begin to feed, producing acid as a byproduct.
That acid can upset the balance of mineral exchange, causing the
tooth enamel to lose more mineral than it takes up. This results
in a net loss of mineral for the tooth or "demineralization,"
and is the start of a cavity. BUT, if the fluoride reservoir is
full, then this is a different story. The same acid that leads
to demineralization triggers off a release of fluoride, which
then becomes available "when" and "where"
it is needed. This fluoride not only inhibits demineralization,
but also promotes remineralization, rebuilding and reinforcing
the tooth enamel, so that it is stronger. In effect the fluoride
"heals" the cavities in the early stages of development.
Many parents are often surprised that the pediatric
dentist may recommend a topical fluoride application to remineralize
an initial cavity. Only if that approach doesnt work, then
the dentist will recommend filling the cavity.
There are two basic ways to get fluoride
- Swallow it- as with supplements, or fluoridated water (Systemic
fluoride)
- And Topical application- as with daily fluoride toothpaste,
mouth-rinses, or gel treatments at the dentists office.
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Last
updated on 03-04-2002