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THE FLUORIDE STORY
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. Let's, 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. That's 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 minreals 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.
It's 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 we've 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 doesn't 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 dentist's office.
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