Topical fluoride vs.

Water
Fluoridation
Rocio Garcia
Kristin Lemmon
and Archie McCoy

Fluoride
What is it?

Fluoride is the ionic form of fluorine

Fluoride is a mineral found in the
earths crust & its widely distributed
in nature.
Fluoride found in food:
High amounts: sea foods and
tea leaves.
Low amounts: fruits, vegetables,
cereals

Ways of using fluoride for

prevention of dental caries
Systemic: Ingested (during tooth
development)
Water fluoridation
Tablets
Drops
Fluoridated milk/salt

Topical: Applied (after eruption)

Fluoride varnish (only applied in

dental office)
Mouth rinses
Toothpaste

History of Water Fluoridation

Colorado Brown Stain:

In 1901 Dentist Mckay traveled to Colorado

Springs
He discovered that the majority of the
population had brown stains in their teeth and
there was no dental cavities!
He found the the source was the water they
were drinking
Years pass and the condition of the brown
satin was later called fluorosis
He concluded that the incidence of mottled
enamel were halted by reducing the level of
fluoride in the water

fluorosis: excessive intake of

fluorine compounds, marked by
mottling of the teeth and, if severe,
calcification of the ligaments

Water Fluoridation

Initiated in 1962 to combat

tooth decay
Commonly in the United
States
CDC recommends 0.7 ppm
fluoride in community
water systems.
Most economical method
of community fluoride
delivery

NEWS
Back then Water Fluoridation concentration
was 0.7 ppm to 1.2 ppm depending on the
geographical area you live.
But now the CDC changed it to 0.7 ppm
because fluoride is now everywhere, and that
way there is less chance to develop fluorosis

Study Water Fluoridation

A New York study (2010)

57 counties and New York City
during 2006
Observed 606,125 children
younger than 21, under the
Medicad program.
They divided the counties that
had high to low fluoridated
water and compared.

Low-income children in less

fluoridated counties needed 33% more
fillings, root canals, and extractions
than those in counties where fluoridated
water was common

Topical Fluoride
Can either be professional applied (dental
office)or self applied.

Self Applied Fluoride

-Dentifrices(toothpaste) :
Is the most known source of topical fluoride.
Fluoride was added to toothpaste in the 1950s.
On August 2014, the AAP issue the following new

recommendation; Fluoridated toothpaste is recommended

for all children starting at tooth eruption.
A small smear toothpaste (size of a grain of rice) should
be used up to age 3. After the age of 3, pea sized amount
should be used.

Mouthwash

Lowest concentration of fluoride compared to toothpaste and varnish.

Children under the age of 6 should not use mouthwash.(However, a study
in Japan stated that 45 year-olds can rinse under supervision.
Children with newly erupting teeth may gain a long term benefit from using
mouth rinses.
Fluoridated mouthrinse programs has been implemented in the United
States.
The state department of health sponsors schools to provide a mouth rinse
program. Mainly elementary schools in a non fluoridated community.
Cost is .25 cent a year per child.
Reduces tooth decay 31%
Children rinse with a 0.2% NaF one minute each week.

1.

ff

mouthrinse is placed in disposable cups

3.
Empty rinse into the cup

2.

Under adult supervision children's rinse for one minute

varnish

5% sodium Fluoride
Arrest incipient decay and reverse carries process.
Prevents and reduces demineralization during orthodontic treatment.
A study showed that when the dentist apply varnish around the teeth and
braces every time it is adjusted, the risk of developing white lesions around
the teeth is reduced by 70%.
Three-month fluoride varnish application reduces radiation caries and
sensitivity.

To Fluoridate or Not to Fluoridate?

Known as an
enzyme disrupter.
Ability to
derange
enzymes of
cariogenic
bacteria.
Alters tooth
composition
making more
permanently
resistant to to
acid
dissolution.

Enzyme disruption
is not exclusively
on teeth.
66 enzymes
are affected by
Fluoride

In 2013 Portland
Oregon residents
voted for the 4th
time to remove
fluoridation of their
water supply

Pros & Cons of Fluoride

PROS

Provides greatest benefit to the population that can least afford preventive and
restorative dental treatment.
Prevention of tooth decay.
Enhances tooth remineralization.
Inhibits tooth demineralization.
Reduces time away from work or school.
Safe at optimal levels.
Cost effective (water fluoridation)
Higher job opportunities with a healthy smile

Pros & Cons of

Fluoride
CONS

Excess Fluoride
toxicity-lethal dose can kill
fluorosis (systemic only)
hypomineralization
risk occurs only during
pre-eruptive stages of
tooth developmentchildren 8 years &
younger
Fluoride Supplements
interfere with some
medications

Dental Fluorosis

First sign of fluoride toxicity.

Can be caused from a
combination of both systemic &
topical fluoride exposure
Appears to be an aesthetic
issue.
Actually in severe cases is
causes enamel to be brittle and
may break down.

THE END

Citations
British Dental Journal 212, 315 - 320 (2012)Published online: 13 April 2012 | doi:10.1038/sj.bdj.2012.260
Cate, J. (2013). Contemporary perspective on the use of fluoride products in caries prevention. British Dental Journal, 214(4), 161-167. doi:
10.1038/sj.bdj.2014.162
Dholam, K. P., Somani, P. P., Prabhu, S. D., & Ambre, S. R. (2013). Effectiveness of Fluoride Varnish Application as Cariostatic and
Desensitizing Agent in Irradiated Head and Neck Cancer Patients. International Journal of Dentistry, 2013, 824982. http://doi.org/10.
1155/2013/824982
Helal Sonbul, Dowen Birkhed Swed Dent J.( 2010)The preventive effect of a modified fluoride toothpaste technique on approximal caries in
adults with high caries prevalence. British Dental Journal. 34(1), 916.
Kumar JV, Adekugbe O, Melnik TA. (2010) Geographic Variation in Medicaid Claims for Dental Procedures in New York State: Role of
Fluoridation Under Contemporary Conditions. Public Health Reports. 125(5),647-54.
Nalbantgil, D., Oztoprak, M. O., Cakan, D. G., Bozkurt, K., & Arun, T. (2013). Prevention of demineralization around orthodontic brackets using
two different fluoride varnishes. European Journal of Dentistry, 7(1), 4147.
Neidell, M., Herzog, K., & Glied, S. (2010). The Association Between Community Water Fluoridation and Adult Tooth Loss. Am J Public Health
American Journal of Public Health, 1980-1985.
Peckham, S., & Awofeso, N. (2014). Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health
Intervention. The Scientific World Journal, 1-10.