What are fluoride treatments?

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, 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 milligram per milliliter, or just under 1 part per million.

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 2–4 parts per million, discoloration (mottling) or damage of 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

A.D.A.M. Medical Encyclopedia. "Fluoride in Diet." MedlinePlus, June 14, 2011.

Ash, Major M., Jr., and Stanley J. Nelson. Wheeler’s Dental Anatomy, Physiology, and Occlusion. 9th ed. St. Louis, Mo.: Saunders/Elsevier, 2010.

"Fact Sheets: Oral Health."World Health Organization, April 2012.

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, April 27, 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.

Wood, Debra, and Brian Randall. "Fluoride and Your Bones: A Mixed Bag." Health Library, June 13, 2012.

Woodall, Irene R., ed. Comprehensive Dental Hygiene Care. 4th ed. St. Louis, Mo.: Mosby, 1993.