Synoynme in a broader sense
Fluoride therapy
Introduction
In dentistry, fluoridation of teeth is performed as a prophylactic measure. Numerous scientific studies prove that fluoride helps in caries prophylaxis. In dentistry, only low doses of fluoride are used, which are completely harmless to health. For example, the fluoride content of toothpaste is limited to 1500ppm (parts per million). In children’s toothpaste, it is reduced to 250 to 500ppm, because children could swallow a large portion of the toothpaste and, in combination with fluoride tablets, could systemically absorb too high a dose of fluoride.
How does fluoride work?
Daily food causes acid attacks on the enamel. The enamel is demineralized by demineralization, i.e. calcium is dissolved from the enamel. On the other hand, calcium is also re-integrated from the saliva, this process is called remineralization.
As long as demineralization and remineralization balance each other out, no caries will form. Only when remineralization can no longer replace the loss of calcium, caries will occur. Fluorides support the remineralization of saliva and thus help to prevent the spread of caries.
The onset of decalcification due to acid attacks does not occur on the surface of the tooth enamel, but immediately below it. As long as the surface is not destroyed, remineralization can prevent the onset of a carious defect. However, if the surface has already been destroyed, the process cannot be stopped by remineralization.
This promotion of remineralization is the one particularly important effect of fluorides. The second effect of fluorides is the hardening of the dental enamel by incorporation of fluorine ions into the enamel. This increases the fluorine content in the apatite of the enamel, which improves the crystal structure and reduces the solubility.
Both of these effects result in a higher resistance to acid attacks. The enamel hardened in this way cannot be attacked so easily by acids. Fluorides thus have a preventive and a repairing effect.
What are the side effects?
If fluorides are used in therapeutic doses, no side effects occur. The situation is different, however, if they are applied in too high a dose, fluoride poisoning may occur. Especially in children, the effects on the teeth are very noticeable.
The permanent teeth can get discoloration, which is called fluorosis. In most cases, brown stains on the teeth can be seen later if excessive doses are taken during childhood. In addition, a tooth damaged by fluoride is not as resistant as an undamaged tooth.
Excessive fluoridation occurs, for example, when drinking water is fluoridated, a fluoride-containing toothpaste is used and fluoride tablets are also administered. It is therefore advisable to take this substance, if possible, through food or jellies to avoid taking tablets. If there is an external overdose of fluoride, whitish spots on the teeth may appear.
In adults there are no side effects on the teeth, but symptoms of poisoning such as irritation of the intestines, vomiting or diarrhoea may occur. If these symptoms occur, you should definitely consult a doctor. If you have ever taken too much fluoride, a glass of milk can help.
The calcium contained in the milk binds the excess fluoride. Please consult your pediatrician or dentist about the exact amount of fluoride you should take. Fluorosis of the teeth means a more or less pronounced discoloration of the permanent teeth, less of the milk teeth.
The color scale ranges from slightly yellowish to brownish. Corrosion can also be present. These are not damages in the sense of caries, but irreversible aesthetic changes that can only be corrected by prosthetic treatment.
The cause is a too high daily dosage of more than 2mg fluoride during the growth phase of the teeth as long as they have not broken through. The decisive period is the phase of tooth development, in which the tooth germs are still supplied with blood. In teeth already in the oral cavity, even very high doses of fluoride cannot lead to such changes.
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