Tooth decay is the most common cause of toothache, especially in children. Since fluoride participates in the build-up of natural tooth enamel, additional fluoride supply is often resorted to in caries prophylaxis. This is also known as fluoridation. However, it is not without controversy.
What is fluoridation?
Since fluoride participates in the buildup of natural tooth enamel, additional fluoride supply is often resorted to in caries prophylaxis. Fluoride is a trace element that occurs naturally in the human body. Among other things, it is involved in bone formation and the maintenance of tooth enamel. The human organism usually has a quantity of about 2 – 5 grams of this element at its disposal. Of this amount, more than 95 percent is found in the bones and teeth. The remaining amount of fluoride is found in the fingernails and toenails, as well as in the hair and skin. If the body becomes deficient in fluoride, the organism cannot be adequately supplied with this micronutrient. For this reason, the food and pharmaceutical industries sometimes resort to fluoridation. This means an additional supply of fluoride via food and dental care products. It involves the addition of fluorides to products such as milk, salt and drinking water. Many toothpastes are also fortified with a high dose of fluorides. The main purpose of fluoridation is to prevent tooth decay. That is why fluoride preparations are also used to protect against caries. Since fluorine is very toxic as a gas, different fluoride compounds are used for fluoridation:
- Sodium fluoride: in fluoride tablets and toothpastes,
- Tin(II) fluoride: in toothpastes,
- Amino fluorides: in toothpastes and gels,
- Potassium fluoride: in table salt,
- Sodium monofluorophosphate: in toothpastes,
- Fluoridosilicates: in drinking water.
Function, effect and goal
It is known that high-dose fluoride protects against tooth decay. This effect is enhanced by applying it directly to the tooth. Therefore, the pharmaceutical industry produces a wide range of fluoride-containing toothpastes and dental rinses for caries prevention. Dentists also perform external fluoridation of teeth in many cases. They seal existing cavities and dangerous spots with a fluoride varnish, for example. Although the positive effect on the tooth enamel is not as strong as with external application due to the intake of fluoride through food, the body still benefits from moderate fluoride intake. Thus, the ingested fluoride has a remineralizing effect on the tooth enamel from the inside. After eating, bacteria process the nutrients, producing acids. These attack the minerals stored in the enamel. The loss of minerals reduces the protection of the teeth. At the same time, the risk of tooth decay increases. With the help of fluoridation, the minerals that have been removed are deposited back into the tooth enamel. In addition, fluorides have the function of inhibiting bacterial metabolism and thus the production of acids. Thus, internal fluoridation also contributes to the maintenance of dental health in the long term. In everyday life, increased fluoride intake can also be controlled through diet, for example with fluoridated salt as well as mineral water containing fluoride.
Risks and dangers
Fluoridation is still controversial among experts because it can be associated with the risk of poisoning; after all, fluorine is also a very toxic gas. Even in very small quantities, it has a toxic effect on the human organism. For this reason, fluoride rather than fluorine is used for fluoridation. However, the latter can also be toxic to the body if taken or applied in large quantities. Thus, the use of highly concentrated toothpastes also requires strict dental control. Anyone who already cooks with fluoridated salt in everyday life should not take fluoride tablets in addition. There is a risk of overdose especially if a very large amount of fluoride is taken at once or if several fluoride-containing products are used at the same time. In rare cases, an overdose can lead to fluoride poisoning, so-called fluorosis. The symptoms vary greatly. They also depend on whether the fluoride overdose occurred internally or externally.If too much fluoride has been applied to the teeth, white spots become visible on the teeth. If, on the other hand, a large amount of fluoride has been ingested, symptoms of poisoning may occur. These manifest themselves as nausea, abdominal pain, diarrhea and vomiting. In the worst case, intestinal irritation, cardiac arrhythmia or blood clotting disorders may also occur. If the overdose is only slight, a glass of milk can also help. The calcium contained in milk has the property of binding excess fluoride. Alternatively, a calcium effervescent tablet can counteract fluoride overdose. If a child has eaten an entire pack of fluoride tablets in one sitting, a doctor should be consulted immediately. However, fluorosis rarely occurs if fluoride-containing products are used very consciously.
