Fluorides are known to most people from dental care. Many toothpastes today contain a proportion of sodium fluoride, there are fluoride tablets and drinking water fluoridation, and for some years even table salt with a fluoride content. Fluoride as a mineral is indispensable for building bones and teeth, but fluoridation is nevertheless not uncontroversial in the field of health prophylaxis.
What is fluoride?
The exact mode of action of fluoride on the body cannot be fully determined. However, it seems likely that the fluoride in toothpaste hardens tooth enamel. Fluorides are compounds of fluorine, a highly toxic gas that is classified as a chemical element of the halogens. Because fluorine reacts quickly with other substances, it does not actually occur in pure form in nature, but combines with other substances, which are then called fluorides. Such compounds include sodium fluoride, known from toothpastes, or calcium fluoride.
Pharmacological effect
The exact mode of action of fluoride on the body cannot be fully determined. However, it seems likely that fluoride hardens tooth enamel. Normally, this is exposed to acid attacks by food and drink every day. These cause minerals to be dissolved out of the dentin and this process leads to the formation of holes in the enamel in the long term. Fluoride prevents this process, although it is not possible to say exactly how, probably through an interaction of various effects. The hard enamel that coats the dentine is made of the mineral apatite. When fluoride is added, it combines with the apatite of the enamel to form fluorapatite, which is more acid-resistant than normal enamel. In addition, fluoride inhibits the metabolism of bacteria that produce acids in the interdental spaces. And last but not least, fluoride helps minerals that have been removed by acids to be reabsorbed into the tooth enamel. This triple action provides better protection for teeth.
Medical use and application
There are several ways and procedures to prevent tooth decay:
Systemic fluoridation.
This includes drinking water fluoridation. Here, fluoride is added to the drinking water, thus ensuring that everyone receives a minimum amount of fluoride. For some years now, there have also been additives in table salt on the market that have the same effect. Fluoride is added to children in the form of fluoride tablets as a preventive measure up to the age of 12 to make the tooth enamel more resistant. Systemic fluoridation, however, is less effective at preventing tooth decay because of its lower concentration. Local fluoridation
Local fluoridation is done through the teeth. This involves using fluoride toothpastes at least twice a day. In addition, a fluoride gel can be applied to the teeth once a week, which is even more effective than toothpastes. Especially in cases of higher susceptibility to caries and sensitivity of the tooth necks, this method is more effective than brushing with a fluoride toothpaste alone. Even more effective than gels are fluoride varnishes, which adhere to the tooth much longer and are more concentrated. These are applied locally to the teeth in dental practices. In children, the fissures on the molars are filled with fluoride varnish as a preventive measure to prevent premature fissure caries. Fluoridated mouthwash solutions also help and are comparable in concentration to the gels.
Risks and side effects
Fluorine in itself is a toxic element and can cause poisoning in higher doses. About the harmfulness of the prophylactic, which is considered harmless to health, opinions differ. Proponents prove the benefit and harmlessness of fluoride prophylaxis by appropriate studies, critics see in it all possible causes of disease and side effects. Of course, every person reacts individually to any kind of medication. An undisputed side effect of dental fluoridation is dental fluorosis, an unsightly, yellowish-spotted discoloration of the teeth caused by an overdose of fluoride. Long-term, high overdose can also cause disturbances in bone structure. But whether fluoridation can also be made responsible for disease patterns such as allergies, cardiovascular diseases, strokes, high blood pressure, rheumatic diseases, etc., this has so far neither been proven nor disproven in studies.
