Current fluoride therapy in dentistry for children

Author(s): S Adair
Journal: Current Opinion in Dentistry
Volume (number): 1:583-591
Month, Year: 1991
Major topic: Fluoride
Minor topic(s): Fluoride
Type of Article: Literature review
Main Purpose: Review literature regarding use, implications, and complications of fluoride supplementation and application.
Overview of method of research: Review of the “current” literature.
Findings: Overall… fluoride is beneficial primarily due to its topical effects, and there are benefits to different modalities of application/supplementation.
Key points/Summary: Early studies showed a 50 to 60% decrease in the incidence of caries due to fluoridation of water. More recent studies show closer to a 20% decrease. This difference is attributed by many to the increased availability of fluoride in dentrifices and rinses. Increased levels of fluorosis have been noted even in optimally fluoridated communities, but fluorisis is usually very mild to mild. Australian study noted a 20-28% decrease in DMFS in fluoridated areas (3463 patients). Quebec showed 23% decrease in optimally fluoridated area (936 patients). In Cheshire, England 66% of children with some degree of dental fluorosis live in optimally fluoridated communities – the remaining 44% live in fluoride-deficient communities. Children with a water source containing 4.7 to 5.3 mg/L fluoride (optimal level is about 1.0 mg/L) in Israel reported 60% with either no or mild fluorosis, and 40% with moderate to severe fluorosis. Studies evaluating the preeruptive effects of fluoride gave mixed results. No difference was noted in tooth morphology, and high sucrose levels in other tests may skew results, as pH can fall below level at which fluoridated teeth are resistant to demineralization. In New Zealand, the diets of small children were analyzed for fluoride content to see if children were being overfluoridated by fluoride in public water. Results showed that even in optimally fluoridated areas, fluoride intake was within currently accepted limits of 0.05 to 0.07 mg F/kg body weight per day. Milk reduced fluoride ingestion, and a meal reduced it much more. Author notes that many physicians prescribe fluoride supplements without taking into account other sources of fluoride e.g. well water fluoride levels, dentrifices, etc… A few studies showed that ingested fluoride is very bioavailable, reporting from 60-11% absorption – so the little kiddos need close supervision if they use fluoride containing dentrifices…. They also should be able to spit well. Mouthrinses have shown some promise as well.
Assessment of article: Great. Like a Cliff’s Notes for fluoride articles…. Which would make this summary like a cliff’s notes of the cliff’s notes…. Anybody taking notes?