30 years after we use fluoride treatment successfully in prevention of dental caries in the US, as a dental practitioner, I still get asked a lot when we recommend fluoride varnish in my office: “what does it really do?” The research on fluoridation and dental health has been extensive, but the peer reviewed journals are beyond comprehension in general population. We have been telling our patients that we should curtail the amount and frequency of sugar intake, clean their teeth diligently everyday to minimize plaque build up, use fluoridated toothpaste and fluoride varnish in office.
What is the science behind it?
Fluoride is a mineral that occurs naturally in many foods and water. Every day, minerals are added to and lost from a tooth’s enamel layer through two processes, demineralization and remineralization. Minerals are lost (demineralization) from a tooth’s enamel layer when acids — formed from plaque bacteria and sugars in the mouth — attack the enamel. Minerals such as fluoride, calcium, and phosphate are redeposited (remineralization) to the enamel layer from the foods and waters consumed. Too much demineralization without enough remineralization to repair the enamel layer leads to tooth decay.
Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay. In children under 6 years of age, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Fluoride also helps speed remineralization as well as disrupts acid production in already erupted teeth of both children and adults by inhibiting key enzymes in acidogenesis of pathogenic bacteria.
In summary, fluoride is by far the most effective treatment and prevention measure for dental decay from the source. The American Dental Association recommends it to all kids and adults who have moderate to high risk for dental decay. These include people who have more than one dental caries, root surface exposure and dry mouth patients.
On top of daily oral hygiene protocol with brushing with fluoridated toothpaste, fluoride varnish treatment in dental office every 6 months is very effective. The concentration of fluoride varinshes is 50 more times than everyday fluoride. They are easily and quickly applied. They dry rapidly and will set even in the presence of saliva. It has a sticky consistency which helps it to adhere to the tooth’s surface thereby allowing the fluoride to stay in contact with the tooth for several hours. Based on published findings, professionally applied fluoride varnish does not appear to be a risk factor for dental fluorosis, even in children under the age of 6. This is due to the reduction in the amount of fluoride which may potentially be swallowed during the fluoride treatment because of the small quantities used and the adherence of the varnish to the teeth. Fluoride varnish treatments are shown to reduce the number of the cariogenic bacteria S. Mutans by over ten-fold.
Posted on behalf of Prime Dental Care
417 Wall St
Princeton, NJ, 08540