Oral Health | Clinical and Risk Asessment | Use of fluorides

Use of fluorides
Session overview
Description
This session describes current thinking on effective delivery of fluoride to the mouth, why fluoride toothpastes have been so successful in reducing caries, enamel solubility and how fluoride can both help to prevent it and reverse the early stages of dissolution.

Learning objectives
By the end of this session you will be able to:

• outline the various modes of delivery for fluoride and explain why fluoride toothpastes have been so successful in reducing dental caries
• explain how fluoride toothpastes modify fluoride concentrations in plaque and saliva and are time dependent after brushing, and explain the impact this has on caries
• give an overview of enamel solubility, and how fluoride can both prevent dissolution of the teeth and reverse the initial stages of caries

Fluoride, and specifically the regular use of fluoride toothpastes, has led to marked reductions in caries wherever it has been used widely.

Enamel has excellent mechanical properties, being both hard and durable. It is essentially insoluble at neutral pH values, but is vulnerable to acid-dissolution following consumption of fermentable carbohydrates and subsequent acid production by some plaque bacteria.

Fluoride has the potential to mitigate against the effects of acid production by reducing enamel solubility, promoting remineralisation of early caries lesions and by direct interference with bacterial metabolism.

The effects of fluoride on enamel solubility and remineralisation are generally agreed to be the means via which fluoride toothpastes exert an anti-caries effect, but the clinical significance of fluoride’s antibacterial effects are still unclear with respect to caries.