Abstract
Background: While there is much scientific evidence supporting the benefits of fluoride for oral health, the concentration of fluoride in over-the-counter fluoride toothpaste should meet United Arab Emirates (UAE) regulations of a fluoride concentration not exceeding 0.15%. Objectives: The current study examines the fluoridated toothpaste products available on the UAE market and aims to quantify their total fluoride content. Methods: A total of 50 toothpaste products were collected and analyzed in this study. Ion Chromatography (IC) conductivity analysis was performed to determine the total fluoride content. Results: Among the 50 products tested, 10 exceeded the recommended concentration of total fluoride of less than 0.15%, while 12 had a total fluoride concentration that was less than was declared on their labels. Moreover, this study has revealed that 22 of the sampled products had a total fluoride concentration below 1000 ppm fluoride. An increased risk of higher total fluoride content was observed in the toothpaste products with monofluorophosphate active ingredients than in products with potassium nitrate/sodium fluoride and sodium fluoride (p = 0.011). Conclusions: There is a need to reassess the effectiveness of current regulations in the UAE to ensure that all fluoridated toothpastes available on the market are safe and effective for the consumer. Specifically, appropriate guidelines should be established on the basis of the risks and benefits inherent in fluoride exposure. Moreover, fluoridated toothpastes need to be subject to stricter monitoring and control regarding their safety and quality through good manufacturing practices (GMPs), education, research, and adverse event reporting.
Highlights
In the 1930s, it was first noted that communities with access to naturally fluoridated water experienced lower rates of tooth decay than those that did not, which thereby indicated the benefits of fluoride for dental health [1]
For each fluoridated oral care product sampled, the total fluoride content (%) was measured and compared with both EU and United Arab Emirates (UAE) S/GSO regulations, which state that all finished fluoridated toothpastes must contain no more than 0.15% (1500 ppm) fluoride
30 (60%) of the active ingredients indicated in the formulation were sodium fluoride, 4 (8%) potassium nitrate/sodium fluoride, and 16 (32%) were sodium monofluorophosphate
Summary
In the 1930s, it was first noted that communities with access to naturally fluoridated water experienced lower rates of tooth decay than those that did not, which thereby indicated the benefits of fluoride for dental health [1]. There is a large body of evidence-based research demonstrating that fluoridated toothpaste is an effective method to address dental caries [5,8,9,10]. Despite these anti-caries properties, it has been proven that the excessive intake of fluoridated toothpaste can have adverse side effects, including dental fluorosis and skeletal fluorosis [14,15]. Research has shown that when children accidentally swallow fluoridated toothpaste it may lead to an exposure level of two or three times what is considered safe, meaning that the use of fluoridated toothpaste by children could represent a dental fluorosis risk factor [17,18]. Fluoridated toothpastes need to be subject to stricter monitoring and control regarding their safety and quality through good manufacturing practices (GMPs), education, research, and adverse event reporting
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