Chapter 7 - Fluoride in Dentistry and Dental Restoratives

Abstract

Fluoride has been shown to be a key element in ensuring that populations develop and maintain sound dental health. At the atomic level, it has an effect on the demineralization/demineralization equilibrium that exists at the tooth surface, shifting it back in favor of demineralization. Fluoride does this by a variety of mechanisms, including reducing the solvating power of saliva towards the tooth mineral, reducing the solubility of the apatite phase, and improving the crystallization kinetics of the mineralization process. It may also have an effect on the bacterial populations living in the oral biofilms, through inhibition of their enzyme activity. Fluoride is supplied to large numbers of populations throughout the world in drinking water and, at the levels used, it is safe and effective, and has been accepted as such by numerous public health agencies worldwide. Fluoride can be delivered partly as a public health measure, mainly through the domestic water supply, but also through its introduction to table salt or milk, and partly on an individual basis. The latter includes the use of fluoridated dentifrices, mouthrinses, topical gels and varnishes, and the use of fluoride-releasing restorative materials to repair of teeth damaged by caries. These tailored individual treatment measures are particularly important in reducing caries in high risk groups within any population. The use of fluoridated products, as well as fluoridation of domestic water supplies, has been one of the most successful approaches ever adopted to improve any aspect of public health.