The fluorine It is a chemical element that is located on the periodic table of elements, at number 9. It is the most chemically reactive element and its most important natural combination is calcium fluoride (CaFtwo).

This element is found in nature, in minerals and those of volcanic origin, which contain fluorides. It is also found in water, both in the sea (in concentrations of 0.8-1.4 ppm, parts per million) and in drinking water. In food, fluoride is found with the highest concentration in tea, spinach, tomatoes, and lentils. Fluoride can also be purchased to form products that include it, such as in toothpastes or mouthwashes.

Fluoride and dental health

Fluoride is one of the most recommended products to prevent tooth decay.

This element as a caries preventive agent, according to current scientific evidence, is not fully understood but it is known that:

  • Inhibits the metabolism of dental plaque and alters its composition
  • It inhibits the ability of bacteria to form large amounts of acid by metabolizing carbohydrate debris.
  • Inhibits the process of demineralization of the teeth
  • It lowers the pH above which the hydroxyapatite crystal (an enamel-forming substance) dissolves.
  • It gives the tooth surface resistance against the acids present in the mouth.
  • Favors the remineralization of the tooth enamel surface.

Therefore, fluoride works in the demineralization and remineralization processes that naturally occur in the oral cavity. After eating, the pH of the oral cavity decreases and causes dental demineralization. This is why fluoride in these cases helps to remineralize the enamel and to strengthen the teeth. The dental remineralization process consists of the acquisition of fluoride by the enamel and the hydroxyapatite is transformed into fluorapatite, which is more resistant to decalcification.

Fluoride can be acquired and reached the dental structure through two ways:

  • Systemic: before the teeth have erupted, that is, it acts in a pre-eruptive way, strengthening the enamel.

There are several methods of application: fluoridation of water for public consumption (at 1.5 ppm), table water with fluoride, fluoride supplements in the diet (200-250 mg per kg), fluoridated salt and vitamin preparations.

  • Topical: once the teeth have erupted, by topical application of fluoride directly to the tooth surface. The use of this modality can begin from the moment the first teeth erupt and continue throughout life, to prevent tooth decay.

The main methods of presentation of topical fluoride are:

  • Varnishes and gels: they have a high concentration of fluoride (between 5000 and 12500 ppm for varnishes, and between 1000 and 56300 ppm for gels) so they are procedures restricted to healthcare professionals only. They are applied using brushes or adjustable trays to the jaws and their frequency varies depending on the risk of tooth decay.
  • Toothpastes: it is the most suitable method due to its effectiveness, low cost and great cultural reach. The concentration of fluoride should vary according to age.
  • Mouthwash: they are only recommended for use in children who control the swallowing reflex.
  • Fluoridated dental floss: helps the remineralization process of the area where it is used.
  • Prophy paste: they incorporate fluorides and serve to polish and clean dental structures effectively and with minimal abrasion.
  • Chewing gum with fluoride: stimulates the formation of saliva through chewing which helps to maintain a level of fluoride in it.

All methods to be used to prevent tooth decay must be correctly prescribed by health professionals.

Conclusion

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