Fluoride and Caries Prevention

Helena Yoshimura

PIMA Medical Institute

Dental Hygiene I

Andrea Higgins

August 25, 2021

Introduction:

Some of the population may still believe fluoride is controversial and can cause adverse

effects on their overall health if used. Most of the public is already exposed to fluoride either

through water sources or other chemical aids, like toothpaste. Both articles reviewed stressed the

importance of fluoride decreasing the chance of caries and looked at the outcomes in different

studies. “Several microorganisms colonize dental biofilms, where S. mutans are strongly

associated with dental caries, and are found in all niches such as saliva, tongue, oral mucosa, and

dental plaque” (Valadas et al., 2021). Mechanical disturbance of the bacteria is still the best way

to completely remove the plaque from eating away at the tooth’s surface, but fluoride will help

keep the bacteria reduced and the caries minimal.

Review 1:

This study looked at a possible more natural fluoride varnish, that contained copaiba and

it’s antimicrobial effects on pathogenic bacteria in the mouth. Copaifera langsdorfa, which is a

medicinal plant, was shown to be effective against both gram negative and positive bacteria

(Valadas et al., 2021). The 90 high-risk caries children were split into the three treatment groups:

copaiba varnish, fluoride varnish, and chlorhexidine. They were treated with the varnish at 3-

month intervals until one year had passed. The number of colonies of S. mutans were observed in

their saliva before the next fluoride treatment. The copaiba and fluoride varnish both had a

significant lower number of bacteria compared to the chlorhexidine group. The use of high

concentration on fluoride (more than 2,500 ppm) were more effective in creating a fluoride

barrier that increased remineralization of the teeth and reduce the colony of bacteria that formed

(Valadas et al., 2021). After the three applications, copaiba varnish gave the high-risk caries

children effective protection against caries for up to 12 months. The fluoride varnish also gave
very similar results, but further studies are needed to fully support effectiveness of the new

copaiba varnish.

Review 2:

In this review, they wanted to see if the different levels of fluoride in drinking water

effected the tooth surface vulnerability. They took a sample size of 748 participants in a certain

area to evaluate where 78% had lower fluoride levels (<0.7 ppm) and 21% had higher fluoride

levels (≥0.7 ppm). The participants teeth were then grouped into 4 different groups, from group 1

being most susceptible (molar surfaces) to group 4 having the greatest number of surfaces since

it looked at the total 28 teeth surfaces. They found that the higher fluoride levels in the drinking

water had a significant lower dental caries rate overall, but the surface-based susceptibility is not

useful for planning preventative fluoride treatment (Stangvaltaite-Mouhat et al., 2021). One of

the main limitations they had where they were unable to ask the participants how long they had

been living in that area which could affect the results as well as many other contributing factors:

another fluoride source, consumption of sugary foods/drinks, last dental visit, and tooth brushing

frequency. This article also needed more adult studies to support their current findings.

Analysis:

To summarize, when exposed to fluoride there was seen a reduction in dental caries in

both reviews of adults and children. There are many additional factors that can contribute to the

effectiveness of prevention of caries, but fluoride had a positive contributing factor to reducing

the caries rate and pathogenic bacteria. Although I agreed with the articles decrease in rates of

caries there still wasn’t enough evidence to fully support the articles by themselves. It’s not only

important to educate the patient’s on how fluoride helps protect teeth but that there are always
alternatives to more health-conscious people that may not trust fluoride. Researching more

options in the future when looking at other types of fluoride could suit their needs better while

still giving them the optimal protection.

 References:

Valadas, L. A. R., Lobo, P. L. D., Fonseca, S. G. da C., Fechine, F. V., Rodrigues Neto, E. M.,
Fonteles, M. M. de F., Aguiar Trévia, L. R. de, Vasconcelos, H. L. P., Lima, S. M. da S.,
Lotif, M. A. L., Fernandes, A. M. B., & Bandeira, M. A. M. (2021, March 26). Clinical
and Antimicrobial evaluation of Copaifera langsdorffii DESF. Dental Varnish in Children:
A clinical study. Evidence-Based Complementary and Alternative Medicine.
https://www.hindawi.com/journals/ecam/2021/6647849/.

Stangvaltaite-Mouhat, L., Puriene, A., Stankeviciene, I., & Aleksejuniene, J. (2021, May 4).
Fluoride in the drinking water and dental caries experience by tooth surface susceptibility
among adults. BMC Oral Health.
https://www.proquest.com/docview/2528995780/FAC2D369F9C4706PQ/1?
accountid=89121.