fluorides

fluorine
trace element
not found in free elemental form in
nature

fluoride
found everywhere throughout nature
water is the major source of ingested
fluoride- deep artesian well

found in soils rich in fluospar ( calcium

fluoride), cryolite (sodium aluminum
fluoride)

found in

other minerals: fluorapatite,

fluorcarbonates, fluorphophatates,
fluorsilicates

fluoride
also found in plants, foodstuffs and
body tissues

in calcified structures: teeth &

skeleton

fluoride
absorption
major site = stomach
there is also intestinal absorption
soluble fluoride in drinking water is
almost absorbed

50-80% of fluoride from the foods

fluoride
distribution
teeth
skeleton
extracellular fluids
intracellular fluids
saliva

fluoride
distribution
teeth & skeleton - highest concentration
affinity to calcium
teeth- cementum, bone, dentin, enamel
( descending order)

increases rapidly- early mineralization

period

increases at a slower rate with age

fluoride
distribution

0.01 ppm in the saliva

when ingested, the salivary fluoride

level increases, beginning after 5-15

mins

reaches a maximum after about 30

mins

decreases to normal levels in about 1

h

fluoride
excretion
major route of excretion is the
urine (90-95%)

5-10% found in the feces

sweat- minute amount

fluoride
excretion
the rapidity of the excretion of
fluoride & high affinity of the
calcified structures

effective mechanisms for

maintaining low concentrations

of fluoride in the soft tissue
plasma

fluoride
excretion
the amount of urinary excretion is

directly related to the degree of active

bone growth

growing child = active laying down of

bone matrix= diminished fluoride
excretion

adults with mature bones and fully

mineralized teeth = fluoride excretion

fluoride
storage
calcified structures
bone & teeth during active stage
of mineralization

fluoride
storage

skeletons of older people contain

more fluoride than those of younger

ones

fluoride in bone gradually increases

with age

rate and amount of fluoride

deposition is greatest during the

active growth years

factors that attract

fluoride to bones
presence of an active growth area
at the ends of the long bones

small size of the bone crystals

close contact that bone has with
the blood supply

fluoride
storage
fluoride is deposited in the enamel via the

systemic route during the developmental

and maturation stages of enamel formation

adult enamel- fluoride penetrates from the

oral environment via diffusion

remineralized carious
dentin contain more fluoride than enamel
chemically similar to bone
adjacent to pulp -highest concentration

fluoride
toxicity
safe- 1 to 8 ppm daily
when ingested in excessive amounts over
a long period of time, fluoride can be
toxic

excessive mineralization of ligaments &

bones

acute toxicity or death - from ingestion of

a single dose of 2.5 to 5.0 grams of NaF

fluoride
dietary sources

all food contain at least traces of

fluoride

waterborne fluorides- constitutes

the most important source for man

fluoridated beverages
optimal levels- 1ppm
fluorosis ( mottled enamel)- 2ppm

fluoride
dietary sources
small amounts of fluoride
meats, fruits, vegetables, & cereals
rich sources
tea- leaves( 75-100ppm)
seafood especially fish with small
bones

sardines & salmon

fluoride &
mottled enamel
Mottled Enamel
clinical characteristics
white and/or brown spotty

staining of the tooth enamel

surfaces

horizontal striations or pits

fluoride &
mottled enamel
histological appearance
deficient in number of ameloblasts, which
affects enamel matrix formation which
causes pitting ( enamel hypoplasia)

deficient in mineral deposits

accompanied by poorly formed

interprismatic rod substance, which
causes chalkiness ( enamel
hypocalcification)

fluoride & mottled

enamel
occur in the formative stages when
metabolism of ameloblasts can be
interfered with.

exposure to high concentrations of

fluoride- 2 ppm or more

fluorides &
dental caries
communal water fluoridation
school water fluoridation
dietary supplements of fluoride
tablets

prenatal fluoride supplements

fluoride acquisition
by the tooth
endogenous or systemic fluoride
uptake

exogenous or topical fluoride

systemic fluoride
uptake of fluoride by the tooth via

the pulp and other source of blood

supply

enamel is still mineralizing

salivary fluoride level
topical effects- post-eruptive
period

topical fluoride
dentrifices or toothpastes
fluoride pastes/ gel or rinse
Na F, Acidulated Phosphate flouride
maintained high level of salivary
fluoride

eating & drinking might speed up the

clearance of fluoride from the mouth

mechanisms of
anti caries action
of
fluoride
an increase in enamel resistance
to acid solubility

results from high concentration

of fluoride in the outer enamel
surface

prevents or retards acid

demineralization

has more crystals - fluorapatite-

fluoride
mechanisms of
anti caries action

the ability of fluoride to

remineralize demineralized or
hypomineralized enamel

interval between meals, there is

a reprecipitation of minerals, or
remineralization

availability of fluoride

fluoride
mechanisms of
anti caries action
fluorides anti-bacterial effects
when given in high

concentrations in a topical or
local vehicle

inhibit many enzymes essential

to cell metabolism & growth of
bacteria