Fluoride prospects for the new millennium-community and individual patient aspects

Abstract

Over the past 2 decades, it has been suggested that with the generalized availability of fluoridated dentifrices, and coupled with a possible increased likelihood of fluorosis, the benefits of community-based fluoridation have receded. However, while this may be so for dentally motivated populations, there are convincing data to suggest that the least fortunate amongst us could still benefit from communally delivered fluoride. Furthermore, the deleterious effects of such program withdrawals have been demonstrated and, with respect to fluorosis fears, client assessment of their own fluorosis status has indicated few concerns. Alternative, centrally delivered means of fluoride dispensing, e.g. via schools, etc., although effective in the short-term, are impractical over longer time-spans. Nonetheless, at the individual level, fluoride supplements and dentifrices, in particular, are successful caries inhibitors. This is especially so if these vehicles are employed in their most effective, proven manners. Finally, fears relating to disfiguring fluorosis should be allayed, but where fluoride abuses result in mild mottling, a simple remineralizing technique obviates the need for traumatic restorative procedures.

Prospective Study of the Effect of Post-Brushing Rinsing Behaviour on Dental Caries

“…Similarly, retrospective studies on the influence of self-reported post-brushing behaviour in caries clinical trials have indicated higher increments in children who had used a beaker of water than in children who used less water [Chesters et al, 1992;O'Mullane et al, 1997;Chestnutt et al, 1998]. As a result, it has been widely recommended that patients be advised not to rinse or to use a minimum amount of water after toothbrushing [Holt and Murray, 1997;Ellwood et al, 1998;Stephen, 1999].…”

Percepção da fluorose dentária e avaliação da concordância entre pais e filhos: validação de um instrumento

“…Entre diagnóstico clínico e preocupação com as manchas fluoróticas, não houve correlação significativa para nenhum dos quatro grupos, e o mesmo ocorreu quando da validação do questionário original com populações norte-americanas e mexicanas, sugerindo que o mero diagnóstico de fluorose não necessariamente significa preocupação de crianças e pais com a aparência dos dentes. Esses achados estão em concordância com estudos anteriores em que pessoas com fluorose manifestaram pouca preocupação com sua condição normativamente diagnosticada pelos cirurgiões-dentistas 7,24 . Peres et al 6 alertam sobre a possibilidade de superestimação das reais necessidades de tratamento das populações quando se utiliza apenas o diagnóstico normativo de fluorose dentária, não associando essa informação à investigação sobre efeitos negativos autopercebidos.…”

Caries Prevalence in a Rural Chilean Community after Cessation of a Powdered Milk Fluoridation Program

“…Milk fluoridation might be considered a short-term measure (24), as it cannot be implemented over a lifetime span. This is because these programs cannot be implemented easily beyond the age when children leave mandatory education (year 12 in Chile).…”

“…Also, the context of these studies should be taken into consideration, as other reports show that dental caries is not evenly distributed in the population and great variation exists within countries (7,(21)(22)(23). Studies also indicate that the communities that may benefit most from the effect of fluoride are usually those least able to access the most common vehicles of community-based fluoride, such as water (24). It would also appear that some segments of the population benefit most from the preventive effect of fluoride through a combination of multiple sources (7)-for example, access to fluoride toothpaste, access to a less cariogenic diet, and to a lesser extent access to oral health care services (723).…”