FLUORIDE -“The double edged sword”

Fluoride, an element known for its anti caries property has been incorporated as an essential component of most of the dental products nowadays.These Products includes tooth pastes,oral rinses, mouth washes, oral chewing gums and what not! These are aimed for prevention of dental caries. Apart from that, fluoride has been a part of dental restorative materials such as Glass ionomer cement(GIC),Pit and fissure sealants(PFS) etc. as well.

Fluoride and its anti caries ability is well known for the dental world since 1970’s. The same was proven by scientists and researchers through the water fluoridation studies happened in USA and Canada during 1945- 1955’s. Most of the studies reported 50%+ reduction in dental caries status compared to its control cities. [( Grand rapids vs Muskegon(1945), Tiel vs Culemborg(1953), Newburg vs Kingston (1945), Evanston vs Oakpark(1946), Brantford vs Sarnia /Stratford(1945) ]

ERA OF TOPICAL FLUORIDES

Fluoride was recommended as anti caries agent by most of the dental researchers and WHO(World Health Organization) as well. The Pioneer strategy was the communal type water fluoridation where the beneficiaries were a village/town/or large group of people. Surprisingly, in early 1970’s it has noticed that the efficacy of fluoride by water fluoridation can be also achieved by providing the fluoride by topical methods such as toothpaste / gels/ varnishes etc. On account of the huge financial expenses of plant installation and maintenance , the authorities mulled changing the strategy which is cost effective. Hence the fluoride toothpaste was marketed and people started using it ever since along with other topical ( on surface of the teeth) products such as gels and varnishes.

The deadly side of fluoride is its toxicity where our country (INDIA) is suffering its effect in 70% of its states. When fluoride consumption exceeds the the permissible limit(>1-2ppm) it creates bone problems such as mottling/erosion /stains in the teeth known as Fluorosis( 2-3 ppm). Extreme levels affects (>5 ppm) the skeletal system of our body causes bending and crippling of the long bones. India is a country which always has concern about its toxicity not its anti caries benefit. DE fluoridation plants and its research are the priority.!And when the fluoride level of body(obtained from the external sources) is much lesser than 1 ppm, there will not be any caries protection. In other words, lesser the fluoride – attack of caries and higher the fluoride – dental & skeletal fluorosis. A weapon which gives benefit only at its optimal level(1ppm). ❗️

Some countries would benefit naturally by ground water with optimal fluoride level(1ppm) where the population would get the benefits of caries protection ,on the other hand countries like India suffering from its toxic level. An element is beneficial and dangerous from country to country, how weird, isn’t it!!

Refernces-Peter S ;Fluoride;textbook of preventive and community dentistry;6th editio

SS Hiremath;Fluorides ;Textbook of preventive and community dentistry;2nd edition.