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Dentifrices, Role of Fluoride in the Treatment of Dental Caries

China and India used dentifrice as early as 500 BC, but modern toothpaste wasn't invented until the 1800s. Therapeutic and Cosmetic dentifrices.

Dentifrices

China and India used dentifrice as early as 500 BC, but modern toothpaste wasn't invented until the 1800s. An example of one of the earliest substances used during this period was alum. A toothpaste tube was invented by Dr. Washington Wentworth Sheffield in 1892. Fluoride toothpaste was the first clinically tested product in 1942 by Bibby. Dental paste is a substance that is used in conjunction with a toothbrush in order to clean the exposed surface of teeth.

Generally, there are two types of dentifrices.

1. Therapeutic dentifrices

In order to reduce dental diseases such as dental caries, therapeutic toothpastes have to reduce the disease process in mouths

2. Cosmetic dentifrices

They effectively remove the end-product of bacterial metabolism called extrinsic staining that appears on the tooth surface, ranging from green to yellow to black.

Applications

It's most effective to place a small amount of toothpaste or gel on the back half of the toothbrush the paste gets spread between the bristles as opposed to coating the tips. Children under the age of six should be given half the amount of dentifrice recommended for adults.

Influence of fluorides on dental caries treatment

A naturally occurring mineral called fluoride contains an ion called fluorine. The fluoride in soil and food is a source of fluoride. Fluoride plays a crucial role in maintaining good dental hygiene. Fluoride protects teeth against tooth decay by absorbing into them. Acids and bacteria are constantly attacking your teeth. By not cleaning your teeth properly, these substances will cause tooth decay, also called caries, which will eventually destroy your teeth. Caries usually begins as microscopic breaks in your teeth. This protective effect of fluoride, similar to concrete poured into a crack, prevents such damage from occurring and even reverses early tooth decay.

Caries develops as a result of cariogenic bacteria (caries-causing bacteria) interacting with carbohydrate (also known as sugar) deposits on the tooth surface over time. Cariogenic bacteria metabolize carbohydrates for energy and produce organic acids for nutrient degradation. This lowers the pH of the biofilms in plaques.

Calcium (Ca2+) and phosphate (PO43-) form the bulk of hydroxyapatite, which is the primary material responsible for tooth enamel's hardness. Approximately 96% of tooth enamel consists of crystalline hydroxyapatites that are in equilibrium with calcium and phosphate ions in saliva. In a process called demineralization, tooth minerals (hydroxyapatite) dissolve when the pH falls below a critical level (5.5 for enamel, 6.2 for dentin). By remineralizing the tooth, the saliva's natural buffer capacity raises pH and thereby remineralizes the tooth.

The first stage of caries results in the development of white spots, caused by acid penetrating and solubilizing subsurface minerals (but not all). If this subsurface damage goes untreated, it may cause the enamel surface structure to collapse (cavitates) because the crystal cannot provide enough support. A number of factors can influence the caries process. In order to prevent caries, remineralization and slow demineralization are the most effective methods. Fluoride therapy can accomplish this. Fluoride is widely accepted as extremely effective at preventing dental caries, especially when it is included in toothpaste and drinking water. Fluoridating water was ranked the 10th most important public health measure in the 20th century by the Center for Disease Control (CDC) in 1999. The results of studies show that regular use of low levels of fluoride prevents tooth decay more effectively than higher levels of fluoride that are used less often. In many countries, water fluoridation is not available, making dental products one of the most important sources of fluoride.

When fluoride is present in oral fluids (i.e., saliva), fluorapatite forms rather than hydroxyapatite during remineralization. Combined with hydroxyl groups (OH-), fluoride ions (F-) form fluoridated tooth minerals as they form the crystal lattice of apatite. It can be quite difficult to dissolve fluorapatite, even under acidic conditions. Likewise, fluorapatite, being less soluble than hydroxyapatite, is more resistant to demineralization as a result of acid challenge. Carries are generally considered to be subsurface phenomena. A non-cavitated lesion treated with fluoride is able to remineralize with fluorapatite and be more resistant to demineralization than one treated with hydroxyapatite. A fluoride anticaries agent is effective at even very low concentrations. Sodium fluoride (NaF), sodium Mono-fluorophosphate (SMFP), and stannous fluoride (SnF2) are the three main sources of fluoride in oral care products used. Fluoride from these three sources provides the important F- ion, which inhibits demineralization while also promoting remineralization of damaged tooth minerals. In addition to its fluoridating properties, SnF2 is thought to possess unique properties, such as its ability to counteract bacteria's acids.
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Ankur Choudhary is India's first professional pharmaceutical blogger, author and founder of Pharmaceutical Guidelines, a widely-read pharmaceutical blog since 2008. Sign-up for the free email updates for your daily dose of pharmaceutical tips.
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