Kinetics of fluoride in the oral fluids

The normal concentration of fluoride in saliva is about 1 mumol/L, which is somewhat less than that in plasma, and the salivary concentration is relatively independent of flow rate. Even this low concentration appears to be significant in terms of maintaining the integrity of tooth mineral. After fluoride consumption, the level in plasma peaks within less than an hour, and this produces a corresponding increase in salivary levels, which achieve baseline values usually within a few hours. At low concentrations (less than 4 mmol/L) in oral fluids, fluoride undergoes only slight reaction with tooth mineral to form fluorohydroxyapatite. However, at higher concentrations calcium fluoride is formed on the tooth surface. Although this mineral is sparingly soluble in saliva, the process of dissolution is retarded for periods of up to a week or longer by surface deposition of salivary phosphate and pyrophosphate. The rate of clearance of exogenous fluoride from saliva is prolonged when initial concentrations are high, due to the deposition of CaF2 on the tooth surface and its gradual dissolution. The clearance rate is also not constant throughout the mouth, but shows considerable site-specificity. In general, clearance is much more rapid lingually than buccally. This appears to be due to the greater lingual exposure to secretions from the major salivary glands, principally the submandibular, whereas buccally, mainly minor mucous gland secretions are present, and these are very viscous and flow at a slow rate.