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Fluoride in caries prevention: is the effect pre- or post-eruptive?
A Groeneveld1, A A Van Eck, O Backer Dirks
1Department of Community Dental Health and Epidemiology, Netherlands Institute for Preventive Health Care, Leiden.
Journal of Dental Research
|February 1, 1990
Summary
Pre-eruptive fluoride significantly reduces dentinal lesions, especially when combined with post-eruptive intake. Topical fluorides are most beneficial for general populations, while pre-eruptive fluoride is crucial for high-risk groups.
Area of Science:
- Dental Public Health
- Cariology
- Fluoride Research
Background:
- Dental caries remains a significant public health concern.
- Fluoride's role in caries prevention is well-established, but the differential impact of pre- and post-eruptive exposure requires nuanced understanding.
- Understanding the timing of fluoride intake is critical for optimizing caries prevention strategies.
Purpose of the Study:
- To evaluate the distinct contributions of pre-eruptive and post-eruptive fluoride intake on dental caries development in children.
- To determine the effectiveness of fluoride based on tooth surface type and caries severity.
- To inform public health recommendations for fluoride use in caries prevention.
Main Methods:
- Longitudinal study tracking children aged 7 to 18.
- Analysis of caries incidence (enamel, dentinal, pit and fissure, smooth, approximal) in fluoridated versus non-fluoridated areas.
- Classification of teeth based on eruption time relative to the initiation of water fluoridation to differentiate pre- and post-eruptive effects.
Main Results:
- No difference in overall enamel lesions between fluoridated and non-fluoridated areas.
- Significant reduction in dentinal lesions with pre-eruptive fluoride, contingent on substantial post-eruptive intake.
- Pre-eruptive fluoride accounted for 66% of caries reduction in pit and fissures, 25% in smooth surfaces, and 50% in approximal surfaces.
- Post-eruptive fluoride's importance increased with decreasing caries severity.
Conclusions:
- While topical fluorides offer the greatest benefit for the general population experiencing declining caries rates, pre-eruptive fluoride remains vital for high-risk groups.
- The timing and duration of fluoride exposure significantly influence its caries preventive efficacy.
- Tailored fluoride strategies are necessary, considering individual risk factors and caries patterns.