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Topical fluorides: effects on physiologic and biochemical processes.

G M Whitford, D W Allmann, A R Shahed

    Journal of Dental Research
    |May 1, 1987
    PubMed
    Summary

    Frequent unsupervised use of fluoride products by young children, especially in fluoridated areas, risks dental fluorosis. Standardized application methods are needed to minimize fluoride ingestion and systemic absorption.

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    Area of Science:

    • Dentistry
    • Public Health
    • Toxicology

    Background:

    • Fluoride ingestion from dental products contributes to daily intake, even with fluoridated water.
    • Young children are at risk of dental fluorosis from unsupervised use of fluoride dentifrices and mouthrinses.
    • High fluoride intake can lead to adverse health effects, including dental fluorosis and potential kidney function impairment.

    Purpose of the Study:

    • To assess the risk of dental fluorosis associated with fluoride ingestion from dental products.
    • To evaluate the effects of specific fluoride application methods, such as APF gels, on systemic fluoride levels.
    • To identify recommendations for minimizing fluoride ingestion and related adverse effects in children.

    Main Methods:

    • Review of existing studies on fluoride intake from dentifrices, mouthrinses, and professional applications.
    • Analysis of plasma fluoride levels and renal concentrating ability in relation to fluoride exposure.
    • Examination of toxicological effects of fluoride on gastric mucosa, cAMP levels, glucose metabolism, and salivary amylase.

    Main Results:

    • Unsupervised use of fluoride products by children under six increases dental fluorosis risk, particularly in fluoridated communities.
    • Acidulated phosphate fluoride (APF) gels, especially without suctioning and proper expectoration, lead to significant fluoride ingestion.
    • Elevated plasma fluoride levels and reduced renal concentrating ability observed in animal and human studies.
    • Gastric distress linked to direct fluoride toxicity on the gastric mucosa.
    • Potential systemic effects include altered cAMP levels, glucose metabolism, and salivary amylase secretion.

    Conclusions:

    • There is a critical need for standardized dental fluoride application protocols to minimize ingestion and systemic absorption.
    • Educating the dental profession on safe application techniques is essential to mitigate risks.
    • Protecting young children from excessive fluoride exposure is paramount for preventing dental fluorosis and other adverse effects.

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