dentist, pedodontist, dental fluorosis, tooth decay, defluoridation, topical fluoride,

 

India is a tropical country with a variety in its landscapes. From forests to deserts to snow capped mountains and many rivers, our country also has a huge reserve of minerals in its nature. One such element is fluoride. Fluoride is present in plenty in rivers and ground water in India. Fluoride in drinking water can prevent dental caries. A survey by the National Water and Sanitation Board has shown that 230 out of 718 districts in India has higher fluoride content in their drinking water. So why and how then is this data relevant to dentists?

Dr Chandrashekar B R, Vice principal JSS Dental College and Hospital elaborates———“Dental caries and dental fluorosis are closely related public dental health problems in India. High amounts of fluoride in drinking water causes fluorosis, the condition ranging from teeth discolouration to mottling of enamel. And the same fluoride is also required for prevention of dental caries in children. The levels of fluoride in drinking water has to be optimum for caries prevention. But the fluoride in drinking water ranges from 0.2 ppm to 48ppm.”

What does the fluoride content in water mean?

Fluoride is required to make stronger teeth. This fluoride can be used systemically or ingested in the form of drinking water to reap the benefits. According to the Ministry of Health and Family welfare, any concentration of fluoride upto 1 ppm ( 1 mg of fluoride in 1 litre of water ) is permissible. 2 ppm o fluoride is considered a high dose and is not recommended for human consumption in drinking water. Since, fluoride is endemic in most water in India and also because of other health concerns in the population, fluoridation of drinking water is not recommended. 

How can you benefit from fluoridation?

Public dental health problems include

As discussed earlier, water fluoridation of drinking water is not possible in our country. Fluoride tablets, fluoridated salt and milk are also ruled out. The best and the most effective way to use fluoride effectively is by topical application. Topical fluoride prevent decay by remineralisation of enamel while preventing demineralisation. So applying fluoride onto the surface of the tooth at regular intervals is the most effective way to prevent decay. This has proven to be very effective as the concentration of fluoride is high and is released in a controlled way.

 

What are the methods of topical fluoride application?

Topical fluoride application can be 

  1. By your dentist
  2. Self application

Your dentist will apply fluoride onto your teeth in the form of high concentration gels. Your dentist will do this procedure in the dental office. Since the gels contain high concentration of fluorides, their application has to be monitored. Topical fluoride application is the most effective method of caries prevention in children.

Self application of fluorides is in tooth pastes and mouth rinses. Brushing twice a day with fluoridated paste is advised for adults.

Should your child’s paste have fluoride?

Children will swallow tooth paste while brushing for its flavour and taste. So, an adult formula paste is a No-No for a child. Children below 4 years of age do not require a fluoridated paste. Good oral hygiene practices like regular brushing especially at night and rinsing your mouth well after every meal should reduce the caries risk by 90%. If your dentist makes an assessment for your child as a high caries risk group, then a child formula paste containing containing 500 ppm is prescribed. However, in children below 8, tooth brushing should be under adult supervision. Children above 13 years can use adult formula tooth paste.

What measures has our government taken to combat endemic fluorosis?

Surface water has lesser amount of fluoride as compared to ground water. Since most city dwellers usr ground water ( Borewell water ) with surface water, the government authorities have provided RO water stations (Reverse Osmosis ) at various areas as part of the water defluoridation programme.