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Chapter 6: Fluoride
Introduction
Fluoride is the negatively charged ionic form of the element fluorine that has a high affinity for calcium. In the human body, it is mainly associated with bones and teeth. Fluoride plays a very important role in the prevention of dental caries. Although the primary mechanism of action of fluoride in preventing dental caries is topical, systemic mechanisms are also important.

Fluoride acts in the following 3 ways to prevent dental caries (listed in order of importance):


 
1.
It enhances remineralization of the tooth enamel. This is the most important effect of fluoride in caries prevention.
 
2.
It inhibits demineralization of the tooth enamel. A mineral structure of the tooth that includes fluoride (fluorapatite) is more resistant to demineralization than one without fluoride (
Hydroxyapatite: A complex phosphate of calcium Ca5(PO4)3OH that occurs as a mineral and is the chief structural element of vertebrate bone.
hydroxyapatite).
 
3.
It makes cariogenic bacteria (eg, streptococcus mutans) less able to produce acid from carbohydrates.

See Chapter 4: Caries for a complete review of the pathogenesis of dental caries.

Sections
1.
Systemic Sources of Fluoride
2.
Topical Sources of Fluoride
3.
Recommendations
   
Water Fluoridation
   
Fluoride Supplementation
4.
Fluorosis
5.
Toothpaste
6.
Key Points
7.
Self-Assessment Questions
 
Upon chapter completion, participants will be able to:
 
1.
State the 3 mechanisms of action of fluoride in dental caries prevention.
 
2.
Summarize the available sources of fluoride and their relative benefits.
 
3.
List strategies to minimize the development of fluorosis.
 
4.
Discuss the fluoride supplementation guidelines.
 
5.
Recognize the various forms of fluorosis and recall their prevalence.
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