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Topical Fluorides. A literature review

©2017 Textbook 87 Pages

Summary

Dental caries is a multi factorial, bacterial, chronic infection that affects millions of people in the world and has become a public health problem. Also referred to as tooth decay, this disease is one of the most common disorders throughout the world, second only to the common cold. Dental caries is the most common chronic childhood disease in the United States and is 5 to 7 times more common than asthma. According to the World Oral Health Report in 2003, dental caries affect 60-80% of school children and a vast majority of adults. Dental caries is a chronic bacterial infection of the hard tissue of the tooth that is characterized by alternating phases of demineralization and remineralization. Dental decay can lead to significant pain and dysfunction that can interfere with basic functions such as eating, sleeping, and speaking. If left untreated, dental caries can result in cavities forming and, eventually, tooth loss. Although the prevalence and severity of dental caries has decreased over the years, this disease can be controlled better with proper fluoride exposure.
Fluoride dentifrices have been shown in numerous clinical trials to be effective anticaries agents and have been recognized as a major cause of the remarkable decline in caries prevalence in many developed countries. Dentifrices have been widely adopted around the world as the principle means of delivering topical fluoride and obtaining caries preventive benefits. Although there is documented literature on the use of topical fluorides, the issue needs to be further researched based on the recent documented literature and guidelines regarding use of topical fluorides. Hence, the present review was conducted with the aim to review the available literature on the use and effectiveness of different topical fluorides used in dentistry.

Excerpt

Table Of Contents



TABLE OF CONTENTS
1. INTRODUCTION ... 7
2. DEFINITIONS ... 11
3. CLASSIFICATION ... 15
4. MODE OF ACTION OF TOPICAL FLUORIDES ... 16
5. HISTORY OF FLUORIDE ... 17
6. MILESTONE STUDIES ... 25
7. HOME APPLIED / SELF APPLIED ... 27
8. PROFESSIONALLY APPLIED ... 42
9. METHODS OF APPLICATION OF TOPICAL FLUORIDE ... 59
10. RECOMMENDATION IN USE OF PROFESSIONALLY APPLIED TOPICAL
FLUORIDES ... 62
11. RECENT ADVANCE IN TOPICAL FLUORIDES ... 66
12. DISCUSSION ... 68
13. CONCLUSIONS ... 72
14. BIBLIOGRAPHY ... 75


7
INTRODUCTION
Dental caries is a multi factorial, bacterial, chronic infection that affects millions of people
in the world and has become a public health problem. Also referred to as tooth decay, this
disease is one of the most common disorders throughout the world, second only to the
common cold. Dental caries is the most common chronic childhood disease in the United
States and is 5 to 7 times more common than asthma. According to the World Oral Health
Report in 2003, dental caries affect 60-80% of school children and a vast majority of adults.
Dental caries is a chronic bacterial infection of the hard tissue of the tooth that is
characterized by alternating phases of demineralization and remineralization. Dental decay
can lead to significant pain and dysfunction that can interfere with basic functions such as
eating, sleeping, and speaking. If left untreated, dental caries can result in cavities forming
and eventually tooth loss. Although the prevalence and severity of dental caries has
decreased over the years, this disease can be better controlled with proper fluoride exposure
1
.
With more than 50 years of clinical success, fluoride serves as the gold standard agent
for preventing tooth decay
2
. Fluoride has both systemic and topical actions that are important
in preventing dental caries. Systemically, fluoride acts on teeth before their eruption by being
incorporated into the crystal structure of enamel and thus making this tissue more resistant to
the caries process. In addition, fluoride limits the demineralization of enamel and promotes
its remineralization into a stable crystal structure which is more caries resistant. Systemic
fluoride therapy is most effective when it is initiated during the maturation of the primary and
permanent teeth. The most common forms of systemic fluoride therapy include water
fluoridation and dietary supplements
3
Fluorides also act topically, (i.e., directly on erupted teeth), by promoting
remineralization and, to a lesser degree, through antibacterial action. These topical effects are
significant and exposure of the tooth surface to low, regular doses of fluoride may be as
critical in preventing caries as is fluoride ingested during tooth formation
2,3
.Topical fluorides
generally fall into two categories: (a) self applied ­ e.g. toothpaste and mouthrinse, and (b)
professionally applied ­ e.g. solutions, gels, foams and varnish. Professionally applied
fluoride varnish, gel and foam are high concentration fluoride vehicles which are applied by
healthcare professionals intermittently for caries prevention. Their caries preventive effect is
topical and although they should not be ingested, small amounts will inevitably be swallowed
by patients
4
.

8
The fluoride solutions which are commonly used includes 2% Sodium Fluoride and
8% Stannous Fluoride solution. Chronologically, neutral 2 percent sodium fluoride solution
(9040 ppm Fluoride ion) applied by the "paint-on" technique was the first topical Fuoride to
be used in public health programs. Both sodium fluoride and stannous fluoride in solutions of
various concentrations have been used as topical agents, and their effectiveness as dental
caries preventives among school children has been reported. A series of four applications of 2
percent solution of sodium fluoride to the teeth of children has been shown to reduce the
incidence of dental caries by approximately 40 percent
5
a) Knutson, J. W., and Armstrong, W. D.: The effect of topically applied sodium
fluoride on dental caries experience. I. Report of findings for the first study year.
Pub. Health Rep. 58: 17011715, Nov. 19,1943. (2)
b) Galagan, D. J., and Knutson, J. W.: The effect of topically applied fluorides on
dental caries experience. V. Report of findings with two, four and six applications
of sodium fluoride and of lead fluoride. Pub. Health Rep. 62: 1477-1483, Oct. 10,
1947).
Reports on the effectiveness of 2 and 8 percent concentrations of stannous fluoride
solution, topically applied, have varied widely among different workers
a) Howell, C. L., Gish, C. W., Smiley, R. D., and Muhler, J. C.: Effect of topically
applied stannous fluoride on dental caries experience in children. J. Am. Dent. A.
50: 14-17, January 1955. (4)
b) Gish, C. W., Howell, C. L., and Muhler, J. C.: Effect of a single topical
application of stannous fluoride on caries experience. International Association of
Dental Research, 34th Meeting, March 1956. (Abstract.) (5)
c) Gish, C. W., Howell, C. L., and Muhler, J. C.: A new approach to the topical
application of fluorides for the reduction of dental caries in children. J. Dent Res.
36: 784-786, October 1957
The concentration of fluoride in gel typically ranges from 5,000 ppm to 12,300 ppm.
It has a viscous texture which allows its professional application in a tray, with cotton wool
or with dental floss. The most commonly used formulation of gel is 1.23% acidulated
phosphate fluoride (APF) containing 12,300 ppm fluoride. A typical fluoride gel treatment

9
using APF gel involves the application of 3 to 5 ml of gel, containing 36.9 to 61.5mg of
fluoride ion. It has been reported that 2.8% to 78% of the initial dose of fluoride may be
retained following fluoride gel application. The amount of fluoride retained depends on the
amount of gel used, the age of the subject and the application technique
6
.
Fluoride varnishes may be aqueous solutions (e.g. Bifluorid) or non-aqueous solutions
of natural resins (e.g. Duraphat, Lawefluor). Resin-based varnishes have a sticky texture,
which prolongs the contact time between the fluoride and the enamel. The concentration of
fluoride in varnish ranges from 1,000 ppm (Fluor Protector) to 56,300 ppm (Bifluorid 12).
The fluoride formulations that are found in most commercially available varnishes are:
a) 5% sodium fluoride (Duraphat, Colgate Palmolive)
b) 1% difluorsilane (Fluor Protector, Ivoclar-Vivadent)
c) 6% sodium fluoride plus 6% calcium fluoride (Bifluorid 12, VOCO GmbH)
Although the fluoride concentration of varnishes is typically very high, the nature of
varnish lends itself to controlled, precise application to specific tooth surfaces. A single 0.25 ml
application of fluoride varnish with 22,600 ppm F contains 5.65 mg of fluoride ion, which is
well below the probably toxic dose (PTD) for fluoride of 5 mg/kg body weight72, even if all
the varnish dispensed is swallowed
6
Fluoride foam is a relatively recent product which has the same fluoride concentration
(12,300 ppm), pH (3­4) and method of application (tray) as conventional APF gel. The
advantage of foam over gel is that less material needs to be used, and therefore the patient's risk
of ingesting excess fluoride is reduced
5,6
.
Fluoride dentifrices have been shown in numerous clinical trials to be effective
anticaries agents and have been recognized as a major cause of the remarkable decline in caries
prevalence in many developed countries . Dentifrices have been widely adopted around the
world as the principle means of delivering topical fluoride and obtaining caries preventive
benefits. Over 95% of all dentifrices,Studies showed that daily toothbrushing using fluoridated
toothpaste (1000 ppm F) could arrest non-cavitated lesions as well as dentin caries lesions .
Toothpaste containing higher fluoride concentration, e.g. 5000 ppm, has better results in
remineralizing carious lesions compared to those containing 1000 ppm . F Recently it has been
demonstrated that elevated fluoride products like dentifrices with 5000 ppm NaF or amine

10
fluoride or oral hygiene tablets directly dissolved in saliva with 4350ppm NaF enhance
remineralization of advanced enamel lesions and result in increased bioavailability of fluoride
in saliva
5
.
Although there is documented literature on the use of topical fluorides, the issues needs
to be futher researched based on the recent documented literature and guidelines regarding use
of topical fluorides hence the present review was conducted with the aim to review the
available literature on the use and effectiveness of different topical fluorides used in dentistry

11
DEFINITIONS
Fluoride [floor´d]: Any binary compound of fluorine.
fluoride poisoning: A toxic condition that sometimes occurs with ingestion of excessive
fluoride.
Acute fluoridepoisoning: Involves an immediate physiological reaction, with nausea,
vomiting, hypersalivation, abdominal pain, anddiarrhea.
Chronic fluoride poisoning: Is a physiological reaction to long term exposure to high levels
of fluoride and is characterized by dental
FLUOROSIS
, skeletal
FLUOROSIS
, and kidney
damage. Called also fluorosis.
Systemic fluoride :A fluoride ingested in water, supplements, or some other form.
Topical fluoride: A fluoride applied directly to the teeth, especially of children, in a
DENTAL
CARIES
prevention program.
BY:Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health,
Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.
Fluoride:
1. A compound of fluorine with a metal, a nonmetal, or an organic radical.
2. The anion of fluorine; inhibits enolase; found in bone and tooth apatite; fluoride has a
cariostatic effect; high levelsare toxic.
BY:Farlex Partner Medical Dictionary © Farlex 2012
Fluoride:
An anion of fluorine. Fluoride compounds are introduced into drinking water or applied
directly to the teeth to prevent toothdecay.
BY:Mosby's Medical Dictionary, 9th edition. © 2009, Elsevier.

12
Fluoride:
A compound of fluorine with a metal, a nonmetal, or an organic radical; the anion of fluorine;
inhibits enolase; found inbone and tooth apatite; fluoride has a cariostatic effect; high levels
are toxic.
BY:Medical Dictionary for the Health Professions and Nursing © Farlex 2012
Fluoride:
A compound of fluorine that replaces hydroxyl groups in teeth and bones and reduces the
tendency to toothdecay. Its therapeutic use was discovered accidentally at Bauxite, Arkansas,
when water containing fluoride was replacedby water lacking fluoride, resulting in an
increase of dental cavities in children.
BY:Collins Dictionary of Biology, 3rd ed. © W. G. Hale, V. A. Saunders, J. P. Margham
2005
Fluoride:
A chemical compound containing fluorine that is used to treat water or applied directly to
teeth to prevent decay.
BY:Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights
reserved.
Fluoride:
A mineral important in bone formation used for the treatment of osteoporosis and prevention
of tooth decay.Overdose can produce tooth mottling, joint pain, stomach pain, and nausea.
BY:Jonas: Mosby's Dictionary of Complementary and Alternative Medicine. (c) 2005,
Elsevier.
Fluoride(s):
A salt of hydrofluoric acid, commonly sodium or stannous (tin).

13
Fluoride dietary supplements:
The orally administered nutritional additives of the chemical fluoride; often taken by
individuals without regularaccess to a fluoridated water supply; available as chewable tablets,
drops, pills, and in combination with vitaminsupplements. See also fluoride drops.
Fluoride drops:
A supplemental liquid form of the chemical fluoride. They can be administered to children
from 6 months to 3years of age but are not usually recommended because most children are
exposed to normal levels of fluoride intheir water systems at home and school and in their
beverages.
Fluoride, stannous:
A compound of tin and fluorine used in dentifrices to prevent caries.
Fluoride tablets/lozenges:
The supplemental forms of the chemical fluoride. Tablets must be chewed, and lozenges must
be held in theoral cavity until dissolved in order to benefit from the fluoride's contact with the
teeth.
Fluoride toxicity:
Poisoning as a result of ingesting too much fluoride. Symptoms range from upset stomach to
death.
Fluoride varnish:
A topical resin containing fluoride that is thinly applied to the tooth surface and used as a
preventive treatmentfor caries. Can also be used as a desensitizing agent to treat dentinal
Fluorides, topical:
Tthe salts of hydrofluoric acid (usually sodium or tin salts) that may be applied in solution to
the exposed dentalsurfaces to prevent dental caries and promote remineralization. They can
be applied by trays or mouthrinses or bytechniques such as paint-on.

14
Fluorides, topical, paint-on technique:
A professionally administered procedure in which the exposed dental surfaces are coated with
a fluoride solutionor gel or varnish to prevent caries and promote remineralization.
BY:Mosby's Dental Dictionary, 2nd edition. © 2008 Elsevier, Inc. All rights reserved.
Fluoride: Any binary compound of fluorine.
BY:Saunders Comprehensive Veterinary Dictionary, 3 ed. © 2007 Elsevier, Inc. All rights
reserved

15
CLASSIFICATION
TOPICAL FLUORIDES
1. HOME USE (SELF APPLICATION)
FLUORIDE DENTRIFICES
FLUORIDE MOUTHRINSES
FLUORIDE GELS
FLUORIDE FOAM
2. PROFESSIONALLY APPLIED
FLUORIDE GEL AND SOLUTION
· SODIUM FLUORIDE (NaF)
· STANNOUS FLUORIDE (SnF2)
· ACIDULATED PHOSPHATE FLUORIDE (APF)
FLUORIDE VARNISH
FLUORIDE FORM
FLUORIDE PROPHYLACTIC PASTE

16
MODE OF ACTION OF TOPICAL FLUORIDES
The primary and most important action of fluoride is topical, when the fluoride ion is present in the
saliva in the appropriate concentration
7
. Hydroxyapatite is the main mineral responsible for
building the permanent tooth enamel after the development of the teeth is finished
8
. During tooth
growth, the enamel is constantly exposed to numerous demineralization processes, but also
important remineralization processes, if the appropriate ions are present in the saliva. These
processes can either weaken or strengthen the enamel. The presence of fluoride in an acidic
environment reduces the dissolution of calcium hydroxyapatite .The main action is inhibition of
demineralization of enamel, which is carried out through different mechanisms. There are different
cariogenic bacteria in the plaque fluid the most important being S. mutans. When bacteria
metabolize sugars, they produce lactic acid which decreases the pH in saliva. When the pH falls
below the critical level of hydroxyapatite (pH 5.5), the process of demineralization of enamel
takes place and caries is formed. At the beginning, the process is reversible and it is possible to
reduce the formation of new lesions with appropriate preventive measures. If fluoride is present in
plaque fluid, it will reduce the demineralization, as it will adsorb into the crystal surface and
protect crystals from dissolution. Because the fluoride ion coating is only partial, the uncoated
parts of the crystal will undergo dissolution on certain parts of the tooth, if the pH falls below level
5.5. When the pH rises above the critical level of 5.5, the increased level of fluoride ion leads to
remineralization, because it absorbs itself into the enamel and forms fluorhydroxyapatite
7,8
. After
repeated cycles of demineralization and remineralization, the outer parts of enamel may change
and become more resistant to the acidic environment due to a lowered critical pH level of newly
formed crystals (pH 4.5) . The most important effect of fluoride on caries progression is thus on
demineralization and remineralization processes. It has also been proposed, that the fluoride ion
can affect the physiology of microbial cells, which can indirectly affect demineralization. Fluoride
ions affect bacterial cells through several mechanisms. One of them being a direct inhibition of
cellular enzymes ­ glycolytic enzymes, H+ATPases). It affects cellular membrane permeability
and also lowers cytoplasmic pH, resulting in a decrease in acid production from glycolysis
7
.
Fluoride prevents caries mainly by its topical effect . Dental caries result when plaque, a
sticky film of bacteria on the surface of the tooth, feeds on sugar and food residue to produce acid,
which dissolves the surface of the tooth(demineralization). Bathing the surface of the tooth with as
little as 1 ppm of fluoride causes a dramatic decrease in enamel solubility. Ingested fluoride, on the
other hand, has little effect on caries, but contributes significantly to the development of fluorosis
9
.

17
HISTORY OF FLUORIDE.
10,11
Figure 1: History of Fluoride
10,11
1530
Fluorine in the form of fluorspar was first described by a German physician
George Bauer, through his book "De re metallica".
1803
Count Carlo Morozzo of Italy found elephant fossil skeleton, which contained
organic substance, carbonic acid, fluoric acid.
1805
Morichini found fluoric acid in human teeth and claimed that fluoric acid is a
main component of dental enamel.
1805
Joseph Louis Gay-Lussac claimed that the enamel of teeth is especially rich in
"fluate" of lime as the fluoride was called then and the canine teeth contain more
of the fluate than the other teeth.
1806
Neither tooth enamel nor bones revealed the slightest traces of fluoric acid after
ashing.
1807
Detection of fluoride in samples of bones and teeth by Jöns Jacob Berzelius.
1820
Diluted fluoric acid might dissolve in the digestive tract any accidentally
swallowed pieces of glass as found by W. Krimer.
1822
Berzelius discovered fluoride 3.3 mg/l in the water of Carlsbad.
1827
Fluoride was detected by the etching-of-glass test.
Gustav Rose gave the formula of apatite ( CaF
4
+ 3 Ca
3
P
2
)
1833
Berzelius stated that bones and teeth contain up to a few tenths of a percent
fluoride.
1839
The chemist Friedrich Wöhler proposed a new method for fluoride estimation:
silica is added to every sample along with sulfuric acid.
1840
Morichini and Gay-Lussac (1805) - calcium fluoride seems to be able to
substitute for calcium phosphate in the bones and teeth.
1842
Girardin and Preisser were unable to find the slightest trace of fluoric acid in
human and animal bones.
1844
Antoine Malagou the French dentist recommended use of fluorides for the
preparation of dental fillings.

18
1849
W. Heintz carried out the etching-of-glass test, with powdered bone -proof of the
presence of fluoride.
1851
George Wilson found fluoride in several waters, in sea-water, in plants, urine,
blood and milk.
1852
Wilson presented new methods for the detection of fluoride in the presence of
silica which usually makes recognition of fluoride very difficult
1853
Fluorine was found in fossil bones of Nebraska.
1854
Fremy claimed that recent bones contain very low and variable amounts of
fluoride. Fossil bones contain more fluoride, silica in the form of quartz.
1856
Jerome Nicklès attributed to fluoride as "an importance it never had before in
medicine and physiology" after its detection in various constituent of the body.
1857
Fluoride is present in glass in small amount or it's the constituent of etching
chemical incoperated in to it
1862
Felix Hoppe could not detect any fluoride in the immature tooth enamel of
newborn pigs but found in mature enamel of adult pigs, humans.
1866
Zalesky saw weight loss of glass plates due to formation of gaseous silicon
fluoride developed from acid-treated samples.
1874
In January, 1874, Alvaro Francisco Carlos Reynosa, of France, did a
Improvement in medical compounds on "Elixir" and "Sirup" containing fluoride
of potassium, sodium or ammonium.
1875
According to Erhardt, that enamel is thinner if not enough fluoride is given but
that the tooth may be kept healthy for a longer time if more fluoride is supplied.
1888
Albert Robin used to prescribe a fluoride (10 to 100 mgs. a day) to his patients as
fluoride is to degrade the enzyme diastase against the unfavorable action of lactic
and butyric ferments.
1889
Hugo Schulz demonstrated the toxicity of sodium fluoride in feeding
experiments on several animal species.
1890
Fluorides and silicofluorides (in dilutions of 1: 1,000) were found to inhibit the
development of certain infective germs in vitro and were useful as additives in
the alcoholic fermentation process.

19
1891
J. Brandl & H. Tappeiner showed more fluoride in root than in crown and more
in dentin than enamel.
1892
Crichton-Browne proved that the enamel of the teeth contains more fluorine, in
the form of fluoride of calcium, than any other part of the body
1893
Wrampelmeyer analyzed the fluoride contents of sound versus diseased teeth of
adults and children.
1894
Gabriel revealed that if there´s any fluoride at all in bones and teeth, it is below
0.1%, and that, therefore, it is definitely of no importance
1897
A. Michel estimated the fluoride content of sound and carious teeth by Fresenius´
method.
1899
Hempel and Scheffler modified Fresenius´ method to separate carbon dioxide
from the silicon fluoride in the course of the procedure.
1899
Heinrich Harms published his results obtained with a modification by Brandl of
the Fresenius method to remove hydrochloric acid from the fumes
1903
After earlier reports that sodium fluoride inhibits bacterial metabolism, it came
into use as a food preservative.
1904
Von Stubenrauch noticed anomalous development of teeth, faulty positions,
heavy wear, and "a typical caries" in dog fed with lot of sodium fluoride.
1907
Albert Deninger, recommended calcium fluoride pills to prevent not only tooth
decay but also appendicitis.
1908
Alphonse Brissemoret regarded calcium fluoride as as an important binding
agent for the minerals of bones and teeth.
1909
Pharmaceutical Company of Berlin, patented a fluoride preparation from which
the substance could be easily absorbed
1910
Another analysis of teeth performed by Gassmann using Walter Hempel´s
method revealed the same "fluoride" values in teeth as found earlier by other
researchers using that procedure.

20
Historic evolution of fluoride in dentistry
1901
Started with the arrival of Dr Fredrick Mckay in Colorado Springs, Colorado,
USA, in 1901, He noticed stains on permanent teeth as "Colorado Stain". He
called the stains later as "MOTTLED ENAMEL
1902
The first systemic endeavour to investigate this lesion was made by Colorado
springs Dental Society in 1902
1908
Mckay presented a case at the annual meeting of State Dental Association in
Boulder and he found that this condition was not only confined to Colorads, but
extended to other towns as well
1912
Mckay came across the article written by Dr.J M Eager (1912) from Italy. Who
reported that a high proportion of Italian residents in Nepal had ugly brown stain
on their teeth known as Denti di chiaie.
1916
Mckay and Black examined 6,873 individual in USA and reported that an
unknown causative factor of mottled enamel was possibly present in domestic
water during the period of tooth calcification.
1930
Kemp and Mckay observed that no mottling occurred in people who grew up in
Bauxite prior to 1909, the year in which Bauxite had changed its supply from
shallow well to deep drilled wells
1931
Chirchill H V, after thorough spectragraphic analysis of the rare elements noted
that fluoride was present in Bauxite water at a level of 13.7ppm
1931
"SHOE LATHER SURVEY" by Trendly H Dean.
1934
Trendly H Dean introduced mottling index which is popularly known as Dean's
index for flourosis.
1942
The important milestone discovery was made by Dean et al that 1 ppm F In
drinking water, 60% reduction in dental caries experience was observed
1945
World first artificial fluoridation plant at Grand rapids ,in January 25 was done in
USA.
1946
Klein examined children of Japanese ancestry who had been transferred from a
community containing 0.1 ppm flouride or less to Arizona, where the water
contained 3 ppm of fluoride

21
1949
Russel examined caries in migrant children who lived in south Dakota with 1
ppm of fluoride in drinking water and had moved into the area containing only
0.2 ppm fluoride, resulted in progressive loss of cariostatic effect of fluoride
1969
Fluoridation was endorsed by the W H O and Dental prosthesis model base
composition containing calcium fluoride, was made.
1971
Cements were produced by additions of stannous fluoride, stannous
fluorozirconate, Indium fluorozirconate, Zirconium hexafluorogermanate, Indium
hexafluorogermanate ort Zirconyl hexafluorogermanate.
1979
"Light curable acrylic dental composition with calcium fluoride pigment" was
introduced.
1985
Fluoride interpolymeric resin was prepared
1987
Fluorine-containing dental materials", boron trifluoride which gives off fluoride
upon contact with water.
1994
Process for preparing a ceramic material for use in dental fillings and dental
crowns contains fluoroapatite.
1995
Fluoridation commemorative monument was dedicated in sept 1995 in
Grandrapids, Michigan
1997
Introducing fluoride into glass, Aluminosilicate glass particles are fluoridated by
stirring them into a solution of NH4-HF2, can be used in glass ionomer cement
compositions with polyacrylic acid without tartaric acid or other chelating agent
2001
Fluoride-releasing amalgam dental restorative material.
Fluoride was first added to toothpaste in 1956 by Proctor and Gamble in the form of Crest
toothpaste.

Details

Pages
Type of Edition
Erstausgabe
Publication Year
2017
ISBN (PDF)
9783960676423
ISBN (Softcover)
9783960671428
File size
912 KB
Language
English
Institution / College
Divya Jyoti College of Dental Sciences and Research
Publication date
2017 (April)
Keywords
Tooth decay Dental caries Anticaries agent Fluoride dentifrice Caries prevention Acidulated Phosphate Fluoride Fluoride varnishes Amine fluoride Prevention of dental caries Study of literature Library
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