Low-levels of fluoride in plaque and saliva and their effects on the demineralisation and remineralisation of enamel; role of fluoride toothpastes

Abstract

Aim: To summarise support for current consensus on the likely means by which fluoride toothpastes reduce caries and review some relevant studies of the effect of low levels of fluoride on the demineralisation and remineralisation of enamel. The major anti‐caries effect of fluoride toothpastes is thought to result from small but protracted elevations in levels of fluoride in plaque and saliva. Fluoride incorporated into enamel systemically does not reduce enamel solubility sufficiently to exert an anti‐caries effect. Fluoride has the potential to exert an anti‐caries benefit largely through three mechanisms; inhibition of demineralisation, promotion of remineralisation and interference with bacterial growth and metabolism. However, the low levels of fluoride thought to influence caries are insufficient to have a significant effect via the latter mechanism. Thus reductions in caries resulting from the use of fluoride toothpastes can be linked to modification of the demineralisation/remineralisation balance by direct effects on dental mineral exerted topically by low levels of fluoride. Numerous in vitro studies have shown that low levels of fluoride, typical of those found after many hours in resting plaque and saliva, and resulting from the regular use of fluoride toothpastes, can have a profound effect on enamel demineralisation and remineralisation.

Is there a role for triclosan/copolymer toothpaste in the management of periodontal disease?

“…The daily topical application of fl uoride via toothbrushing strengthened enamel and healed the early carious lesion. 2,3 Dental caries is, however, not the only oral health care problem that the dental team is Dental caries and periodontal disease are the most common oral conditions experienced by adults today. The treatment of these diseases by the dental team can only be performed when patients attend dental practices.…”

Comparison of the newer preventive therapies on remineralisation of enamel in vitro

“…Many studies have demonstrated the profound effect of fluoride on enamel demineralisation and remineralisation that resulted from regular use of toothpaste, even with low levels of fluoride (Bowen, 1995, Lynch et al, 2004.…”

Systemic Methods of Fluoride and the Risk for Dental Fluorosis

“…The low levels of fluoride are those found after many hours on resting dental plaque and saliva, and resulting from the regular use of fluoride toothpastes. Another source of low levels of fluoride are the constant exposure to this substance from water, milk, salt or whatsoever source is available on the oral environment (Lynch et al, 2004).…”