Total and Free Fluoride in Toothpastes from Some Non-Established Market Economy Countries

Abstract

In 101 fluoride toothpastes, bought in local shops in Burkina Faso (n = 3), China (n = 5), Myanmar (n = 22), Nepal (n = 19), Philippines (n = 13), Syria (n = 22), Togo (n = 7) and Vietnam (n = 10), the total and free ionisable fluoride concentrations were established. The total fluoride concentration of the toothpastes was determined by gas liquid chromatography. The amount of soluble fluoride was measured after dilution in artificial saliva and treatment of the supernatants with acidic phosphatase. The free fluoride concentration in this mixture was measured with a fluoride electrode. Twenty-five percent of all toothpastes contained less than 738 ppm total fluoride, and another 25% contained between 738 and 977 ppm fluoride. Regarding free ionisable fluoride the 25th, 50th, and 75th percentile contained ≤275, 780 and 990 ppm fluoride, respectively. Of the 61 toothpastes with declared fluoride concentration, 75% contained a total F concentration of ≧89% of the declared concentration. In 25% of these toothpastes the free ionisable fluoride was ≤55% of the declared fluoride, and in another 25% of the pastes the free ionisable fluoride concentration was ≧89% of the declared fluoride. In conclusion, deficiencies were found regarding the total as well as the free ionisable fluoride concentration of toothpastes bought in non-established market economy countries. Unclear labelling concerning the type and concentration of fluoride was often encountered. A need for quality control of fluoride toothpastes is recommended.

Dental volunteering – a time for reflection and a time for change

“…14 Another worrying aspect is that many so-called fluoride toothpastes, even well known brands, in developing countries do not contain the required levels of free ionisable fluoride to make them effective for caries prevention. 23 There is therefore an urgent need to work on methods by which fluoride toothpaste can be made more affordable while ensuring adequate quality control to maintain its effectiveness • Promotion of proper infection control in dental and other health settings (Fig. 4).…”

Evaluation of fluoride bioavailability in toothpastes

“…However, in order to interfere with the caries process, fluoride ions need to be soluble in their formula of the fluoride toothpastes so that they can be available for the de-and remineralization process 10) . However, other components of toothpaste including abrasives can bind to fluoride ions and interfere with their activity 17) .…”

“…However, as more number of investigations were done on fluoride toothpastes, it was found that for the toothpastes to be effective against caries, the fluorides need to be in soluble form and that the anti-caries effect could be reduced by insoluble salts formed between the free fluoride ions and the abrasives contained in the toothpastes 9,10) . Thus, it is crucial for the toothpastes to contain sufficient concentration of not only the total fluoride but also the soluble fluoride to be effective in prevention of caries.…”

“…Considering the maximum permitted fluoride content in toothpaste used to be 1,000 ppm when these studies were performed, it can be assumed that most of the fluoride toothpastes commercialized in Korea contained soluble fluoride in close proximity of the labeled fluoride. Nevertheless, there was a previous study which determined total and free fluoride from the toothpastes purchased in low-income countries, and they reported that in 25% of the toothpastes, <55% of the declared fluoride was in free fluoride form 10) .…”

Mondzorgvrijwilligerswerk in ontwikkelingslanden 2. Effectief zorgverlenen

“…Een laatste belangrijk aspect van het verbeteren van preventieve zorg is het bevorderen van het gebruik van betaalbare en effectieve fluoridetandpasta. Veel fluoridetandpasta's in de derde wereld bevatten onvoldoende vrije fluoride ( Van Loveren et al, 2005). De aanwezigheid van vrije fluoride is een voorwaarde voor de werkzaamheid tegen cariës (Van Palenstein Helderman et al, 2004).…”