How much for whom and in what form?


But, as is often the case, the right dose decides whether it’s a poison or a blessing. A constant overdose of fluoride disrupts the formation of tooth enamel, and also causes the appearance of white or brown spots. This dental fluorosis often affects the incisors, especially in infants and young children. According to the European Food Safety Authority (EFSA), the optimal dose with the highest caries preventive effect and the lowest risk of fluorosis is 0.05 mg/kg body weight per day. [16]. However, a daily dose of 0.1 mg/kg body weight should not be exceeded as the Tolerable Upper Intake Level (UL). [6]. The narrow therapeutic range is precisely taken into account in the current recommendations for young children with 1000 ppm. However, for this, parents must dose their children with toothpaste, and up to the age of two, they only consume an amount the size of a grain of rice. From two years of age, a pea-sized amount is desirable. In the first year of life, the simultaneous use of fluoride toothpaste and fluoride tablets should be avoided – and after the first birthday, the use of tablets is no longer recommended anyway. Nevertheless, fluorides are not a panacea because caries is not a fluoride deficiency disease. Along with nutrition, regular checkups and proper dental care, they are an important pillar of dental health.

Literature:

[1] Gangler P et al. Conservative dentistry and periodontology. 2010, 34-36, doi: 10.1055/b-0034-18490

 [2] Gesenhues S, Ziesché R. Handbook of general medical practice. 5th edition, 2006; 1340-1344

 [3] Schiffner U. Use of fluorides in caries prevention. Bundesgesundheitsblatt Health Research Health Protection, 2021;64(7):830-837, doi: 10.1007/s00103-021-03347-4

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 [4] Elmex jelly dental gel. Special information from CP GABA GmbH. in 2021 March. specialized information directory Germany, www.fachinfo.deviewed in 2022 August 24

 [5] Lussi A et al. Fluorides – mechanisms of action and recommendations for their use. Oral prophylaxis and pediatric dentistry 2012; 34, Deutscher Ärzteverlag, Cologne

 [6] Berg B et al. Caries prevention in infancy and early childhood. Monthly Schr Kinderheilkd 2021;169;550-558, doi: 10.1007/s00112-021-01167-z

 [7] Cury JA et al. Effect of calcium carbonate-based toothpaste on enamel demineralization in situ. Caries Res 2003;37(3):194-199, doi: 10.1159/000070444

 [8] Hellwig E, Klimek J, Wagner H. The Influence of Plaque on Reaction Mechanism of MFP and NaF in vivo. Journal of Dental Research 1987;1:46-49

 [9] Kauer I. Stannous fluoride – a multifunctional talent for daily dental care. Management culture of ZMK Dentistry 2022; www.zmk-aktuell.de/fachgebiete/prophylaxe/story/zinnfluorid–ein-multitalent-in-der-taeglichen-zahnpflege__11658.htmlviewed in 2022 August 28

[10] Van der Mei HC, Engels E, de Vries J, et al. Effects of amine fluoride on biofilm growth and salivary layers. Caries Res 2008;42(1):19-27, doi: 10.1159/000111746

[11] Information about dental medicines. Information from the Drug Commission for Dentists. from 2022 month of January. www.bzaek.de/fileadmin/PDFs/iza_pdf/IZA.pdf

[12] Oosterkamp BCM, van der Sanden WJM, Frencken JEFM, et al. Caries prevention in orthodontic practice: development of medical guidelines. Information from Orthodontie & Kieferorthopädie 2017;49(02):122-131, doi: 10.1055/s-0043-112086

[13] Scholz KJ, Buchalia W. Root caries – know, recognize, treat successfully. Das Deutsche Zahnärzteblatt 2019;128(10):501-509, doi: 10.1055/a-1011-7974

[14] Hellwig E, Klimek J, Lussi A. Fluorides – mechanisms of action and recommendations for their use. ZMK Dentistry Management Culture, 2013 December 17 https://www.zmk-aktuell.de/fachgebiete/prophylaxe/story/fluoride–wirkungsmechanismen-und-empfehlungen-fuer-deren-gebrauch__977.htmlviewed in 2022 August 28

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[15] durafat. Fluoride 5 mg/g toothpaste. Special information from CP Gaba GmbH, 2014. April, specialized information catalog Germany, www.fachinfo.de

[16] Scientific Opinion on Dietary Reference Values ​​for Fluoride. European Food Safety Authority (EFSA), EFSA Journal, 2013, 11(8):3332, https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa.2013.3332

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