RESUMO
La mayor expectativa de vida de la población mundial ha llevado a una mayor conservación dentaria y como consecuencia, a una mayor prevalencia de caries radicular en la población mayor. La información epidemiológica ha mostrado que el enfoque invasivo de la odontología restauradora no ha sido capaz de dar una solución a esta problemática de salud pública. El enfoque de la Minimal Intervention Dentistry (MID), a través de las terapias no invasivas (TNIs) en base a fluoruros de alta concentración, podrían ser la clave para abordar esta problemática debido a su enfoque conservador, centrado en el paciente y a través del curso de vida. Este artículo pretende mostrar la evidencia existente acerca de las TNIs en base a fluoruros de alta concentración más utilizadas para lesiones de caries radicular (RCLs), a saber, los dentífricos de 5.000 ppm, barnices de flúor y fluoruro diamino de plata. La evidencia científica demuestra que estas TNIs son una alternativa terapéutica en población mayor a pesar de la aun limitada evidencia científica existente para este grupo etario. Por lo tanto, se requieren mayores estudios en población mayor que sustenten estas intervenciones clínicas, principalmente en aquella población con compromiso funcional y/o cognitivo.
The longer life expectancy of the world population has led to a greater dental conservation and, as a consequence, to a higher prevalence of root caries in the elderly population. Epidemiological data have shown that the invasive approach of restorative dentistry has not been able to provide a solution to this public health problem. The Minimal Intervention Dentistry (MID) approach, through non-invasive therapies (NIT) based on high-concentration fluorides, could be the key to address this problem due to its conservative, patient-centered and life-course approach. This article aims to show the existing evidence about the most commonly used high-concentration fluoride-based NITTs for root caries lesions (RCLs), namely 5,000 ppm dentifrices, fluoride varnishes and silver diamine fluoride. The scientific evidence shows that these NITs are a therapeutic alternative in the elderly population despite the still limited scientific evidence for this age group. Therefore, further studies are required in the elderly population to support these clinical interventions, mainly in the population with functional and/or cognitive compromise.
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Objectives: This study investigates the estimation of the fluoride concentration in drinking water in Rohtak district, Haryana, and quantifies its effect on the prevalence of dental fluorosis and dental caries. Materials and Methods: A cross-sectional survey was conducted among 1262 school children in endemic fluoride areas of Haryana. Using simple random sampling, thirty villages from five blocks of Rohtak districts were selected, and children 6–12 years of age were examined. A questionnaire survey form was filled out to record the demographic details of the samples. Dental caries was recorded according to DMFT (D = Decayed, M = Missing due to caries only, F = Filled, T = Teeth)/deft index (d = decayed, e = extracted due to caries, f = filled, t = teeth). Assessment of Dental Fluorosis was done according to Dean's Fluorosis index, modified in 1942. The data were analyzed using SPSS version 19, and nonparametric tests were used to assess the significance. Results: The study participants included 615 males and 647 females among which Mean DMFT in the area of study ranged from 0.32 to 1.90. Mean deft in the area of study ranged from 0.34 to 1.91. The fluoride concentrations in groundwater are in the range of 0.532–8.802. Out of 1262 children examined, 655 (51.90%) children were having dental fluorosis. 607 (48.10%) of the subjects were free from fluorosis. 16.09%, 13.39%, 9.11%, and 8.16% and 5.15% were having questionable, very mild, mild, moderate, and severe form of fluorosis, respectively. Conclusion: It can be concluded that in Rohtak district, the fluoride levels in drinking water and the prevalence of dental fluorosis are high, so requiring an urgent need to improve the quality of water and institute de-fluoridation of drinking water in affected areas to lower the burden of dental fluorosis in the community.
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Dental treatment is a highly sought-after but costly procedure in the world, so it is important to consider measures to prevent dental disease. Among the ways of prevention, drinking water fluoridation, which involves adding relevant amounts of fluoride to the water supply reaching communities, stands out. However, it is not clear whether there are enough researchers who have addressed the issue, or that their methodology has been adequate to provide alternatives to solve some conditions, such as dental fluorosis, which, in contrast, is manifested by excessive fluoride intake. The main objective was to explore and analyse the academic production on the concentration of fluoride present in drinking water in order to find a relationship with dental fluorosis in children. To this end, the PRISMA model was used as a starting point in order to carry out a systematic review of academic articles chosen according to selection criteria. These will be extracted from five databases, using a documentary-type methodology, whose data collection will be carried out in virtual environments. From this, it was concluded that the academic production includes the concentration of fluoride in drinking water as a means of prevention for dental pathologies; however, the levels of fluoride allowed in children should be known, as the excess of fluoride in the teeth causes dental fluorosis, which turns out to be the cause of psychological complexes in children due to an aesthetic issue.
El tratamiento dental es un procedimiento muy solicitado en el mundo, pero costoso de realizar; por lo que, es importante considerar medidas para prevenir enfermedades dentarias. Entre las formas de prevención, destaca la fluoración del agua potable, que implica añadir cantidades pertinentes de flúor al suministro de agua que llega a las comunidades. Sin embargo, no se precisa si existen suficientes investigadores que hayan abordado el tema, o que su metodología empleada haya sido la adecuada como para brindar alternativas para solucionar algunas afecciones, tales como la fluorosis dental que; en contraste, se manifiesta por la excesiva ingesta de flúor. El objetivo principal, realizar una exploración y análisis de la producción académica sobre la concentración de flúor presente en el agua potable con el fin de encontrar una relación con la fluorosis dental en niños. Para ello, se partió del modelo PRISMA con el fin de proceder una revisión sistemática de artículos académicos escogidos mediante criterios de selección. Estos serán extraídos de cinco bases de datos, valiéndose entonces, de una metodología de tipo documental, cuya recolección de datos se efectuará en entornos virtuales. A partir de ello, se concluyó que la producción académica incluye a la concentración del flúor en agua potable como un modo de prevención para patologías dentales; no obstante, se debe conocer los niveles de flúor permitido en los niños, pues el exceso de flúor en los dientes origina fluorosis dental, la cual resulta ser causante de complejos psicológicos en los niños debido a un tema estético.
Assuntos
Fluorose Dentária , Doenças Dentárias , Água Potável , Halogenação , FluoretosRESUMO
Objective To study the benchmark dose (BMD) of fluoride concentration in saliva,and to evaluate the significance of saliva fluoride on control and prevention of endemic fluorosis.Methods In September 2014,middle school students in endemic fluorosis areas and non-endemic fluorosis areas in North China Petoleum were selected as objects.The contents of fluoride in water,urine and saliva were determined.The correlation of fluoride content in water,urine fluoride and fluoride concentration in saliva was analyzed.According to the levels of the saliva fluoride concentration,the children were divided into 11 groups,＜ 1.00,1.00-,2.00-,3.00-,4.00-,5.00-,6.00-,7.00-,8.00-,9.00-and ≥ 10.00 mg/L.The prevalence of dental fluorosis and defected dental fluorosis were investigated and the saliva fluoride concentration was calculated by Banch-Mark Dose Software.Results Compared with non endemic areas,the fluoride contents in water,urine and saliva [(2.13 ± 0.13),(1.29 ±0.73),(4.01 ± 3.61) mg/L] were higher than that in endemic areas [(0.67 ± 0.13),(0.38 ± 0.08),(0.75 ± 0.12) mg/L,t =158.730,24.780,18.114,all P ＜ 0.01].The fluoride concentration in saliva was positively correlated with the fluoride content in water and urine in endemic areas (r =0.626,0.945,all P ＜ 0.01).The (BMDs and benchmark dose lower bound (BMDLs) were 0.91,0.54,3.72,3.32 mg/L respectively,calculated by Banch-Mark Dose Software.With the increase of fluoride concentration in saliva,the prevalence of dental fluorosis and defect dental fluorosis had increased too,especially when the fluoride content in saliva was more than 4 mg/L.There were significant doseresponse relationships between the urine fluoride and the prevalence of dental fluorosis and defected dental fluorosis.Conclusion The fluoride concentration in saliva could be used as one of the evaluation indexes of fluorosis,and the BMD of saliva fluoride concentration in endemic fluorosis areas is suggested as 0.91 mg/L.
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Objectives: To compare the overall dental aesthetic index scores between rural and urban areas, males and females, and to correlate dental aesthetic index score with fluoride concentration in drinking water. Settings and Design: The study was cross sectional and conducted among 15 year old adolescents in the rural and urban areas of Nalgonda district, Andhra Pradesh, India (an endemic fluoride belt). Materials and Methods: Six out of 59 mandals in Nalgonda district were first selected by simple random sampling technique. Then 24 secondary schools were selected from these six selected mandals. All eligible grade X children from these sixteen rural and eight urban schools, having different fluoride concentrations in drinking water, selected by simple random sampling, were considered for the study. Dentofacial anomalies with criteria of dental aesthetic index were used for assessing malocclusion. The information on the dietary habits, orthodontic treatment history, parafunctional habits, continuous residence etc., was collected using a pre-designed questionnaire. The examination was carried out by three trained and calibrated dentists. The Dental Aesthetic Index (DAI) scores, in areas with below optimal, optimal and above optimal fluoride concentrations, between urban and rural areas were compared and analyzed using SPSS windows version 16. Results: The mean DAI scores, for the rural and urban population were 21.37 ± 5.845 (mean ± SD) and 22.26 ± 6.115, for males and females, it was 20.86 ± 5.100 and 22.70 ± 6.713 respectively. The mean DAI scores in areas with below optimal, optimal and above optimal fluoride concentration were 23.42 ± 7.205 (mean ± SD), 20.85 ± 4.658 and 19.93 ± 4.312 respectively. Conclusion: The prevalence and severity of malocclusion was more in urban than rural areas, more among females than males, and it decreased with increasing concentration of fluoride in drinking water.
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OBJECTIVES: This study aimed to confirm the efficacy of the urinary fluoride concentration/creatinine ratio for monitoring fluorine intake in fluoridated and non-fluoridated communities. METHODS: The correlations among the fluoride concentration in drinking water and that in the urine and fingernails of 52 preschool children (age, 60-72 months) from fluoridated and non-fluoridated communities were analyzed. RESULTS: The urinary fluoride concentration/creatinine ratio had a relatively high correlation with the fluoride concentration in drinking water (Pearson's correlation coefficient, 0.606; P0.05). CONCLUSIONS: The findings of this study suggest that the urinary fluoride concentration/creatinine ratio in children can be utilized as an index for monitoring excess fluoride intake in fluoridated communities.
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Criança , Pré-Escolar , Humanos , Ingestão de Líquidos , Água Potável , Fluoretação , Fluoretos , Flúor , UnhasRESUMO
OBJECTIVES: Present study was undertaken to investigate the crystal growth onto synthetic hydroxyapatite (HA) seeds in pH 4.3 and pH 7.0 supersaturated solutions with different fluoride concentrations. MATERIALS AND METHODS: 8 groups of pH 4.3 and 7.0 calcium phosphate supersaturated solutions were prepared with different fluoride concentrations (0, 1, 2 and 4 ppm). Calcium phosphate precipitates yield crystal growth onto the HA seed surface while solutions flow. For evaluation of crystallizing process, the changes of Ca2+, PO4(3-), F- concentrations of the inlet and outlet solutions were determined. The recovered solid samples were weighed to assess the amount of minerals precipitated, and finally determined their composition to deduce characteristics of crystals. RESULTS: During the seeded crystal growth, there were significantly more consumption of Ca2+, PO4(3-), F- in pH 4.3 solutions than pH 7.0 (p < 0.05). As fluoride concentration increased in pH 4.3 solution, Ca2+, PO4(3-), F- consumption in experimental solutions, weight increment of HA seed, and fluoride ratio in crystallized samples were increased. There were significant differences among the groups (p < 0.05). But in pH 7.0 solution, these phenomena were not significant. In pH 7.0 solutions, analyses of crystallized samples showed higher Ca/P ratio in higher fluoride concentration. There were significant differences among the groups (p < 0.05). But in pH 4.3 solution, there were not significant differences in Ca/P ratio. CONCLUSIONS: Crystal growth in pH 4.3 solutions was superior to that in pH 7.0 solutions. In pH 4.3 solutions, crystal growth increased with showed in higher fluoride concentration up to 4 ppm.
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Baías , Cálcio , Fosfatos de Cálcio , Cristalização , Durapatita , Fluoretos , Concentração de Íons de Hidrogênio , Minerais , SementesRESUMO
Background: The regular ingestion of fluoride lowers the prevalence of dental caries. The total daily intake of fluoride for optimal dental health should be 0.05-0.07 mg fluoride/kg body weight and to avoid the risk of dental fluorosis, the daily intake should not exceed a daily level of 0.10 mg fluoride/kg body weight. The main source of fluoride is from drinking water and other beverages. As in other countries, consumption of bottled water, juices and carbonated beverages has increased in our country. Objective: To analyze the fluoride content in bottled water, juices and carbonated soft drinks that were commonly available in Davangere city. Materials and Methods: Three samples of 10 commercially available brands of bottled drinking water, 12 fruit juices and 12 carbonated soft drinks were purchased. Bottled water and carbonated soft drinks were stored at a cold place until fluoride analysis was performed and a clear juice was prepared using different fruits without the addition of water. Then, the fluoride analysis was performed. Results: The mean and standard deviation of fluoride content of bottled water, fruit juices and carbonated soft drinks were measured, which were found to be 0.20 mg (±0.19) F/L, 0.29 mg (±0.06) F/L and 0.22 mg (±0.05) F/L, respectively. Conclusion: In viewing the results of the present study, it can be concluded that regulation of the optimal range of fluoride in bottled drinking water, carbonated soft drinks and fruit juices should be drawn for the Indian scenario.
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Ananas , Bebidas/análise , Bebidas Gaseificadas/análise , Carica , Cariostáticos/análise , Citrullus , Citrus aurantiifolia , Citrus sinensis , Fluoretos/análise , Fragaria , Frutas , Humanos , Índia , Eletrodos Seletivos de Íons , Malus , Mangifera , Águas Minerais/análise , Musa , Lythraceae , VitisRESUMO
Plasma inorganic fluoride concentrations were measured in adult patients without hepatic or renal disease following sevoflurane-N2O anesthesia (n = 7) or enflurane-N2O anesthesia (n = 6). The anesthetic dosage of sevoflurane and enflurane was 6.48 +/- 2.15 %-hours and 6.57 +/- 2.50 %-hours, respectively. The mean peak plasma inorganic fluoride concentration in the sevoflurane group was 19.5 +/- 13.4 mumol/L 1 hour after anesthesia, which decreased to preanesthetic levels 24 hours after anesthesia. In the enflurane group the values were 13.2 +/- 5.8 mumol/L at the end of anesthesia and decreased, but remained, still twice as high as the preanesthetic level 24 hours after anesthesia. The relationship of plasma inorganic fluoride concentration and anesthetic dosage was more pronounced in the sevoflurane group (r = 0.68, slope = 4.2) than in the enflurane group (r = 0.39, slope = 1.2). In conclusion, sevoflurane-N2O anesthesia results in similar subnephrotoxic levels of plasma inorganic fluoride as enflurane-N2O anesthesia, and although the fluoride concentration had a better correlation to anesthetic dosage in the sevoflurane group than in the enflurane group, its excretion was faster in the sevoflurane group than in the enflurane group.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Anestesia Geral , Anestésicos , Estudo Comparativo , Enflurano , Éteres , Fluoretos/sangue , Pessoa de Meia-Idade , Óxido NitrosoRESUMO
Plasma inorganic fluoride concentrations were measured in adult patients without hepatic or renal disease following sevoflurane-N2O anesthesia (n=7) or enflurane-N2O anesthesia (n=6). The anesthetic dosage of sevoflurane and enflurane was 6.48+/-2,15%-hour and 6.57+/-2.05%-hour, respectively. The mean peak plasma inorganic fluoride concentration in the sevoflurane group was 19.5+/-13.4 umol/L 1hour after anesthesia, which decreased to preanesthetic levels 24 hours after anesthesia. In the enflurane group the values were 13.2+/-5.8 umol/L at the end of anesthesia and decreased, but remained, still twice as high as the preanesthetic level 24 hours after anesthesia. The relationship of plasma inorganic fluoride concentration and anesthetic dosage was more pronounced in the sevoflurane group (r=0.68, slope=4.2) than in the enflurane group (r=0.39, slope=1.2). In conclusian, sevoflurane-N2O anesthesia results in similar subnephrotoxic levels of plasma inorganic fluoride as enflurane-N2O. anesthesia, and although the fluoride concentration had a better correlation to anesthetic dosage in the sevoflurane group than in the enflurane group, its excretion was faster in the sevoflurane group than in the enflurane group.