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Biomedical subjects

Gary M Whitford

Publications and source records attributed to Gary M Whitford.

7 recordsLinked to original sources

Relationship between daily fluoride intake from diet and the use of dentifrice and human plasma fluoride concentrations.

The literature contains reports of the relationship between the fluoride concentrations in drinking water and human plasma. None of these studies, however, documented individual levels of daily fluoride intake, which can vary considerably among individuals served by the same water supply. Furthermore, while water can be an important source of fluoride, other sources, especially fluoridated dentifrices, also contribute substantially. This 2-day study with five 25-35-year-old subjects in each of three communities (Bauru, 0.6-0.8 ppm F; Domelia, 0.7 ppm F; Floresta, 0.3 ppm F) determined plasma fluoride concentrations and fluoride intake from diet and the use of dentifrice which, together, approximate total daily fluoride intake. The purposes were to determine: (1) the extent to which plasma fluoride concentrations approached levels known to affect the quality and quantity of bone; (2) the relationship between fluoride intake and plasma concentrations. Plasma was collected at 4-h intervals starting at 0800 h and ending at 2000 h each day. Average fluoride intakes from diet and the use of dentifrice in the three communities ranged from 0.16 to 0.82 mg/day and from 0.29 to 3.16 mg/day, respectively. The overall average plasma concentrations in the three communities were 0.44, 0.45 and 0.54 micromol/l (P<0.005). They were directly related to intake from the use of dentifrice (P=0.030) and to total intake (P=0.033), but were not related to dietary intake (P=0.176). In conclusion, despite fluoride intake from various sources, the plasma fluoride concentrations of the study subjects remained at levels far below those associated with effects on bone production.

Adult↗

Fluoride concentrations in dental plaque and saliva after the use of a fluoride dentifrice preceded by a calcium lactate rinse.

Plaque fluoride concentrations ([F]) are directly related to plaque calcium concentrations [Ca]. Attempts to increase plaque F uptake from dentifrices or rinses have used methods designed to increase plaque [Ca] but with inconsistent results. This double-blind, double-crossover study tested the effect of a 150 mM calcium lactate rinse used prior to brushing with placebo or fluoridated dentifrices (1030 p.p.m. as NaF) on plaque and salivary [F] and [Ca]. Sixteen children (8-10 yr of age) were randomly assigned to four different groups according to the four treatments (placebo dentifrice or fluoridated dentifrice preceded by calcium lactate or deionized water prerinses). Plaque and saliva were collected 1 and 12 h after brushing on day 7 after starting to use the dentifrices. F was determined using the electrode and Ca was determined using atomic absorption spectrometry. Plaque and salivary [Ca] were not significantly increased after use of the calcium lactate prerinse, except for plaque [Ca] 1 h after the use of the placebo dentifrice. A significant increase in salivary [F] was associated with the calcium lactate prerinse only at 1 h after the use of the fluoridated dentifrice. The the calcium lactate prerinse did not significantly affect plaque [F] under any condition.

Calcium↗

A reproducibility study for a fluoride assay in bone.

Osteosarcoma is a rare malignancy of largely unknown etiology. Although there is no consistent evidence for an association between fluoridation and cancer, some concerns remain about osteosarcoma. As part of the design of a collaborative study, bone samples were collected to allow for an evaluation of the association between osteosarcoma risk and individual fluoride exposure measured by levels of fluoride in bone. In this report, we provide the results of pilot experiments to consider issues that arose during the study design and to assess the reliability of the bone assays. Correlations of fluoride levels between normal bone near the affected area and iliac crest bone were strong and positive. The day-to-day laboratory analysis of fluoride in human and deer jaw bone yielded acceptable average coefficients of variation below 10% and an overall estimate of 5%. The intraclass correlation (ICC) is of particular importance to epidemiologists because it indicates the effect of measurement error on study results. Here, the estimated ICC is 0.86, and the estimated downward bias is only 14%. Hence, the ICC is strong enough so that the estimates of the relative risk will suffer little attenuation from lab measurements.

Animals↗

Elevated serum fluoride concentrations in women are not related to fractures and bone mineral density.

Epidemiologic studies of the relations between drinking-water fluoride levels and bone mineral density (BMD) and fracture are characterized by disparate conclusions and an absence of information about individual circulating fluoride levels. This study relates serum fluoride concentrations, which reflect individual fluoride exposures, to BMD and bone fractures. Data are from 1300 female residents of 3 small communities in which the water fluoride concentrations were 52.6 or 210.4 micromol/L. Circulating serum fluoride concentrations were assessed by ion-specific electrode. Fluoride intake was estimated from interviews describing water and water-based beverage consumption and duration of residence in the community. BMD was measured by dual-energy X-ray densitometry and single-photon densitometry. Self-reported fractures were confirmed by medical record abstraction. The mean serum fluoride concentration in the high-fluoride community, 2.11 +/- 0.05 micromol/L, was significantly higher than serum fluoride concentrations in the control and high-calcium communities with water fluoridation to 52.6 micromol/L. The mean serum fluoride concentrations in these latter 2 communities were 1.6 +/- 0.04 and 1.22 +/- 0.05 micromol/L, respectively. Serum fluoride was not significantly related to BMD after adjusting for covariates including age and body size. The mean distal radius BMD, however, was significantly higher in the high-fluoride community. Serum fluoride concentrations were not related to incident osteoporotic fractures with 4 y of observation. Serum fluoride concentrations were not associated with BMD or osteoporotic fractures among female residents of communities with water fluoride concentrations of 52.6 or 210.4 micromol/L.

Absorptiometry, Photon↗

Fluoride metabolism when added to salt.

The purpose of this review is to present the general characteristics of the metabolism of fluoride particularly as it occurs when ingested with fluoridated salt. Following the absorption of salt-borne fluoride from the stomach and intestines, its metabolism is identical to that of water-borne fluoride or other vehicles containing ionized fluoride. Because fluoridated salt is almost always ingested with food, however, absorption from the gastrointestinal tract may be delayed or reduced. Reports dealing with this subject have shown that fluoride absorption is delayed and, therefore, peak plasma concentrations are lower than when fluoride is ingested with water. The amount of ingested fluoride that is finally absorbed, however, is not appreciably affected unless the meal is composed mainly of components with high calcium concentrations. In this case, the extent of absorption can be reduced by as much as 50%. Fluoridated salt is also ingested less frequently than fluoridated water. Data are presented to show that the dose size and frequency of ingestion have only minor effects on fluoride retention in the body and on the concentrations in plasma, bone and enamel. Finally, calculations are presented to show that the risk of acute toxicity from fluoridated salt is virtually non-existent.

Absorption↗

Monitoring fluoride exposure with fingernail clippings.

The purpose of this review is to discuss new information regarding the relationship between the level of fluoride exposure and the corresponding fluoride concentrations in fingernail clippings. While there are several techniques available to extract fluoride from fingernails prior to analysis with the electrode, the HMDS-facilitated diffusion method is the most popular. Fluoride enters fingernails at the growth end and reaches the distal end approximately three months later. The fluoride concentration in the clipping reflects the average fluoride intake and plasma concentration during the period when the clipping was formed. Therefore, the concentration in the clipping is directly related to the average fluoride exposure that occurred during a 1-2 week period (depending on the length of the clipping) about three months ago and not to recent and possibly variable exposures that occur during the day. Published studies have demonstrated that fingernail fluoride concentrations reflect fluoride exposures from drinking water, toothpaste and the work environment and can be expected to do so for any source of intake including salt.

Cariostatic Agents↗

Plaque fluoride concentrations are dependent on plaque calcium concentrations.

Despite the 1000-fold difference between the fluoride concentrations ([F]) in dentifrices and fluoridated drinking water, clinical and epidemiological studies have shown that they have similar cariostatic effects. This double-blind, crossover study was done to determine whether the [F] in dental plaque is related more to the [F] of the dentifrice used or to the plaque concentrations of calcium and magnesium. The subjects (n = 13) were adults and residents of a city served with fluoridated drinking water. After 1 week of using a fluoridated dentifrice (940 ppm) or a placebo dentifrice, whole saliva and plaque were collected 1.0 h and approximately 12 h after the last use of the dentifrices. The average salivary [F] after brushing with the F dentifrice was higher than after using the placebo. The average plaque [F] 1.0 h after brushing with the F dentifrice was higher than after using the placebo (p < 0.01), but the difference at 12 h was not significant. Plaque [Ca] and [F] were directly related under all experimental conditions (p = 0.0001). The relationships between plaque [Mg] and [F] were weaker and inconsistent. Based on these findings and reports in the literature it is concluded that, for persons whose drinking water is fluoridated, plaque [F] throughout much of the day is not significantly increased by the use of a fluoridated dentifrice. Instead they are directly related to plaque [Ca]. These findings offer at least a partial explanation for why fluoridated dentifrices and drinking water have similar cariostatic effects.

Adult↗