Fluoride in sugar.

Abstract

Results of caries model studies in vitro and in animals suggest that the tooth-protective potential of fluoride may be best utilized if fluoride is brought to the local caries milieu at the moment of each caries attack. Two clinical trials performed so far indicate that a reduction in caries increment of about 40 per cent can be obtained within 3 years through small (0.5-1.0 mg) daily intakes of fluoride when it is incorporated in highly cariogenic sucrose products or in tablets having a sucrose base. When incorporated in sucrose products, fluoride caused a complete arrest of caries during the third year. There was substantial accumulation of the supplemental fluoride in surface and subsurface enamel beneath the plaque fermenting the F-supplemented sucrose. This may be one of the preventive mechanisms involved. In plaque fluid, the supplemental fluoride, together with fluoride released from the plaque material and by the action of acid on the surface enamel of high fluoride content, may strongly reduce further enamel dissolution and promote its remineralization. Further metabolism of the plaque bacteria including their acid production may also be inhibited. Among the many advantages of using this principle are that: the supplemental fluoride in sugar automatically seeks the caries risk subjects who use sugary products; the amount of fluoride needed per kg of sugar may remain low and thus the risk of excessive intake of fluoride may also be low; the technical process is low in cost and easily performed; and the products are easily distributed nationwide. Furthermore, non-fluoridated sugary products may still be distributed to those who may continue to prefer them.