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Comparative uptake of fluoride from sodium fluoride, ammonium fluoride, and barium fluoride in rat teeth when predominantly administered in the pre-eruptive stage of development.

A comparative study was undertaken which focused on the systemic uptake of sodium fluoride (NaF), ammonium fluoride (NH4F), and barium fluoride (BaF2) in rat pups. Two critical achievements made this comparative study possible: (a) the demonstration of significant increases in fluoride (F) uptake-deposition in the treatment group pups relative to control group rats as a result of stomach tube feeding; and (b) the demonstration of clear-cut differences in F concentration levels between the treatment groups as a result of this stomach tube-systemic uptake. Data were reliable and significant enough to suggest that, of the 3 compounds in question, NH4F is absorbed most successfully in a systemic fashion, whereas BaF2 is the least absorbed.

Ammonia

Urinary fluoride excretion in children using potassium fluoride containing salt or sodium fluoride supplements.

With the introduction of fluoridated domestic salt in France in 1986, questions have arisen with respect to its efficacy in caries prevention. It has been of interest to compare the urinary excretion of fluoride in children who consume fluoridated salt to that in children who take fluoride tablets. Ninety-three schoolchildren, 10-14 years of age, participated in the study and were divided into four groups: group I consumed fluoridated salt with every meal; group II ate at a school restaurant once a day and consequently consumed fluoridated salt at only their evening meal, as fluoridated salt is not authorized for use in collective restaurants; group III consisted of children taking fluoride tablets (1.0 mg F/day) exclusively, and group IV did not receive any systemic administration of fluoride for prevention and constituted a low-fluoride control group. Total 24-hour urine samples were collected from all subjects. The average daily urinary flow rates varied from 0.51 to 0.68 ml/min, but showed no statistically significant differences among the groups. The average urinary fluoride concentrations were 0.60, 0.30, 0.99, and 0.28 mg/l, respectively, for groups I-IV. The mean 24-hour urinary fluoride concentrations and excretion rates for children who consumed fluoridated salt at all meals (group I) were not statistically different from those using tables (group III). There were also no statistically significant differences between groups II and IV. The differences between urinary fluoride concentrations and excretion rates of groups I and III, as compared with group IV, were statistically significant.

Administration, Oral

Current regulations and recommendations concerning water fluoridation, fluoride supplements, and topical fluoride agents.

In recent years, an increase in the prevalence of dental fluorosis, mostly of the very mild to mild category, has been seen in the United States. This paper therefore discusses the safety of dental fluoride products, primarily with respect to the risk of dental fluorosis due to chronic ingestion of these products by pre-school children. No change is indicated in the optimal fluoride level (0.7 to 1.2 ppm) for water fluoridation. A reduction in the dosage of fluoride supplements is recommended for children aged from three to six years (14.5 to 22 kg body weight) residing in communities with less than 0.7 ppm F. Physicians, pharmacists, and dentists need to be better educated in correctly prescribing fluoride supplements; such prescriptions should be based on the fluoride concentration of the domestic water supply and the child's weight/height/age. No change is recommended in the concentration of fluoride used in dentifrices and mouthrinses. The US Food and Drug Administration should require more explicit labeling of fluoride products with regard to avoidance of ingestion, use of small amounts, and need for supervised use by pre-school children. The efficacy of water fluoridation, fluoride supplements, and topical fluoride agents has been amply documented elsewhere.

Child

The prevalence of developmental defects of enamel in 15-16-year-old children residing in three districts (natural fluoride, adjusted fluoride, low fluoride) in the north east of England.

Developmental defects of enamel were assessed in 15-year-old children born and continuously resident in three communities in the north east of England. In naturally fluoridated Hartlepool (F = 1.0-1.3 ppm), artificially fluoridated Newcastle (F = 1.0 ppm) and non-fluoridated Middlesbrough (F < 0.2 ppm) 361, 356 and 376 children respectively were examined. Conventional clinical recording and a photographic technique where colour slides are assessed at random were used and compared. Scoring in both assessments was done by using a modified version of both the Murray and Shaw index and the developmental defects of enamel index. In the clinical assessment more white lines and diffuse opacities were found in the fluoridated areas than in the non-fluoridated area. More opacities were recorded using the photographic assessment than with the clinical assessment, but a similar trend of an increased prevalence of white lines and diffuse opacities was observed using the photographic method. Overall, there was only a small increase in the prevalence of milder forms of enamel defects in fluoridated compared with non-fluoridated areas.

Adolescent

Fluoride retention after rinsing with sodium fluoride and amine fluoride.

Fluoride retention from fluoride rinses (250 ppm F), calculated from F-concentrations and volumes of expectorates, and fluoride clearance, determined in whole saliva samples collected 1, 5 and 10 minutes after rinsing, were studied in 70 adults. F-retention from a 1:1 oleylamine-cetylaminefluoride rinsing solution (15 ml. 15 sec) was 410 mjg F, from a sodium fluoride rinse 343 mug F. 563 mug F were retained from a 30-sec amine fluoride rinse. Fluoride clearance was significantly slower after cetylaminefluoride rinses than after NaF rinses. Prerinsing with sodium lauryl sulfate or cetylaminechloride annihilated the F clearance superiority of cetylaminefluoride over NaF.

Adult

Fluoride in dog parotid saliva after intravenous administration of sodium fluoride, sodium monofluorophosphate, and calcium fluoride.

Sodium fluoride, sodium monofluorophosphate, or calcium fluoride, in amounts equivalent to 0.5 mg/kg, were given intravenously to dogs and the effect on parotid saliva F was determined. Significant (P less than 0.01) differences in saliva F levels were related to the ionization of NaF, the hydrolysis of the PO3F ion, and the insolubility of CaF2.

Animals

[Urinary excretion of fluorides in inhabitants of the Canton Vaud who consume fluoridated salt as compared with that of the inhabitants of neighboring cantons who consume nonfluoridated salt].

In the Swiss canton of Vaud (512000 inhabitants) the salt available for human consumption has been fluoridated since 1969 by adding 250 mg F- per kg of salt. The urinary excretion of fluoride has been investigated in large samples of the population in 1970 and in 1974. The present study reports the results of the 1974 study, in which the urinary fluoride excretion of persons living in the canton of Vaud was compared to that of a smaller sample of people living in small townships across the border of the canton, in which neither edible salt nor water are fluoridated. The concentration of fluoride in 444 single samples of urine from adult persons living in the canton of Vaud was 1.06 +/- 0.03 mg/l, in 40 subjects living two townships across the border 0.62 +/- 0.06 mg/l. The excretion of fluoride per 24 hrs has been evaluated by measuring simultaneously the creatinine concentration in the urine samples under the assumption of constant creatinine and fluoride excretion within 24 hour periods. The calculated fluoride excretion in 366 subjects living in the canton of Vaud was 1.14 +/- 0.03 mg/24 hrs, that of 40 subjects living outside of the canton 0.60 +/- 0.05 mg/24 hrs when the figure inserted for the excretion of creatinine within 24 hours was taken from a study of Rowe [9]. A few data reported suggest that the mean excretion of creatinine in the urine of normal subjects living in Switzerland was only 67% of that measured in the U.S. by Rowe. Total fluoride excretions calculated under this assumption were 0.76 +/- 0.02 mg/24 hrs for persons living in Vaud vs. 0.40 +/- 0.04 mg/24 hrs in the subjects living outside of Vaud. The concentrations of fluoride found in the urine of the adult subjects of the present study did not differ significantly from those found in school children aged 7-15 living in the same communities. Concentrations of fluoride in urine appear to have increased since 1970 in subjects living in the canton of Vaud. This fact may indicate that a steady state equality between intake and urinary excretion of fluoride had not yet been reached in 1970. In 366 urine samples of subjects living in Vaud in 1974, the concentration of fluoride in urine could be represented as a linear regression on the concentration of creatinine. The slope of this regression was smaller than unity indicating an enhanced fluoride excretion at higher rates of urine flow and a depressed excretion at low rates of urine flow. The occurrence of diurnal variations in the urinary excretion of fluoride or of creatinine could not be excluded in the present study. The urinary excretion of fluoride exceeded 2.5 mg/24 hr in approximately 2% of the subjects living in the canton of Vaud but was smaller than 0.8 mg/24 hr in approximately 18%. It was concluded that fluoridation of salt at the level indicated should be an effective measure for the prevention of dental caries. It was, furthermore, concluded that salt fluoridation at the level indicated does not present any risk of toxicity.

Adult

Influence of dietary fluoride restriction on regulation of plasma nd soft tissue fluoride contents.

The adjustments in total fluoride concentration in plasma, bones, liver, and muscle were examined when rats were given a diet of very low fluoride content following a dietary regimen of elevated fluoride intake. The animals received a diet containing 34 ppm of fluoride and water with 50 ppm added fluoride in the 28-day initial period and in the depletion period they were given a diet containing only 0.21 ppm of fluoride and distilled water. The findings indicated a 12-fold increase in the fluoride content of the humeri after 28 days of high-flurodie intake with a greater increment by the epiphyses than by the diaphyses. During 21 days of the depletion period the skeletal fluoride was reduced by only 7.7% indicating a marked retention of fluoride during processes of bone remodeling and growth. The plasma, muscle, and liver total fluoride contents were significantly increased at the end of the period of high-fluoride intake, but these concentrations were found to be restored to base-line levels in 3-7 days of the depletion period. By comparison of the distribution of total fluoride with injected radiofluoride between tissue and plasma waters, it was concluded that muscle and liver contain bound fluoride that does not exchange completely with ionic fluoride.

Animals

[Incidence of caries in the Canton Waadt (Vaud) after the change from fluoride tablets to fluoridization of salt].

This report shows results of a survey on dental caries in the Canton of Vaud in the years 1970 and 1974. In this canton fluoridation was carried out by means of fluoride tablets distributed at school until 1969/70 and in subsequent years by adding 250 mg F/kg fluoride to domestic salt. For comparison, results from adjoining and other cantons are also presented. In 1970 the 3 communities in the Canton of Vaud (Moudon, Grandson and Vevey) showed a remarkably low overall caries level due to the distribution of fluoride tablets, supplemented in Grandson with regular brushings with fluoride solution. When the fluoride tablets were discontinued in 1968/70 and fluoridated domestic salt containing 250 mg F/kg NaCl was introduced, caries incidence reached an even lower level. In these 3 communities caries prevalence fell to the lowest level reached, so far, by means of preventive measures in Bettlach (Canton of Solothurn, toothbrushing with fluoride solutions 6 times per year combined with information, fluoride tablets on every school day, and in addition consumption of table salt fluoridated at a suboptimal level of 90 ppm). The children in the control communities Romont (Canton of Fribourg), St-Aubin (Canton of Neuchâtel) and Châtel-St-Denis (Canton of Fribourg) also showed decreases of caries levels from 1970 to 1974. This decrease can be attributed to the distribution of fluoride tablets started at the schools of this community in the late sixties. Caries incidence in the age spans 8 to 12 and 10 to 14 years was estimated. Children from the Canton of Vaud where fluoridated table salt was practically the only preventive measure showed a smaller DMF increase than those from the cantons Fribourg and Neuchâtel. By means of a method combining DMF means of various age groups it was possible to obtain sufficiently large numbers of children for a study of the caries prevalence in each community. All communities showed a decrease of caries levels. In the Canton of Vaud this reduction started at a lower initial level and in 1974 reached consistently lower values than those of the control communities of the cantons of Fribourg and Neuchâtel.

Adolescent

Industrial fluoride pollution. Chronic fluoride poisoning in Cornwall Island cattle.

An aluminum plant on the south bank of the St. Lawrence river, southwest of Cornwall Island, Ontario, Canada, has emitted 0.816 metric tons of fluoride daily since 1973; considerably higher amounts were emitted from 1959 to 1973. The plant has been designated as the "major source of fluoride emissions impacting on Cornwall Island." Chronic fluoride poisoning in Cornwall island cattle was manifested clinically by stunted growth and dental fluorosis to a degree of severe interference with drinking and mastication. Cows died at or were slaughtered after the third pregnancy. The deterioration of cows did not allow further pregnancies. Fluoride concentrations in ash of biopsied coccygeal vertebrae increased significantly with age and were dependent on distance from and direction to the aluminum plant. Fluoride in bone ash of a 7-month old-fetus exceeded 500 ppm; fluoride thus was passed transplacentally. Analyses of fluoride in ash of bones obtained at necropsy of cattle from 4 months of age to 4 to 5 years of age showed increased amounts with age. Cancellous bone retained far higher amounts than cortical bone, a reflection of the normally higher metabolic rate of cancellous bone. Concentrations exceeding 10,000 ppm fluoride were recorded in cancellous bone of a 4-to 5-year-old cow. The target cells for fluoride in chronic fluorosis were shown to be the ameloblasts, the dental pulp cells and the odontoblasts and, in bone, primarily the resorbing osteocytes and also the osteoblasts. Atrophy and necrosis of the ameloblasts were responsible for enamel defects. The existing enamel showed brown discoloration from fluoride deposits. The pulp cells underwent fibrous and osseous metaplasia and necrosis of the ectopic bone occurred. The odontoblasts were atrophic and the dentin showed brown discoloration. The resorbing osteocytes were inactive and osteosclerosis resulted. This was especially pronounced in areas of normally great apposition, i.e. in the metaphyses. The epiphyseal plate became squeezed between petrotic bone and growth was stunted. Resorption of alveolar bone surrounding the deciduous teeth was severely retarded or arrested. A delay in eruption of permanent teeth occurred; it was up to 3.5 years in incisor teeth. Interference with the resorbing osteocytes in fluorotic bone was also demonstrated by loss of collagen birefringency in such bone. Failure of bone resorption also caused retention of trabecular bone in the cortices; this was observed even in a 4-t0-5-year-old cow. In areas where modeling into osteonic bone had begun, fluoride deposits were extremely heavy but this bone showed numerous soft osteons in microradiographs. The toxic effect of fluoride on osteocytes also resulted in the death of the cells. Such osteonecrosis occurred mainly in gnathic bone. There was atrophy of the osteoblasts. Osteopenia thus resulted from osteonecrosis and osteoporosis. Subperiosteal exostoses were not observed in long bones. The degree of fluorosis in Cornwall Island cattle was severe...

Air Pollutants

[Total frequency of dental caries in the Canton of Vaud after the transition from fluoride tablets to fluoridation of table salt].

This report shows results of a survey on dental caries in the canton of Vaud in the years 1970 and 1974. In this canton fluoridation was carried out by means of fluoride tablets distributed at school until 1969/70 and in subsequent years by adding 250 mg F/kg fluoride to domestic salt. For comparison, results from adjoining and other cantons are also presented. In 1970 the 3 communities in the canton of Vaud (Moudon, Grandson and Vevey) showed a remarkably low overall caries level due to the distribution of fluoride tablets, supplemented in Grandson with regular brushings with fluoride solutions. When the fluoride tablets were discontinued in 1968/70 and fluoridated domestic salt containing 250 mg F/kg NaCl was introduced, caries incidence reached an even lower level. In these 3 communities caries prevalence fell to the lowest level reached, so far, by means preventive measures in Bettlach (canton of Solothurn, toothbrushing with fluoride solutions 6 times per year combined with information, fluoride tablets on every school day, and in addition consumption of table salt fluoridated at a suboptimal level of 90 ppm). The children in the control communities Romont (canton of Fribourg), St-Aubin (canton of Neuchâtel) and Châtel-St-Denis (canton of Fribourg) also showed decreases of caries levels from 1970 to 1974. This decrease is attributed to the distribution of fluoride tablets started at the schools of this community in the late sixties. Caries incidence in the age spans 8 to 12 and 10 to 14 years was estimated. Children from the canton of Vaud where fluoridated table salt was practically the only preventive measure showed a smaller DMF increase than those from the cantons of Fribourg and Neuchâtel. By means of a method combining DMF means of various age groups it was possible to obtain sufficiently large numbers of children for a study of the caries prevalence in each community. All communities showed a decrease of caries levels. In the canton of Vaud this reduction started in 1970 at an already low level and in 1974 reached consistently lower values than those of the control communities of the cantons of Fribourg and Neuchâtel.

Administration, Oral

The effects of age and fluoride exposure on fluoride, citrate and carbonate content of human cementum.

A study was conducted to determine the values of several chemical components of dental cementum. Extracted teeth from continuous residents of low, optimal, and high natural fluoride areas were selected to determine the effects of fluoride exposure and age on the fluoride, citrate and carbonate content of cervical and apical areas of sound and periodontally diseased human cementum. 1. For normal cementum the mean fluoride content of all 18 groups was 0.443 plus or minus 0.04%on an ash basis and 0.253 plus or minus 0.02% on a dry weight basis; the mean citrate content was 1.52 plus or minus 0.10% on an ash basis and 0.86 plus or minus 0.06% on a dry weight basis; the mean carbonate content was 4.95 plus or minus 0.39% on an ash basis and 2.79 plus or minus 0.22% on a dry weight basis. 2. For diseased cementum the mean fluoride content of all 12 groups was 0.575 plus or minus 0.03% on an ash basis and 0.342 plus or minus 0.02% on a dry weight basis; the mean citrate content was 1.19 plus or minus 0.07% on an ash basis and 0.71 plus or minus 0.05% on a dry weight basis; the mean carbonate content was 5.95 plus or minus 0.47% on an ash basis and 3.50 plus or minus 0.28% on a dry weight basis. 3. There is a general increment in fluoride content of normal cervical and apical cementum, both with age and fluoride exposure. For diseased cementum this held true for fluoride exposure but not age. 4. The mean fluoride content of cervical cementum is greater than that of apical cementum for both normal and diseased groups. For citrate and carbonate no definite statistical differences were noted between cervical and apical areas. 5. The diseased cementum has a significantly higher mean fluoride content, a significantly lower citrate content, and a slightly, but not statistically significant, higher carbonate content than normal cementum. 6. Unlike bone, no inverse fluoride/citrate or fluoride/carbonate relationship was observed. 7. For both normal and diseased groups the carbonate content of cementum of individuals over age 40 tended to be lower than for individuals 20-40 years of age.

Adolescent

Effect of dietary fat on fluoride absorption and tissue fluoride retention in rats.

The effect of dietary fat on fluoride toxicity was investigated in rats fed isoenergetic diets with graded levels of fat (0, 10%, 30% or 50% of energy) containing 400 ppm fluoride. Growth rate was depressed in all groups receiving fluoride but most severely in the 50% dietary fat group. Plasma, liver and femur fluoride concentrations were increased by increasing dietary fat. This was apparently due to increased absorption of fluoride, since urinary fluoride increased and fecal fluoride excretion decreased as fat intake was elevated. The enhancement of fluoride absorption by fat is believed to be due to the delaying effect of fat and fluoride on gastric emptying, thereby allowing more time for the fluoride to be absorbed from the stomach.

Absorption

Fluoride content of dental plaque before, during and after ingestion of sucrose modified with fluoride or bicarbonate-phosphate.

Students ingested tablets daily during a period of 3 d growth of dental plaque and in connection with the collection of plaque specimens. The tablets varied in composition: sucrose (C), sucrose containing sodium bicarbonate-monopotassium orthophosphate and fluoride (BPF), and sucrose modified with fluoride (F). The daily fluoride dose in conjunction with the growth of plaque and the collection of specimens was 0.5 mg of total fluoride and 0.2 mg in the determination of ionized fluoride. The fluoride taken during the growth period did not significantly affect the total and ionized fluoride contents of the plaque. During the consumption of all the tablets, the total fluoride content of the plaque increased temporarily, after which a drop took place to close to the original value. In the case of the C- and the BPF-tablets, the increase was statistically significant (P-values less than 0.02 and less than 0.001, respectively). During the consumption of the BPF- and F-tablets, the ionized fluoride content dropped significantly (P-values less than 0.001 and less than 0.01, respectively). The investigation showed that a binding of the free fluoride ions in dental plaque takes place in connection with fermentation.

Administration, Oral

Comparison of salivary fluoride concentrations after administration of a bioadhesive slow-release tablet and a conventional fluoride tablet.

The in-vitro and in-vivo fluoride release of bioadhesive, slow-release tablets prepared from a mixture of polyethylene glycol polymers, containing 0.1 mg of fluoride as NaF was studied, and their ability to sustain fluoride levels in saliva were compared with conventional fluoride tablets with the same fluoride content. In-vitro release experiments showed that the bioadhesive tablets needed 8 h to release all their fluoride compared with less than 1 h for the conventional fluoride tablets. In-vivo, the bioadhesive tablets had a retention period of 6 h and could sustain a salivary fluoride level of more than 10 microM above the baseline for 7 h. The conventional fluoride tablets achieved a peak concentration of 0.5 mM directly after dissolution in the mouth, but the fluoride level could not be sustained for longer than 1 h. A good agreement was found between the in-vitro swelling behaviour of the bioadhesive tablets and their in-vitro and in-vivo release characteristics and their in-vivo retention time.

Adult