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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

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

Mortality in selected cities with fluoridated and non-fluoridated water supplies.

Mortality rates (for blacks and whites only) in 24 cities with fluoridated and 22 with non-fluoridated water supplies in the United States were compared for the years 1969-1971. During these three years 570,671 deaths occurred in the cities with fluoridated water; the 1970 reference population in those cities was 15,972,817. The figures for the cities with non-fluoridated water were 351,053 and 11,106,746 respectively, so that the crude death rates for all causes were 1190.9 (fluoridated) and 1053.6 (non-fluoridated) per 100,000 person-years. Adjustments for age, sex and race reduced differences for some causes and removed them for others. Further correction, using analyses of covariance for city characteristics that influence mortality, gave adjusted death rates for all causes of 1123.9 and 1137.1, and for malignant neoplasms 195.3 and 196.9, in the cities with fluoridated and non-fluoridated water respectively. I found no evidence of a harmful effect of fluoridation.

Age Factors

Magnesium-fluoride interrelationships in man II. Effect of magnesium on fluoride metabolism.

The effect of magnesium on the fluoride balance was investigated in man by determining metabolic balances of fluoride and magnesium in control studies and during magnesium supplementation. The magnesium intake averaged 264 mg/day in the control studies and 825 in the experimental studies. The studies were carried out during four calcium intakes that ranged from 200 to 2,200 mg/day and during phosphorus intakes ranging from 800 to 2,000 mg/day. The studies were carried out during a fluoride intake of about 4 mg/day that was due to the dietary fluoride content and the intake of water and during a high fluoride intake of 25 mg/day that was due to the addition of sodium fluoride. During the high magnesium intake, both the urinary and fecal magnesium excretions increased and the magnesium balances became more positive. These changes were not associated with any significant changes of either the urinary or fecal fluoride excretions or of the fluoride balances during the different intakes of calcium phosphorus, or fluoride.

Adult

The caries-preventive effect of amine fluorides and inorganic fluorides in a mouthrinse or dentifrice after 30 months of use.

The study groups using a dentifrice and mouthrinse both containing fluorides, a dentifrice containing stannous fluoride and a mouthrinse containing sodium fluoride, or a mouthrinse containing sodium fluoride with a placebo dentifrice had a 20.7% to 29.0% lower DMF increment than the control group after 30 months. These differences were significant. The study groups using a dentifrice containing amine fluorides and a placebo mouthrinse, a mouthrinse containing amine fluorides and a placebo dentifrice, or a dentifrice containing stannous fluoride and a placebo mouthrinse had a 13.6% to 22.4% lower DMF increment than the control group. These differences were not statistically significant. There was no significant difference in effectiveness against caries between the use of the organic or inorganic fluoride products.

Amines