The administration of fluoride as a preventive element

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The faculty of health sciences. Dentistry (University Rey Juan Carlos, Madrid) said that to avoid dental fluorosis, we shouldn’t use many products that contains fluoride (fluoride supplements are not recommended). Children under six years old must not take mouthwash with fluoride. We should use appropriate amounts of toothpaste in our young children and we must begin to give them fluoride toothpaste after the child turns two years old. The proper amount of toothpaste placed in the brush is about the size of a pea. When the child already learns to rinse thoroughly and not to swallow toothpaste, the amount of it can be increased in the brush; It is very important to monitor your child while he/she brush her teeth, to check that it is done with the correct technique and to not swallow toothpaste.

People with dental fluorosis can also have high levels of fluoride in other parts of the body. Skeletal fluorosis is common when the bones have an excess of fluoride. Having too much fluoride in the body is a risks. Fluoride in some cases is the direct cause of some diseases such as cancer, kidney disease, thyroid problems, diseases of the bones, arthritis, immune deficiencies, dental fluorosis, skeletal fluorosis and more.

Elise Bassin, as part of his doctoral thesis in 2001, found a connection between fluoride and cancer to the bones in adolescent boys.

- Discussion: While more fluoride is ingested, most tooth is delayed to erupt. While

more it is delayed a tooth in erupt, more severe is the fluorosis. When the dental fluorosis occurs only during the phase of formation of teeth, this will be visible by all sides, as the first visible sign that an excessive dose of fluoride has occurred in the child during this vulnerable period.

A recent study in USA, investigated the health of children suffering from dental fluorosis and the results were compared with others who did not show such defects of teeth. It was observed that children with dental fluorosis had more gastrointestinal diseases (37%), respiratory diseases (29.5%), bone and muscle (13.8%), mental disorders (11.3%), superficial diseases (9.4%), and 8.2 percent suffered diseases of the nervous system and sensory disorder.

The excess of fluoride in the first two years of life will cause fluorosis in permanent teeth, which usually erupt when the child is around seven or eight-year-old. When the disease is in its initial phase, it is possible that the denture is restored. If the diet is deficient, the dental problem can aggravate. Fluoride can also cause disease in bones, such as bone fluorosis, and osteoporosis.

Foods with higher contribution - main sources of fluoride: water fluoride (contain between 0.7 - 1.2 milligrams (mg) of fluoride per liter), tea, sea fish (salmon, cod, sardines, seafood), Jelly, Chicken, fluoridated milk (0.1 to 0.2 mg/liter), breast milk (0.007 to 0.01 mg/liter), fluoride dental, Greens: lettuce, spinach, potatoes, prepared food and drinks with water.

Table 1. Intake of fluoride

AGE

APPROPIATE INTAKE (mg/day)

MAXIMUM TOLERABLE INTAKE LEVEL (mg/day)

0-6 months

0.01

0.7

6-12months

0.5

0.9

1-3 years

0.7

1.3

4-8 years

1.1

2.2

9-13 years

2.2

10

14-18 years

3,2 (boys); 2,9 (girls)

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Institute of Medicine. Fluoride. National Academy Press, 1997.

Prior to initiating this study, institutional approval from the Bioethics Committee of the Health Sciences Institute was obtained. The study population consisted of 120, forty-eight to fifty-nine months old healthy children with similar low fluoride drinking water supplies, both genders, from low and high socio-economic status, attending either the Colombian Family Well-being Day-care Centers or private Day-care Centers in the cities of Bogotá, Medellin, Manizales and Cartagena. The parents were informed of the project and gave their consent for their children to participate.

This study was undertaken in order to determine the total daily fluoride intake by young children from four fluoridated Colombian cities, considering diet (including water) and toothpaste use; assess their fractional urinary fluoride excretion relative to the total daily fluoride ingestion under customary fluoride intake conditions and evaluate whether the socioeconomic status has any influence on the total fluoride exposure.

In order to determine the fluoride intake from foods and beverages through the duplicate all of the ingested foods and beverages, was collected over three days. When the children finished their portion comparable amounts of food were added or removed to the duplicate sample. The importance of keeping the children's usual diet was emphasized to the parents. Urine collection was carried out at home on the same day, in plastic cups; over a twenty-four hours’ period. The parents collected from the second urine the following day, after the first urine was take. The cup with urine was kept in the in the refrigerator.

In order to determine the individuals' fluoride intake from toothpastes the following steps were followed; The amount of toothpaste used was measured by weighing the toothbrush and then the toothbrush with toothpaste. Then the amount of fluoride in the toothpaste used was determined by micro-diffusion analysis from a toothpaste sample used by each child. After, the amount of non ingested fluoride was calculated from the recovered rinsing solution. Then, the amount of recovered fluoride was subtracted from the amount of fluoride used; the result was supposed to be the ingested amount. Finally, the amount ingested was multiplied by the number of tooth brushings per day in order to estimate the daily fluoride intake. The fluoride intake for each child is expressed as the total amount (mg F/day) and as

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