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Medical Forum / General / Dentistry / April 2005Fluoride treatments
Hi, I'm in Tobago and I apologize in advance if I'm hitting a nerve (ooh, terrible, unintended dental pun), but I'm working out of an Internet cafe and I don't have time to research whether this has been answered before. I need to know whether or not to supplement my 10-month-old baby with fluoride drops. We just moved here. The pediatrician here doesn't know about fluoride treatments and can't advise me. I can't tell from the following journal article whether or not I should use the fluoride drops (.5 ml) my pediatrician gave me before we moved here. We drink bottled water and brush her gums with non-fluoride baby toothpaste. I don't want to overdose her with fluoride. Anyone want to chip in? http://www.hdassoc.org/site/epage/21150_351.htm 15. Analysis of Fluoride Sources in Trinidad and Tobago A.A. ADEWAKUN1, E.A. VALDEZ2, J. LOZANO-PINEDA2*, C. GODDARD3, A.-M. MCMILLAN-HAYNES3, S. RAMSUBHAG4, B.T. AMAECHI2 1 Oral Healthcare Solutions, St. Augustine, Trinidad and Tobago, 2 University of Texas Health Science Center at San Antonio, USA, 3 Water and Sewerage Authority, Trinidad and Tobago, 4 The University of the West Indies, Trinidad and Tobago. Objective: Previous studies reported a moderate (1961, DMFT = 3.9) and a high (1989, DMFT = 4.9) caries prevalence among 12 years old children in Trinidad and Tobago (TT). Completed part of this project, examining the oral health status of children in Trinidad and Tobago, showed a low prevalence in 2003 with DMFT and dmft of 1.35 and 1.78 respectively for children 6, 12 and 15 years old. The cause of this low prevalence may be an increased availability of fluoride. Therefore, the aim of the present study was to determine the fluoride availability in Trinidad and Tobago by analyzing the fluoride level in different sources. Method: Fluoride levels in mouth rinses, salts, toothpastes, medications, chewing gum, bottled water, natural and tap-borne water, collected from different locations, in TT were determined using a Thermo Orion ISE/pH meter model 710APlus and a fluoride electrode model 96-09. The extent of use among children aged 15 years and under in 26 government dental centers in the 4 Health Regions was also investigated. Results: Distribution of natural levels in water ranged from 0.009-1.9 mg/l in Trinidad (mean 0.198+/-0.262) and 0.006-0.87 mg/l in Tobago (mean 0.249+/-0.261). Bottled water levels ranged from 0.0- 0.3 ppm. Salt levels ranged from 0-0.25% fluoride. Toothpaste levels ranged from 0-1.8% fluoride. Fluoride in high-fluoride and normal mouth rinse brands ranged from 250-1450 ppm and 0-1.9 ppm respectively. Professional fluoride application is by APF gel (1.23% NaF) and available to 5-35% of eligible children. One liquid vitamin preparation had 0.25 mg/ml and fluoride was absent in all dental floss and chewing gum brands. Conclusions: Children residing in Trinidad and Tobago are obtaining optimal amounts of fluoride, hence, the decline in caries prevalence between 1989 and 2003. Toothpaste and mouth rinses are the most available and consistent source of optimal fluoride. Salt is the most unreliable and variable source of optimal fluoride. The general low fluoride levels in water sources are deemed adequate. Bump > Hi, I'm in Tobago and I apologize in advance if I'm hitting a nerve > (ooh, terrible, unintended dental pun), but I'm working out of an [quoted text clipped - 50 lines] > is the most unreliable and variable source of optimal fluoride. The > general low fluoride levels in water sources are deemed adequate. Fluoride is neither a nutrient nor essential to healthy teeth. Ingesting fluoride is useless and can only lead to adverse effects such as dental and skeletal fluorosis. Any purported beneficial effect from fluoride is topical only. Some dentists claim that swallowed fluoride emerges into the saliva to bathe the teeth with fluoride - but that isn't substantiated by science. The U.S. Centers for Disease Control reports that the amount of fluoride in saliva is too low to have any therapeutic effect and that fluoride levels in tooth enamel are not inversely related to less tooth decay NYS Coalition Opposed to Fluoridation http://www.orgsites.com/ny/nyscof Fluoride given to children while their teeth are developing is incorporated into the tooth structure and creates a more decay resistant enamel structure. It is not the amount of fluoride in the saliva that gives the great benefit. What is the fluoride dosage in the prescription given to you by your pediatrician? > Fluoride is neither a nutrient nor essential to healthy teeth. > Ingesting fluoride is useless and can only lead to adverse effects such [quoted text clipped - 13 lines] > NYS Coalition Opposed to Fluoridation > http://www.orgsites.com/ny/nyscof > Fluoride given to children while their teeth are developing is incorporated > into the tooth structure and creates a more decay resistant enamel > structure. Nonsense.  Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- >> Fluoride given to children while their teeth are developing is >> incorporated >> into the tooth structure and creates a more decay resistant enamel >> structure. > > Nonsense. I followed your link and could not find one peer-reviewed study that said that fluoride does not make enamel more resistant to decay. > >> Fluoride given to children while their teeth are developing is > >> incorporated [quoted text clipped - 10 lines] > I followed your link and could not find one peer-reviewed study that said > that fluoride does not make enamel more resistant to decay. Perhaps you could cite one that does? Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- >> >> Fluoride given to children while their teeth are developing is >> >> incorporated [quoted text clipped - 12 lines] > > Perhaps you could cite one that does? There were 10-year studies in the 40's and 50's that showed caries reduction resulting from fluoridated water. I'm wondering if you're challenging the statement that "fluoride in developing teeth make them more resistant to decay", or if you're challenging the idea that fluoride makes already-erupted teeth more resistant to decay. The pre-eruptive benefits are there, but not significant. The post-eruptive benefits of water fluoridation and topical application of fluoride are very significant and indisputable. > >> >> Fluoride given to children while their teeth are developing is > >> >> incorporated [quoted text clipped - 15 lines] > There were 10-year studies in the 40's and 50's that showed caries reduction > resulting from fluoridated water. Did you ever see/read the original series of papers on these trials? Additional material on these early experiments is contained in the papers of Henry Trendley Dean and Ruth Roy Harris, at the National Library of Medicine. Guess what they reveal? Anything but proof of a fluoride effect! > I'm wondering if you're challenging the statement that "fluoride in > developing teeth make them more resistant to decay", or if you're > challenging the idea that fluoride makes already-erupted teeth more > resistant to decay. It does neither. > The pre-eruptive benefits are there, but not significant. The post-eruptive > benefits of water fluoridation and topical application of fluoride are very > significant and indisputable. This is your view. What is indeed "significant" is the influence of the so-called "confounding variables"! Nothing else. And "indisputable" means that you are not interested in any discussion. So why should I elaborate? Just to be ignored for saying what nobody here wants to hear/read? I´m not interested in wasting time. I´ll elaborate on that elsewhere. Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- >> >> >> Fluoride given to children while their teeth are developing is >> >> >> incorporated [quoted text clipped - 30 lines] > > It does neither. Sure it does...and the evidence is overwhelming that it helps already-erupted teeth. >> The pre-eruptive benefits are there, but not significant. The >> post-eruptive [quoted text clipped - 8 lines] > hear/read? I´m not interested in wasting time. I´ll elaborate on that > elsewhere. Elsewhere? Elsewhere you have no hope in influencing a single person who matters. At least on sci.med.dentistry, you could conceivably convince a handful of dentists here, who could then pass your message along to several thousand patients each year. If you're afraid to try to make your case among educated professionals, I can certainly understand. It's much easier to herd the uniformed masses via a website. > Sure it does...and the evidence is overwhelming that it helps > already-erupted teeth. Overwhelming to you, but not to me. > >> The pre-eruptive benefits are there, but not significant. The > >> post-eruptive [quoted text clipped - 14 lines] > thousand patients each year. If you're afraid to try to make your case > among educated professionals, I can certainly understand. C´mon. I already convinced many dentists, not at smd, but in real life. I have been talking at dental and medical congresses here. But to what avail? I received letters saying that the dentists (and even physicians) have been threatened by their local associations, or by their colleagues (rethinking their referral practice). I have been told by others that it is much more convenient to give topical fluoride applications instead of denying it, for they had to explain their position to a patient which costs time "which I am not paid for". Fluoride application is "standard of care" nowadays, and if it is denied a patient might sue for neglect. These are the arguments I usually hear from professionals. I gave up trying to convince any of them anymore. I rather think they know already, but prefer to act under the protection of their associations (hidden in a group). It is very hard to change such a system. Anyway, even the professionals here could easily go to my website and read what I have to say, if they are really interested. I would also be ready to have a reasonable discussion here or by email (my real email address is available under "imprint" at my website). > It's much easier > to herd the uniformed masses via a website. It is harder to "herd uninformed masses" than to talk to professionals. BTW: my website does not just attract "uninformed masses". Read, just as an example, the history chapter (online availabe) of "Fluorides in the environment" (by Davison and Weinstein, 2004) which makes rather extensive use of it (although somewhat selective). Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- >>Sure it does...and the evidence is overwhelming that it helps >>already-erupted teeth. [quoted text clipped - 47 lines] > environment" (by Davison and Weinstein, 2004) which makes rather > extensive use of it (although somewhat selective). I can't argue with your assessment that dentists may give fluoride treatments because patients expect it, but this is very troublesome. IMO any dentist who allows the patient to dictate treatment has no business practicing. My hope is that they claim this just so as not to get into an argument with you. ;-) Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Sure it does...and the evidence is overwhelming that it helps >> already-erupted teeth. [quoted text clipped - 48 lines] > environment" (by Davison and Weinstein, 2004) which makes rather > extensive use of it (although somewhat selective). I've read numerous studies (both epidemiological and controlled), that have shown that fluoride is effective. I asked you to post even one study that shows fluoride is not effective in reducing caries, and you tried to flip the burden of proof back to me. Just doing a medline search with the words fluoride and caries returns thousands of hits. Countries like Brazil and Costa Rica that started fluoridating their water in the last 2 or 3 decades, have seen a drastic reduction in the number of DMFT (decayed/missing/filled teeth). The studies that tracked the decline all attribute the drop to the fluoridation programs. I found controlled studies that were able to remineralize caries-like lesions. I just can't seem to find any that say fluoride is not beneficial in *high-caries* individuals. None. Zero. Zip. Nada. Can you? Kind regards to all of you. I much appreciate your discussion. To answer your questions, the pediatrician in New York sent me off with drops of fluoride in .5ml dose. The water here, according to the study I sited above is "0.006-0.87 mg/l in Tobago (mean 0.249+/-0.261). Bottled water levels ranged from 0.0- 0.3 ppm." I am still breast feeding. I had fluoride treatments and floridated water growing up and feel they are responsible for my good teeth. Both my parents have a mouthful of fillings, but their three children have had very few cavities. I believe this is due to the fluoride, so with respect, I do want my daughter to have this benefit. I would just like to know whether it is ok to supplement the levels she is receiving through cooking (I boil her vegetables in the tap water). She does not drink the tap water, boiled or otherwise, but does drink the filtered bottled water they sell here, as do I. > Kind regards to all of you. I much appreciate your discussion. To > answer your questions, the pediatrician in New York sent me off with > drops of fluoride in .5ml dose. The water here, according to the study > I sited above is "0.006-0.87 mg/l in Tobago (mean 0.249+/-0.261). PLENTY! That plus natural fluoride should never exceed one mg per L. One mg (milligram) per L means one part per million. Joel > Bottled water levels ranged from 0.0- 0.3 ppm." I am still breast > feeding. I had fluoride treatments and floridated water growing up and [quoted text clipped - 6 lines] > the tap water, boiled or otherwise, but does drink the filtered bottled > water they sell here, as do I. >> Kind regards to all of you. I much appreciate your discussion. To >> answer your questions, the pediatrician in New York sent me off with [quoted text clipped - 8 lines] > >Joel I agree with my find Joel .. Stephen Mancuso, D.D.S. Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. > >> Kind regards to all of you. I much appreciate your discussion. To > >> answer your questions, the pediatrician in New York sent me off with [quoted text clipped - 11 lines] > I agree with my find Joel > .. Would you please realize that 1 mg/l is just a _concentration_ not a dose. The dose of fluoride you get depends, inter alia, on the amount of such water consumed a day. If it is one liter, you´ll get one mg fluoride (in the case of 1 mg/l). Plus the mg´s fluoride you ingest with food, drops, tablets, (swallowed) toothpaste, ... Someone who consumes two liters water a day gets two mg fluoride from this source alone. Peter Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- Yup and we are most likely overfluoridated ...... With people moving around so much and buying our food from distant sources (with varying degrees of fluoridation) well who knows how much fluoride people ingest. Joel > > >> Kind regards to all of you. I much appreciate your discussion. To > > >> answer your questions, the pediatrician in New York sent me off with [quoted text clipped - 27 lines] > --- http://www.fluoride-history.de/index.htm --- > ---------------------------------------------------- We agree. Peter > Yup and we are most likely overfluoridated ...... > [quoted text clipped - 31 lines] > > > > Peter Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- > Hi, I'm in Tobago and I apologize in advance if I'm hitting a nerve > (ooh, terrible, unintended dental pun), but I'm working out of an [quoted text clipped - 10 lines] > toothpaste. I don't want to overdose her with fluoride. Anyone want to > chip in? Hi, Since your baby's first teeth are not permanent, why take the risk? By the time your child's permanent teeth start coming in, she will be old enough to brush her teeth with fluoride-containing toothpaste and/or receive fluoride treatments in a dentist's office. If she were my child, I definitely would NOT give her supplemental fluoride. Considering the toxicity of fluoride, and the fact that the first set of teeth are not permanent, giving fluoride to babies is NOT logical. Best regards, Phil Calvert I suggest testing the local water used for cooking and drinking to determine fluoride levels before determining supplement dosages. Is tap water being used to make baby formula in this household? Hopefully, the mother is breastfeeding during the first year. I believe Peter can give us data on how much fluoride is passed through mother's milk. Most areas do not require supplementation. If the local water tests completely free of fluoride, then an educated decision needs to be made based on the consumption of foods prepared in a fluoridated area, the caries risk of the family, and the age of the child. Ideally, you want to have some fluoride in the child's system while teeth are developing. Teeth begin developing in the womb. Permanent teeth begin development about the time the child begins to walk. Peter makes his argument based on studies and correlated data. He is respectful when discussing fluoride and does not deserve to filtered out like the hydra does. He is a reasonable debater. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >> Hi, I'm in Tobago and I apologize in advance if I'm hitting a nerve >> (ooh, terrible, unintended dental pun), but I'm working out of an [quoted text clipped - 28 lines] > > Phil Calvert I was watching TV ads for Aquafina bottled water last night. I am always amazed by the people who will not drink tap water, but will drink any bottled water and pay for the bottled water than they do for gasoline. BTW, Aquafina is bottled right out the tap in Detroit. It is water from Lake Huron which has been filter, chlorinated, and fluoridated (among other treatments). My point is that the OP needs to check where the bottled water is coming from, she may be getting plenty of fluoride in the bottled water. My all time favorite is the bottled water which says it is bottled "near the source of the [xyzyx] spring". That sounds great at first glance, but really only means they took it from the tap within a few miles of the "spring". Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >I suggest testing the local water used for cooking and drinking to >determine fluoride levels before determining supplement dosages. Is tap [quoted text clipped - 45 lines] >> >> Phil Calvert > I was watching TV ads for Aquafina bottled water last night. I am always > amazed by the people who will not drink tap water, but will drink any [quoted text clipped - 10 lines] > really only means they took it from the tap within a few miles of the > "spring". Bottled water is indeed a big issue. "Vichy", which is often sold here, contains around 6 ppm fluoride. Because of this high fluoride content it must bear a label saying "fluoridhaltig" ("contains fluoride"). Most people certainly buy this water because they think this labeling is some kind of recommendation. Many bottled waters sold here contain more than 1 ppm fluoride. And they may contain other contaminants as well, which mostly are not mentioned on the label. Not to speak of bacterial growth. Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- >> I was watching TV ads for Aquafina bottled water last night. I am always >> amazed by the people who will not drink tap water, but will drink any [quoted text clipped - 22 lines] > may contain other contaminants as well, which mostly are not mentioned > on the label. Not to speak of bacterial growth. Yes, indeed. Every time the TV does a big story on DUWL contamination, I always laugh because they ignore the bacterial contamination of bottled water, the piping in soda pop dispensers, refrigerator water dispensers, etc. Aquafina, Pepsi's bottled water product, is tap water filtered by reverse osmosis; so no fluoride. It's the same with Coke's bottled water product. However, Coke and Pepsi made in fluoridated areas have fluoride. Not on the label. So it's anyone's guess how much fluoride those children with soda-bombed out teeth are getting. >and the fact that the >first set of teeth are not permanent, giving fluoride to babies is NOT [quoted text clipped - 3 lines] > >Phil Calvert Musta never seen a kid with a mouthful of cratered teeth. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
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