Fluoride

Abstract

This chapter describes how individuals with severe enamel fluorosis (mottled tooth enamel) became associated with fluoride in the public water supply and protection from dental caries. A comparison of caries experience with the fluoride content of public water supplies and enamel fluorosis in adolescents indicated that 1 μg fluoride/mL (1 part/million) in the water provides caries protection with minimal enamel fluorosis (sect. 1). One mechanism is the spontaneous isomorphic replacement of apatite’s hydroxide anions with fluoride, which reduces enamel solubility. A second is fluoride-mediated inhibition of enolase, which retards bacterial acid production at teeth surfaces. These findings led to the use of fluoride in toothpastes, which provides better protection from caries at tooth surfaces than water fluoridation alone (sect. 2). The chapter concludes with a discussion of potentially harmful effects of fluoride ingestion (sect. 3).