Fluoride Toothpaste for Increased Risk of Caries
Fluoride toothpaste is a fundamental, cost-effective method to prevent cavities at any age. Regular brushing with fluoride toothpaste strengthens teeth by slowing demineralization and promoting remineralization.
Table of contents
his article is based on an original article in Swedish which can be found here
BACKGROUND
Toothpaste with fluoride was introduced in Sweden during the late 1960s, and today most toothpastes on the market contain fluoride in some form. There is a consensus that the globally improved dental health of children and adolescents can primarily be attributed to fluoride toothpaste [1], and therefore fluoride toothpaste is now included on the WHO's list of "Essential dental medicines" [2].
The most common fluoride compounds in toothpaste are sodium fluoride and sodium monofluorophosphate or combinations of these. There are also toothpastes that contain amine fluoride and stannous fluoride. The majority of all commercial toothpastes for adults and children contain between 1000 and 1450 ppm (parts per million) fluoride. There are also over-the-counter toothpastes with 5000 ppm fluoride available at pharmacies in Sweden. These can also be prescribed and are covered by the high-cost protection for medications.
In addition to fluoride compounds, toothpaste contains cleaning agents in the form of abrasives and surfactants. Toothpastes may also contain enzymes, bleaching agents, and antibacterial substances, as well as additives that prevent tartar. Toothpaste with antibacterial additives should only be used on individual recommendation from a dentist or dental hygienist.
Daily use of fluoride toothpaste is, next to water fluoridation, the most cost-effective measure to prevent caries. The calculation is based on the premise that fluoride toothpaste does not cost more than toothpaste without fluoride. The cost of fluoride toothpaste with 5000 ppm fluoride is estimated to be 5 – 7 times higher than regular toothpaste.
The vast majority report that they brush their teeth with toothpaste at least once a day [3], but compliance is not optimal. Studies suggest that about 1/3 of the population, primarily adolescents, adult males, and socioeconomically disadvantaged groups, do not brush their teeth every day. Even fewer utilize the full potential of fluoride toothpastes by following all recommendations [4].
TREATMENT
Fluoride toothpaste provides basic protection and should be used by everyone at all ages, regardless of caries risk. The National Board of Health and Welfare recommends that fluoride toothpaste be introduced at 1.5 – 2 years of age, but in many places, parents are encouraged to start brushing with fluoride-containing toothpaste as soon as the first tooth erupts. There is no high-quality research supporting either viewpoint.
