Fluoride and Oral Health.

The discovery during the first half of the 20th century of the link between natural fluoride, adjusted fluoride levels in drinking water and reduced dental caries prevalence proved to be a stimulus for worldwide on-going research into the role of fluoride in improving oral health. Epidemiological studies of fluoridation programmes have confirmed their safety and their effectiveness in controlling dental caries. Major advances in our knowledge of how fluoride impacts the caries process have led to the development, assessment of effectiveness and promotion of other fluoride vehicles including salt, milk, tablets, toothpaste, gels and varnishes. In 1993, the World Health Organization convened an Expert Committee to provide authoritative information on the role of fluorides in the promotion of oral health throughout the world (WHO TRS 846, 1994). This present publication is a revision of the original 1994 document, again using the expertise of researchers from the extensive fields of knowledge required to successfully implement complex interventions such as the use of fluorides to improve dental and oral health. Financial support for research into the development of these new fluoride strategies has come from many sources including government health departments as well as international and national grant agencies. In addition, the unique role which industry has played in the development, formulation, assessment of effectiveness and promotion of the various fluoride vehicles and strategies is noteworthy. This updated version of 'Fluoride and Oral Health' has adopted an evidence-based approach to its commentary on the different fluoride vehicles and strategies and also to its recommendations. In this regard, full account is taken of the many recent systematic reviews published in peer reviewed literature.

Community-oriented administration of fluoride for the prevention of dental caries: a summary of the current situation in Asia.

Dental caries is the most prevalent chronic disease affecting human populations around the world. It is recognized that fluoride plays a significant role in dental caries reduction. Meanwhile, several low- and middle-income countries of Asia have not yet implemented systematic fluoride programs; contributing factors relate to misconceptions about the mechanisms of fluoride, low priority given to oral health in national health policy and strategic plans, and lack of interest among public health administrators. A workshop on the effective use of fluoride in Asia took place in Phang-Nga, Thailand, in 2011. A series of country presentations addressed some of the topics mentioned above; in addition, speakers from countries of the region provided examples of successful fluoride interventions and discussed program limitations, barriers encountered, and solutions, as well as possibilities for expanding coverage. Participants acknowledged that automatic fluoridation through water, salt, and milk is the most effective and equitable strategy for the prevention of dental caries. Concerns were expressed that government-subsidized community fluoride prevention programs may face privatization. In addition, the use of affordable fluoride-containing toothpastes should be encouraged. The workshop identified: strengths and weaknesses of ongoing community-based fluoride programs, as well as the interest of countries in a particular method; the requirement for World Health Organization (WHO) technical assistance on various aspects, including fluoridation process, feasibility studies, and implementation of effective epidemiological surveillance of the program; exchange of information; and the need for inter-country collaboration. It was acknowledged that program process and evaluation at the local and country levels need further dissemination. The meeting was co-sponsored by the World Health Organization, the International Association for Dental Research, and the World Dental Federation.

Urinary fluoride excretion by children 4-6 years old in a south Texas community.

This study evaluated urinary fluoride excretion by school children 4-6 years old who were living in a south Texas rural community that had concentrations of fluoride in drinking water supplies generally around the optimal level. We took supervised collections of urine samples in the morning and afternoon at school, and parents of the participating students collected nocturnal samples. We recorded the beginning and end times of the three collection periods and then determined the urinary volume and urinary flow for each of the periods. We measured urinary fluoride concentrations and calculated the urinary excretion rate per hour. The children had breakfast and lunch provided at the school, where the drinking water contained 1.0-1.3 milligrams/liter (mg/L) fluoride. Fluoride concentrations in the tested household water supplies, from wells, ranged from 0.1 to 3.2 mg/L fluoride. The children's average urinary fluoride concentrations found for the day were similar to those for the night, with means ranging from 1.26 mg/L to 1.42 mg/L. Average excretion was 36.4 micrograms/h in the morning, 45.6 micrograms/h in the afternoon, and 17.5 micrograms/h at night. The lower nocturnal excretion rates are easily explained by low urinary flow at night. Based on the 15 hours of urine collected, the extrapolated 24-hour fluoride excretion was 749 micrograms. In conjunction with similar studies, the data from this study will help in developing upper limits for urinary fluoride excretion that are appropriate for avoiding unsightly fluorosis while providing optimal protection against dental decay.

Comparative study of the direct-lift and platinum foil techniques in the marginal discrepancy of collarless metal ceramic restorations.

This study was carried out to evaluate the marginal discrepancy of collarless metal ceramic restorations, using a combination of three different techniques to manufacture the porcelain butt margin with two brands of body porcelain. Statistical analysis showed no significant difference between the techniques or brands of body porcelain used in this study.

Effect of acid etching on the flexural strength of a feldspathic porcelain and a castable glass ceramic.

This project studied the effect of altering surface topography by chemical etching on the strength of a feldspathic porcelain and castable glass ceramic. Fifty specimens of each ceramic material were subjected to five different etch times (in groups of 10). A silane coupling agent and composite resin cement were applied. Specimens were then subjected to a three-point flexural strength test. Representative specimens were examined under scanning electron microscope to elucidate more information on the effect and the depth of etch. There was no significant difference in the mean flexural strengths between the etched and nonetched groups and no significant difference between the different etching times for either material. Photomicrographs revealed dissimilar etch depths and selective dissolution of the phases. It appears that chemical etching can improve the retention of ceramic laminate veneers without significant loss of strength.

A method for determining adequate resistance form of complete cast crown preparations.

A diagram with various degrees of occlusal convergence, which takes into consideration the length and diameter of complete crown preparations, was designed as a guide to assist the dentist to obtain adequate resistance form. To test the validity of the diagram, five groups of complete cast crown stainless steel dies were prepared (3.5 mm long, occlusal convergence 10, 13, 16, 19, and 22 degrees). Gold copings were cast for each of the 50 preparations. Displacement force was applied to the casting perpendicularly to a simulated 30-degree cuspal incline until the casting was displaced. Castings were deformed at margins except for the 22-degree group. Castings from this group were displaced without deformation, and it was concluded that there was a lack of adequate resistance form as predicted by the diagram. The hypothesis that the diagram could be used to predict adequate or inadequate resistance form was confirmed by this study.