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CAR Connect: Let's Get the Facts About Fluoride in Dental Caries Control - Why, When and How?

Description

Cariology Research Group

Fluoride is the ionic form of fluorine, the thirteenth most abundant element in the earth and released into the environment naturally both in water and air. Other important natural sources of fluoride are tea and seafood that contains edible bones or shells. Nowadays, there are several ways to use fluoride, such as dentifrices, gels, varnishes, foams. The American Dental Association strongly supports fluoridation of community drinking water supplies; however, strong contradictory opinions are also present (ADA, 2017). The first ‘artificial’ water fluoridation for caries control was introduced in the USA (1945), then in Canada (1946). The success of water fluoridation in preventing and controlling dental caries led to the development of several fluoride-containing products, including toothpaste, mouth rinse, dietary supplements, and professionally applied or prescribed gel, foam, or varnish.

In addition, IADR position statement (2022) indicated that fluoride toothpastes should be recommended to everyone as an effective method of fluoride use, as part of their daily oral hygiene regime. Brushing two or more times daily with a fluoride toothpaste provides greater caries protection compared to only once a day or less. An additional exposure to fluoride (via high fluoride concentration toothpastes, mouth rinses, or professionally applied products) may be recommended for individuals at increased risk for caries following caries risk assessment.

Dental caries is still the most prevalent condition worldwide affecting billions of people (Kassebaum, 2015). There is clear evidence demonstrating the effect of fluoride on the incidence of dental caries and reduction in the progression of existing lesions. The efficacy and effectiveness of the delivery mode of fluoride in preventing and controlling dental caries has been well-established according to the recommended concentration, frequency of use, and dosage schedule. Interestingly, recently a trend has been growing worldwide against fluoridation, emphasising the possible risk of toxicity. The fast spread of inaccurate news about fluoride on social media poses potential problems by possibly misleading the public and causing unwarranted fear and rejection of an effective oral health intervention. Therefore, health-care professionals and the public may require guidance with regards to the cons and pros of fluoridation. This panel would potentially discuss the different aspects of fluoride on dental caries as a public measure.

Speakers

  • David J. Manton
    Fluoride and the management of caries in children
  • Bente Nyvad
    Fluoridated toothpaste for caries control at the population level: The Danish experience
  • Domenick Zero
    The Why and the How of Using Topical Fluorides

Learning Objectives:

  • Participants will have a sound understanding of the multifactorial nature of dental caries in order to deliver effective and tailored caries control.
  • Participants will have the opportunity to acknowledge of caries lesion activity as a prime importance for the management of dental caries.
  • Participants will have a clear knowledge of why, when and how to use fluoride in caries management with advantages and disadvantages.

Contributors

  • Bente Nvyad

    Aarhus University, Denmark

    Bente Nyvad, DDS, MPH, PhD, Dr. Odont. is a Professor emerita at the Department of Dentistry and Oral Health at Aarhus University, Denmark. She is # 4 on the list of most-cited cariology researchers in the world. Her research has mainly focused on oral microbial ecology and experimental caries. Moreover, she has pioneered the development of a new classification of caries lesions into active and inactive stages and shown that such a classification is important in daily patient management. Bente Nyvad has published more than a hundred publications in peer-reviewed international journals and has been a diligent writer of textbook chapters. She is a longstanding Editor of the international textbook “Dental Caries. The Disease and Its Clinical Management”, which has recently come out with an updated fourth edition. Professor Nyvad has been an Associate editor of Caries Research (2000-2020), and has taken various leadership positions in the European Organization for Caries Research (ORCA), including the position as President (2003-2005). Bente Nyvad has received several awards, the most prestigious of which is the Yngve EricsonPrize for Research in Preventive Odontology in appreciation of her research on the role of fluoride in caries control.

  • David Manton

    The University of Groningen

    Professor of Paediatric Dentistry focussing on cariology
    Centrum voor Tandheelkunde en Mondzorgkunde, UMCG
    Rijksuniversiteit Groningen, The Netherlands.

    Visiting Professor, Paediatric Dentistry, Academic Center for Dentistry Amsterdam (ACTA), the Netherlands

    Professorial Fellow, Melbourne Dental School, University of Melbourne, Australia.

    David has spent nearly 40 years in private practice and academia and is currently a Professor of Paediatric Dentistry at the UMCG, University of Groningen and at ACTA in Amsterdam. He previously convened the specialist training program in paediatric dentistry at the University of Melbourne, and was chair of the postgraduate education and research committee. David is involved in several collaborative and postgraduate research projects in both paediatric dentistry and orthodontics. Graduated BDSc (Melb) in 1984 and worked in general practice until 1991 when he undertook an MDSc in Paediatric Dentistry. He was dental advisor to the Australian Federal Government from 1994 – 1996 and won the KG Sutherland Prize of the Royal Australasian College of Dental Surgeons in 2007. He is an associate editor of Caries Research and on the advisory panel (board) of the European Caries Research Association (ORCA). He is also a long term member of the editorial boards of the European Archives of Paediatric Dentistry and the International Journal of Paediatric Dentistry. David is a past president of the IADR paediatric oral health research group.

    Over the past 20 years David has spoken throughout Australia, Asia and Europe and has wide ranging research experience in Minimum Intervention Dentistry, caries remineralisation, especially CPP-ACP, the detection of carious lesions, developmental defects of enamel (especially MIH), resin infiltration of MIH lesions, and the use of calcium silicates in endodontics. He has published more than 170 manuscripts in peer-reviewed journals and according to Google scholar he has been cited over 10,000 times since 2019. He is currently supervising far too many PhD and masters student research projects.

  • Domenick Zero

    Indiana University

    Domenick T. Zero, DDS, MS, BS is a tenured professor in the Department of Biomedical and Applied Sciences, Indiana University School of Dentistry. He recently stepped down as director of the Oral Health Research Institute after serving for 22 years. He is an internationally recognizing Cariologist and widely regarded for his expertise in running clinical trials.

    Dr. Zero’s current research interests include evaluation of the clinical anticaries efficacy of topical fluorides, non-fluoride remineralization agents, new early caries diagnostic systems, caries-associated virulence properties of dental biofilms, and the use of biologics for the treatment of Sjögren’s disease and temporomandibular joint disorder. As a principal investigator, he has received research grants from the National Institutes of Health and private industry totaling well over 30 million dollars. He has published more than 170 articles in peer-reviewed scientific journals and book chapters and over 220 abstracts. His work has been cited over 20,000 times.

    In 1996 he assumed the presidency of the IADR Cariology Research Group. From 1999 to 2001 he served as an elected member European Organization for Caries Research (ORCA) Advisory Board. He has also served as chair and vice-chair of the American Dental Association Council on Scientific Affairs, as a member of the Dental Products Panel of the Food and Drug Administration's (FDA) Medical Devices Advisory Committee, and as a member of the Centers for Disease Control and Prevention's Expert Panel on School-based Dental Sealant Programs. He is a founding board member of the International Caries Detection and Assessment System Foundation and the recently formed American Academy of Cariology. He currently serves as a member of the ADA Center for Evidence-Based Dentistry’s Expert Panel for the American Dental Association (ADA) Clinical Practice Guideline on Caries Management, a consultant to the ADA Presidential Task Force on Sugar, Nutrition, and Diet, and recently has been again appointed as a member of Dental Products Panel of the Medical Devices Advisory Committee of the FDA.

    He has recently received several awards recognizing his research contributions, including the Yngve Ericsson Prize for Research in Preventive Odontology, the American Dental Association's Norton M. Ross Award for Excellence in Clinical Research, and the IADR Distinguished Scientist William H. Bowen Research in Dental Caries Award.

  • Aylin Baysan

    Queen Mary University of London
    London, United Kingdom

October 17, 2024
Thu 8:00 AM EDT

Duration 1H 30M

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