Demineralization of tooth enamel is a process that occurs when acids attack and break down enamel. Plaque on the teeth produces these acids continuously, and if it is not removed, it will continue to cause tooth decay. Fluoride is a mineral found naturally in many foods and water, and it plays an important role in remineralizing the enamel layer of the tooth. Every day, minerals are added to the enamel layer of the tooth and are lost from it through two processes, demineralization and remineralization.
Minerals are lost (demineralization) from the enamel layer of the tooth when acids (formed by plaque, bacteria and sugars in the mouth) attack the enamel. Minerals such as fluorine, calcium and phosphate are re-deposited (remineralization) in the enamel layer from food and water consumed. Excessive demineralization without sufficient remineralization to repair the enamel layer causes tooth decay. If you have had a restoration done in the past year due to a new decay, you are at greater risk of tooth decay. Fluoride treatments are a great way to prevent further tooth decay in patients who are already prone to it.
Unfortunately, more and more parents are refusing the use of topical fluoride for their children during preventive medical and dental visits. This incipient clinical and public health problem deserves attention from dental professionals and the scientific community. There are immediate clinical and community strategies available to improve fluoride-related communications with parents and the public. As for future research priorities, screening tools need to be developed to identify parents who are likely to reject topical fluoride and diagnostic tools to discover the reasons for the rejection of topical fluoride. The goal is to use these tools and instruments to measure the effectiveness of programs aimed at addressing fluoride rejection.
Over time, this knowledge will lead to evidence-based strategies that can be widely disseminated in clinical practice. These efforts will help parents make optimal decisions about preventive dental care for their children, reduce dental diseases in high-risk children, and reduce persistent inequalities in pediatric oral health. In the long term, measures need to be developed to identify parents who are likely to reject topical fluoride and to discover the reasons for the rejection of topical fluoride. Before fluoride was added to toothpaste, studies found that people who had fluoridated water were 40 to 60 percent less likely to have tooth decay. The American Dental Association (ADA) states that people who drink bottled water may be overlooking the cavity-preventive effects of optimal fluoridated water available in their community's water sources. The association between vaccination and fluoride rejection highlights the importance of vaccine literature in identifying possible causes of fluoride rejection. In conclusion, the growing number of parents who reject topical fluoride in clinical practice deserves attention from dental professionals and the scientific community.
Fluoride is found naturally in most water sources, but adding small amounts of fluoride to tap water is especially beneficial for people who don't have regular access to a dentist. There are clinical and community strategies available to improve communication with parents about fluoride and educate the public about its importance.