Why prefer a fluoride toothpaste?
Among the antique toothpastes, those with fluorine are undoubtedly the most appreciated and used; just think that 90-95% of toothpaste preparations are made with fluorine.
Penetrating into the more superficial layers of the enamel, fluorine binds to the calcium ions that make up hydroxyapatite, one of the main mineral constituents of bones and teeth. In this way, fluoride makes dental enamel stronger and more resistant to flaking caused by bacterial plaque acids.
Prevent tooth decay
For the past twenty years, the obturation and devitalization interventions required to treat tooth decay have clearly decreased. The above seems to be explained by the regular use of fluoride-enriched toothpastes.
Data in hand, an adequate and constant use of fluoridated dentifrices reduces the formation of caries by 33.3% (compared to a fluorescent-free "placebo" toothpaste).
- ATTENTION: fluoride toothpaste works effectively in the prophylaxis of caries only if used regularly and adequately. It makes no sense to use fluoride toothpaste when daily dental cleaning is performed quickly, worse if the teeth are brushed horizontally or towards the gum. To make the most of the effectiveness of a toothpaste it is essential to pay particular attention also to the use of other basic dental hygiene tools, namely toothbrush, dental floss (or brush) and mouthwash.
Fluorine salts
In toothpastes, fluoride is not added as such, but in the form of soluble salts. The most common sources of fluoride used in the preparation of these toothpastes are:
- Sodium fluoride (NaF): probably the most common source of fluoride in toothpaste
- Stannous fluoride (SnF 2 ): seems to be the most effective fluorine salt in reducing the incidence of cariogenic processes and in controlling gingivitis
- Sodium monofluorophosphate (Na 2 PO 3 F)
- Amine fluoride
Fluorine concentration
The concentration of fluorine (or better fluoride) in a toothpaste, expressed in parts per million (ppm), should always be specified on the label to inform the consumer about the quality of the product. Often, however, on the label, the quantity of mineral added is reported only in percentage: how is it possible to convert a percentage value into ppm? The following table can clarify the concept.
Type of fluorine salt contained in toothpaste | Percentage present in toothpaste | Corresponding quantity expressed in ppm |
Sodium fluoride | 0.32% | 1500ppm |
| 0.22% | 1000ppm | |
0.11% | 500 ppm | |
Sodium monofluorophosphate | 1.14% | 1500ppm |
| 0.76% | 1000ppm | |
| 0.38% | 500 ppm |
The European Union has banned the placing on the market of toothpastes containing an amount of fluoride higher than 1500 ppm. Good quality toothpastes must contain the right concentration of fluoride, which must not be excessive but not too low. Most toothpastes contain a variable amount of fluoride from 1, 000 to 1, 100 ppm; in the United Kingdom, the content of fluoride salts in toothpaste is generally higher (1, 450 ppm).
In addition to fluoride ...
A fluoride-enriched toothpaste contains a mixture of multiple ingredients that, acting in synergy, encourage tooth cleaning and help prevent tooth decay.
A fluoride toothpaste is often made up of:
- Medium abrasive substances to remove dirt and surface stains from teeth: calcium carbonate, silica gel, aluminum oxides and hydrates, phosphate salts and salicylates
- Fluorine salts to strengthen tooth enamel: sodium fluoride, potassium fluoride and stannous fluoride
- Humectants such as glycerol, sorbitol and polyethylene glycol
- Flavoring agents to improve the taste of toothpaste
- Acariogenic sweeteners such as saccharin, also important for making the aroma of fluoride toothpaste more pleasant. Xylitol can not be missing from the list of anti-sweeteners, also indicated to prevent plaque formation
- Thickeners to stabilize toothpaste formulation (mineral colloids, algae, synthetic cellulose)
- Sodium sulfate, sodium N-lauryl sarcosinate and other foaming agents
- Some fluoride toothpastes contain antibacterial substances (eg triclosan and chlorhexidine), useful to prevent gum inflammation
Sensitive teeth
Some fluoride toothpastes are enriched with other ingredients to reduce dentinal hypersensitivity, while guaranteeing good protection against caries. Fluoride toothpastes for sensitive teeth may contain potassium nitrates, zinc citrate or strontium chloride.
Risks and dangers
Dentifrices formulated with fluoride at a concentration of 1, 000 ppm in the form of monofluorophosphate are generally not recommended for children. The risk is that the child will swallow the toothpaste, thus absorbing overabundant concentrations of fluoride.
An overdose of fluoride in the child's diet can lead to fluorosis, a clinical-pathological syndrome characterized by alterations in the chromatic tone of the enamel (the teeth become stained), functional modifications of the enamel that, in the most serious cases, can cause a progressive stiffening of the bones to deform the skeleton.
Frequent ingestion of fluoride during the first seven years of life risks progressively discoloring the permanent teeth.
That said, the experts have come to a single conclusion: toothpastes for children (up to the age of 6) must not contain a concentration of fluoride above 500-600 ppm. Once this age is reached, children can safely brush their teeth with fluoride toothpastes in the concentrations indicated for adults.
Alternatively, if toothpastes with standard fluorine concentration (1, 000 ppm) are used, up to 6 years the doses applied to the toothbrush must be minimal, the size of a pea.
