Toothpastes (technically called toothpastes) are usually active through the use of fluoride in the form of sodium fluoride or sodium monofluorphosphate, which is a recognized antimicrobial and anticariogenic agent. Its action is related to the high electronegativity of this ametal and also to its ability to exchange with the calcium of the enamels, thus interfering with the adhesion of bacteria such as the
. This remarkable action has also motivated the implementation of this element in urban water in many cities around the globe as a way to prevent the occurrence of caries.
In fact, fluoride is among the micronutrients necessary to maintain good health and its sources range from vegetables such as algae and camellia (
), seafood such as filter fish (sardines for example) and planktonic beings such as the Krill (
). It can also be found in some water bodies such as lakes and rivers, especially those that pass in areas of volcanic past. Thus it is understood that it is ingested naturally many times without realizing it, not even depending on toothpastes or mouthwashes.
Since the late 19th and early 20th century the use of fluoride has been well spread, so that the best known adverse events to its ingestion are related to intestinal irritations, allergies, fluorosis in infants and children up to 6 years of age (the impact would occur during odontogenesis). Even in the latter case the data are contradictory because the studies date back to 1942 in several American cities, revealing the quantity that is ingested because in water the added fluoride is of the order of 1ppm, while in toothpastes the content is 1250ppm and in mouthwash is 225ppm. This way the adverse events are more related to the quantitative incorporated and short-term, in which the symptoms described involve: diarrhea, nausea, vomiting and colic. To get an idea of the toxicity parameter to measure this, the so called Probable Toxic Dose (in English PTD –
) is stipulated in 5mg/kg body weight.
The allergenic and irritating aspect of fluoride can occur in children and/or adults and has encouraged the release of many toothpastes and mouthwash that replace it with essential oils (mint, eucalyptus, melaleuca, clove, cinnamon, orange), polyols such as xylitol and minerals such as activated carbon. Such agents are as effective as halogen and still add a great ecological proposal, since fluoride is highly reactive even when discarded in the environment.
Fluoride is still the subject of many debates about its real benefits and uses in dental health, but it is well registered by associations such as the European Academy of Pediatric Dentists (in English EPAD –
) which recommend its use in all age groups, even in pregnant women. And for those who want scientific data I recommend these readings:
70 years of fluoridation of public water supply requires debate
. (2015), vol.67 no.2
FLUORIDE: A REVIEW OF USE AND EFFECTS ON HEALTH
Necessity to review the Brazilian regulation about fluoride toothpastes
; 49: 74