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Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2024; 10:CD010856. [PMID: 39362658 PMCID: PMC11449566 DOI: 10.1002/14651858.cd010856.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
BACKGROUND Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community water fluoridation (CWF) is currently practised in about 25 countries; health authorities consider it to be a key strategy for preventing dental caries. CWF is of interest to health professionals, policymakers and the public. This is an update of a Cochrane review first published in 2015, focusing on contemporary evidence about the effects of CWF on dental caries. OBJECTIVES To evaluate the effects of initiation or cessation of CWF programmes for the prevention of dental caries. To evaluate the association of water fluoridation (artificial or natural) with dental fluorosis. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and four other databases up to 16 August 2023. We also searched two clinical trials registers and conducted backward citation searches. SELECTION CRITERIA We included populations of all ages. For our first objective (effects of initiation or cessation of CWF programmes on dental caries), we included prospective controlled studies comparing populations receiving fluoridated water with those receiving non-fluoridated or naturally low-fluoridated water. To evaluate change in caries status, studies measured caries both within three years of a change in fluoridation status and at the end of study follow-up. For our second objective (association of water fluoridation with dental fluorosis), we included any study design, with concurrent control, comparing populations exposed to different water fluoride concentrations. In this update, we did not search for or include new evidence for this objective. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. For our first objective, we included the following outcomes as change from baseline: decayed, missing or filled teeth ('dmft' for primary and 'DMFT' for permanent teeth); decayed, missing or filled tooth surfaces ('dmfs' for primary and 'DMFS' for permanent teeth); proportion of caries-free participants for both primary and permanent dentition; adverse events. We stratified the results of the meta-analyses according to whether data were collected before or after the widespread use of fluoride toothpaste in 1975. For our second objective, we included dental fluorosis (of aesthetic concern, or any level of fluorosis), and any other adverse events reported by the included studies. MAIN RESULTS We included 157 studies. All used non-randomised designs. Given the inherent risks of bias in these designs, particularly related to management of confounding factors and blinding of outcome assessors, we downgraded the certainty of all evidence for these risks. We downgraded some evidence for imprecision, inconsistency or both. Evidence from older studies may not be applicable to contemporary societies, and we downgraded older evidence for indirectness. Water fluoridation initiation (21 studies) Based on contemporary evidence (after 1975), the initiation of CWF may lead to a slightly greater change in dmft over time (mean difference (MD) 0.24, 95% confidence interval (CI) -0.03 to 0.52; P = 0.09; 2 studies, 2908 children; low-certainty evidence). This equates to a difference in dmft of approximately one-quarter of a tooth in favour of CWF; this effect estimate includes the possibility of benefit and no benefit. Contemporary evidence (after 1975) was also available for change in DMFT (4 studies, 2856 children) and change in DMFS (1 study, 343 children); we were very uncertain of these findings. CWF may lead to a slightly greater change over time in the proportion of caries-free children with primary dentition (MD -0.04, 95% CI -0.09 to 0.01; P = 0.12; 2 studies, 2908 children), and permanent dentition (MD -0.03, 95% CI -0.07 to 0.01; P = 0.14; 2 studies, 2348 children). These low-certainty findings (a 4 percentage point difference and 3 percentage point difference for primary and permanent dentition, respectively) favoured CWF. These effect estimates include the possibility of benefit and no benefit. No contemporary data were available for adverse effects. Because of very low-certainty evidence, we were unsure of the size of effects of CWF when using older evidence (from 1975 or earlier) on all outcomes: change in dmft (5 studies, 5709 children), change in DMFT (3 studies, 5623 children), change in proportion of caries-free children with primary dentition (5 studies, 6278 children) or permanent dentition (4 studies, 6219 children), or adverse effects (2 studies, 7800 children). Only one study, conducted after 1975, reported disparities according to socioeconomic status, with no evidence that deprivation influenced the relationship between water exposure and caries status. Water fluoridation cessation (1 study) Because of very low-certainty evidence, we could not determine if the cessation of CWF affected DMFS (1 study conducted after 1975; 2994 children). Data were not available for other review outcomes for this comparison. Association of water fluoridation with dental fluorosis (135 studies) The previous version of this review found low-certainty evidence that fluoridated water may be associated with dental fluorosis. With a fluoride level of 0.7 parts per million (ppm), approximately 12% of participants had fluorosis of aesthetic concern (95% CI 8% to 17%; 40 studies, 59,630 participants), and approximately 40% had fluorosis of any level (95% CI 35% to 44%; 90 studies, 180,530 participants). Because of very low-certainty evidence, we were unsure of other adverse effects (including skeletal fluorosis, bone fractures and skeletal maturity; 5 studies, incomplete participant numbers). AUTHORS' CONCLUSIONS Contemporary studies indicate that initiation of CWF may lead to a slightly greater reduction in dmft and may lead to a slightly greater increase in the proportion of caries-free children, but with smaller effect sizes than pre-1975 studies. There is insufficient evidence to determine the effect of cessation of CWF on caries and whether water fluoridation results in a change in disparities in caries according to socioeconomic status. We found no eligible studies that report caries outcomes in adults. The implementation or cessation of CWF requires careful consideration of this current evidence, in the broader context of a population's oral health, diet and consumption of tap water, movement or migration, and the availability and uptake of other caries-prevention strategies. Acceptability, cost-effectiveness and feasibility of the implementation and monitoring of a CWF programme should also be taken into account.
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Affiliation(s)
| | - Tanya Walsh
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Sharon R Lewis
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Janet E Clarkson
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Division of Oral Health Sciences, School of Dentistry, University of Dundee, Dundee, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Lucy O'Malley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Taher MK, Momoli F, Go J, Hagiwara S, Ramoju S, Hu X, Jensen N, Terrell R, Hemmerich A, Krewski D. Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water. Crit Rev Toxicol 2024; 54:2-34. [PMID: 38318766 DOI: 10.1080/10408444.2023.2295338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Fluoride is a naturally occurring substance that is also added to drinking water, dental hygiene products, and food supplements for preventing dental caries. Concerns have been raised about several other potential health risks of fluoride. OBJECTIVE To conduct a robust synthesis of evidence regarding human health risks due to exposure to fluoride in drinking water, and to develop a point of departure (POD) for setting a health-based value (HBV) for fluoride in drinking water. METHODS A systematic review of evidence published since recent reviews of human, animal, and in vitro data was carried out. Bradford Hill considerations were used to weigh the evidence for causality. Several key studies were considered for deriving PODs. RESULTS The current review identified 89 human studies, 199 animal studies, and 10 major in vitro reviews. The weight of evidence on 39 health endpoints was presented. In addition to dental fluorosis, evidence was considered strong for reduction in IQ scores in children, moderate for thyroid dysfunction, weak for kidney dysfunction, and limited for sex hormone disruptions. CONCLUSION The current review identified moderate dental fluorosis and reduction in IQ scores in children as the most relevant endpoints for establishing an HBV for fluoride in drinking water. PODs were derived for these two endpoints, although there is still some uncertainty in the causal weight of evidence for causality for reducing IQ scores in children and considerable uncertainty in the derivation of its POD. Given our evaluation of the overall weight of evidence, moderate dental fluorosis is suggested as the key endpoint until more evidence is accumulated on possible reduction of IQ scores effects. A POD of 1.56 mg fluoride/L for moderate dental fluorosis may be preferred as a starting point for setting an HBV for fluoride in drinking water to protect against moderate and severe dental fluorosis. Although outside the scope of the current review, precautionary concerns for potential neurodevelopmental cognitive effects may warrant special consideration in the derivation of the HBV for fluoride in drinking water.
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Affiliation(s)
- Mohamed Kadry Taher
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
| | - Franco Momoli
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Jennifer Go
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Shintaro Hagiwara
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Siva Ramoju
- Risk Sciences International, Ottawa, ON, Canada
| | - Xuefeng Hu
- Department of Biology, Faculty of Science, University of Ottawa, Ottawa, ON, Canada
| | - Natalie Jensen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Rowan Terrell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Alex Hemmerich
- Risk Sciences International, Ottawa, ON, Canada
- Faculty of Education, Queen's University, Kingston, ON, Canada
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
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Velez-León E, Pacheco-Quito EM, Díaz-Dosque M, Tobar-Almache D. Worldwide Variations in Fluoride Content in Beverages for Infants. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1896. [PMID: 38136098 PMCID: PMC10741400 DOI: 10.3390/children10121896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
In situations where breastfeeding is impractical, milk formulas have emerged as the primary choice for infant nutrition. Numerous global studies have scrutinized the fluoride content in these formulas, uncovering fluctuations in fluoride levels directly associated with the method of preparation. This variability poses a potential risk of elevated fluoride concentrations and, consequently, an increased susceptibility to dental fluorosis in infants. The primary objective of this review is to intricately delineate the fluoride content in dairy formulas and emphasize the variability of these values concerning their reconstitution process. The review's findings reveal that, among the 17 studies assessing fluoride levels in infant formula, milk-based formulas exhibit a range of 0.01-0.92 ppm, with only two studies exceeding 1.30 ppm. Conversely, soy-based formulas demonstrate values ranging from 0.13-1.11 ppm. In conclusion, the observed variability in fluoride levels in infant formulas is ascribed to the choice of the water source employed in the preparation process. This underscores the paramount importance of meticulously adhering to recommendations and guidelines provided by healthcare professionals concerning the utilization of these formulas and their meticulous reconstitution.
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Affiliation(s)
- Eleonor Velez-León
- Unidad Académica de Salud y Bienestar, Facultad de Odontología, Universidad Católica de Cuenca, Cuenca 010105, Ecuador;
- Grupo de Investigación Innovación y Desarrollo Farmacéutico en Odontología, Facultad de Odontología, Jefatura de Investigación e Innovación, Universidad Católica de Cuenca, Cuenca 010105, Ecuador
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
| | - Edisson-Mauricio Pacheco-Quito
- Unidad Académica de Salud y Bienestar, Facultad de Odontología, Universidad Católica de Cuenca, Cuenca 010105, Ecuador;
- Grupo de Investigación Innovación y Desarrollo Farmacéutico en Odontología, Facultad de Odontología, Jefatura de Investigación e Innovación, Universidad Católica de Cuenca, Cuenca 010105, Ecuador
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
| | - Mario Díaz-Dosque
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
- Laboratory of Pharmacology, Institute for Research in Dental Sciences (ICOD), Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago 8380544, Chile
| | - Daniela Tobar-Almache
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
- Laboratory of Pharmacology, Institute for Research in Dental Sciences (ICOD), Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago 8380544, Chile
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Umer MF. A Systematic Review on Water Fluoride Levels Causing Dental Fluorosis. SUSTAINABILITY 2023; 15:12227. [DOI: 10.3390/su151612227] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/12/2024]
Abstract
Dental fluorosis is a long-existing public health issue resulting from inequitable access to potable water. Socially disadvantaged rural communities in fluoride-endemic areas, where a conventional irrigation system is absent and groundwater containing natural fluoride is the predominant source of drinking water, face a significant oral public health threat. This study aimed to determine the association between water fluoride levels and dental fluorosis. A systematic review aligned with PRISMA principles was conducted using the SPIDER search methodology and relevant keywords on many search engines, such as Google Scholar, PubMed, Elsevier, Sage, Web of Science, Cochrane, and Scopus. This review sought to ascertain the PICO model’s application as a search strategy tool. The reviewers gathered and assessed 1164 papers from January 2010 to January 2023. In total, 24 research papers from diverse databases were included. Using the Newcastle–Ottawa Scale, grades resulting from several data screens were evaluated. According to a previous systematic review, there may be publication bias in studies examining the association between fluoride in drinking water and dental fluorosis. The findings of this systematic review indicate that subpar fluoride is detrimental to human health. The author outlines legislative tools and technological advancements that might reduce fluoride levels.
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Affiliation(s)
- Muhammad Farooq Umer
- Preventive Dentistry Department, College of Dentistry, King Faisal University, Hofuf 31982, Saudi Arabia
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5
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Tang H, Wang M, Li G, Wang M, Luo C, Zhou G, Zhao Q, Dong L, Liu H, Cui Y, Liu L, Zhang S, Wang A. Association between dental fluorosis prevalence and inflammation levels in school-aged children with low-to-moderate fluoride exposure. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 320:120995. [PMID: 36603756 DOI: 10.1016/j.envpol.2022.120995] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/24/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Inflammation mediates the neurological deficits caused by fluoride. Thus, whether inflammation is the underlying mechanism of dental fluorosis (DF) in school-aged children is worth exploring. A cross-sectional study was conducted to investigate the association between inflammation and the prevalence and severity of DF with low-to-moderate fluoride exposure. Fasting morning urine and venous blood samples were collected from 593 children aged 7-14 years. The fluoride content in the water and urine samples was measured using a fluoride ion-selective electrode assay. The levels of interleukin-1β (IL-1β) and C-reactive protein (CRP) were detected using an enzyme-linked immunosorbent assay. The Dean's index was used when performing dental examinations. Regression, stratified, and mediation analyses were performed to analyze the association between fluoride exposure, inflammation, and DF prevalence. In the adjusted regression models, the prevalence of mild DF was 1.723-fold (95% confidence interval [CI]:1.612, 1.841) and 1.594-fold (1.479, 1.717) greater than that of normal DF for each 1 mg/L increase in water and urinary fluoride content, respectively. The prevalence of mild DF increased by 3.3% for each 1 pg/mL increase in the IL-1β level and by 26.0% for each 1 mg/L increase in the CRP level. Stratified analysis indicated a weaker association between fluoride concentration and DF prevalence in boys than in girls, and susceptibility in the boys was reflected by the association of IL-1β with very mild and moderate DF prevalence. For every 1 mg/L increase in water and urinary fluoride levels, the proportion of IL-1β-mediated effects on the prevalence of mild DF was 10.0% (6.1%, 15.8%) and 8.7% (4.8%, 15.2%), respectively, and the proportion of CRP-mediated effects was 9.2% (5.5%, 14.9%) and 6.1% (3.3%, 11.0%), respectively. This study indicates that the DF prevalence may be sex-specific. Inflammatory factors may partially mediate the increased prevalence of mild DF in school-aged children with low-to-moderate fluoride exposure.
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Affiliation(s)
- Huayang Tang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Mengru Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Henan Center for Disease Control and Prevention, Zhengzhou, Henan, PR China
| | - Gaochun Li
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Mengwei Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chen Luo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Guoyu Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Qian Zhao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Lixin Dong
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Hongliang Liu
- Tianjin Center for Disease Control and Prevention, Tianjin, PR China
| | - Yushan Cui
- Tianjin Center for Disease Control and Prevention, Tianjin, PR China
| | - Li Liu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Shun Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Aiguo Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
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Wang X, Tewari N, Sato F, Tanimoto K, Thangavelu L, Makishima M, Bhawal UK. Biphasic Functions of Sodium Fluoride (NaF) in Soft and in Hard Periodontal Tissues. Int J Mol Sci 2022; 23:ijms23020962. [PMID: 35055148 PMCID: PMC8780524 DOI: 10.3390/ijms23020962] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/04/2023] Open
Abstract
Sodium fluoride (NaF) is widely used in clinical dentistry. However, the administration of high or low concentrations of NaF has various functions in different tissues. Understanding the mechanisms of the different effects of NaF will help to optimize its use in clinical applications. Studies of NaF and epithelial cells, osteoblasts, osteoclasts, and periodontal cells have suggested the significant roles of fluoride treatment. In this review, we summarize recent studies on the biphasic functions of NaF that are related to both soft and hard periodontal tissues, multiple diseases, and clinical dentistry.
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Affiliation(s)
- Xingzhi Wang
- Department of Biochemistry, Nihon University School of Medicine, Tokyo 173-8610, Japan;
| | - Nitesh Tewari
- Centre for Dental Education and Research, Division of Pedodontics and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Fuyuki Sato
- Shizuoka Cancer Center, Pathology Division, Shizuoka 411-8777, Japan;
| | - Keiji Tanimoto
- Department of Translational Cancer Research, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Lakshmi Thangavelu
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India;
| | - Makoto Makishima
- Department of Biochemistry, Nihon University School of Medicine, Tokyo 173-8610, Japan;
- Correspondence: (M.M.); (U.K.B.)
| | - Ujjal K. Bhawal
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India;
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Correspondence: (M.M.); (U.K.B.)
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