Re: extra fluoride treatment necessary?

nyscof wrote:
On Aug 15, 8:48 am, Mark & Steven Bornfeld
<bornfeldm...@xxxxxxxxxxxxxxx> wrote:

Paul--

Just to clarify; 22,600 ppm is a CONCENTRATION, and not a dose. It is
very likely that the bulk of fluoride in varnish not absorbed into the
enamel is brushed off within 24 hours and expectorated.

Steve

Steve

So, oh learned one, enlighted us all. How many milligrams of fluoride
is in fluoride varnish applied to an adult's mouth.


Depends on how much you use, silly. Easy enough to figure out--average application is on the order of 1/10 ml--let's say 10mg. At 5% NaF, I could easily do the calculation if there were a reason to--probably a few ug. But there really isn't, because the amount ingested is far smaller.

Dose and concentration are indeed two different things. However, when
you tell people fluoridation is safe and effective at 1 ppm, do you
tell them that they have to count up all the fluoride they eat, drink,
gargle with, brush with, inhale, etc. to figure out the dose because
the EPA says 4 mg daily can lead to skeletal fluorosis. And the
recent NRC fluoride panel said that level is too high to be protective
against fluoride's advers effects..


This is of course a valid issue, and your knee-jerk hostility to me is understandable. However, as you well know, calculating a total dose is generally impossible, since there are imponderables such as rinsing efficiency, absorbtion, etc.
But you are wrong to assume that I or other dentists are the troglodytes with regard to this issue that you would have some believe.
For the interested, here is a nice survey of the literature on acute and chronic fluoride toxicity. As NYSCOF says, much of the acute and chronic fluoride toxicity is in fact related to fluoride supplements, so of course this is an issue that should be dealt with honestly. This paper is much less alarmist about skeletal fluorosis than NYSCOF is; however, acute poisoning (as well as dental fluorosis) is not something we can ignore--even if it means acknowledging it when a hostile entity confronts us with it:

http://jdr.iadrjournals.org/cgi/reprint/71/5/1249.pdf

Steve


We are constantly told to ask our dentists if we need extra fluoride
because maybe we are getting "enough" already from our food supply.

Tell us how you tally your patients daily fluoride intake.

Not Paul, but you can call me that.







--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

Relevant Pages

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