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 SOURCES OF FLUORIDES
Ê Fluorine is one of the physiologically essential elements for normal
growth and development. It is the 13th most frequently occurring
elements which represents 0.06%to 0.09% of the earth crust.
Ê Fluorine is a yellowish green diatomaceous gas. The highest fluoride
value has been recorded in the rift valley of Kenya.{2800mg per kg
-5600mg per kg in soil} fluoride in atmosphere is highest in the
vicinity of fertilizers factories and industry involved in production
of plants uranium and aluminum. Plants like tea also contain
fluoride.
Ê Fish have a high content of fluoride because oceans contain about
1 ppm of fluoride.
 À
 À  À
À
   
À
À
èIR
èirborne fluoride exists in gaseous and particulate forms,
which are emitted from both natural and anthropogenic
sources. Fluoride released as gaseous and particulate matter
is deposited in the general vicinity of an emission source,
although some particulates may react with other
atmospheric constituents.
WèTER
Ê Fluoride levels in surface waters vary according to location
and proximity to emission sources. Surface water
concentrations generally range from 0.01 to 0.3 mg/litre.
Seawater contains more fluoride than fresh water, with
concentrations ranging from 1.2 to 1.5 mg/litre.
 SOIL
Fluoride is a component of most types of soil, with total
fluoride concentrations ranging from 20 to 1000 µg/g in
areas without natural phosphate or fluoride deposits and up
to several thousand micrograms per gram in mineral soils
with deposits of fluoride.

TERRESTIèL BIOTè
Ê Fluorides can be taken up by aquatic organisms directly from
the water or to a lesser extent via food. Fluorides tend to
accumulate in the exoskeleton or bone tissue of aquatic
animals
Ê Mean fluoride concentrations of 150²250 mg/kg were
measured in lichens growing within 2²3 km of fluoride
emission sources, compared with a background level of <1
mg fluoride/kg.
FOOD STUFF

Ê Virtually all foodstuffs contain at least trace amounts of

fluoride. Elevated levels are present in fish. Tea leaves are
particularly rich in fluoride

Ê The concentration of fluoride in food products is not

significantly increased by the addition of superphosphate
fertilizers, which contain significant concentrations of
fluoride (1²3%) as impurities, to agricultural soil, due to the
generally low transfer coefficient from soil to plant material
HISTORY OF FLOURIDES

Ê 1901: Doctor Frederick McKay of USè discovered

permanent stain on teeth and referred them as ¶colorado
brown stains· later named as mottled enamel.
Ê 1916:McKay and Brown examined 6873 individual in USè
and reported that unknown causative of mottled enamel
was possibly present in domestic water during the period of
tooth calcification.
Ê 1931: identification of chloride in drinking water,a
discovery made independently in three different places at
about the same time.
Ê 1941: 21 city study carried out by Dean et al.
The part consisted of clinical data from children 12 to
14 year·s old living in area with stable mean fluoride levels.
The project later added 13 additional communities. This
was the landmark epidemiologic survey which leads to
adoption of 0.7-1 mg fl/lt of water as optimum amount of
fluoride and drinking water.
Ê 1945:World·s first artificial fluoridation was started at Grand
Rapid,USè.
Ê 1969:Fluoridation was endorsed by WHO
PHYSIOLOGY OF
FLUORIDES
Ê METèBOLISM
Source of fluoride
The principle source of human fluoride ingestion is water.
It is present in nearly all ground water, though concentration in
water supply is very small.
It is also derived from plants, marine animals and even dust particles.
Fluoride content varies in different types of food like
Certain types of fishes, dried mackerel and dried salmon contain a
large amount of fluoride i.e. 84.5ppm.Potatoes give 6.4 ppm
Tea contains an average of 97ppm.
Ê CHEMISTRY OF FLUORIDE
Chemically fluoride is so violently reactive that it rarely or
never occurs in nature as elemental fluorine. Its atomic
weight is 19.0 and exits chemically in form of fluorides,
chiefly as:
Fluorspar(CaF2)
Fluor apatite(Ca10(PO4)6F2)
Cryolite(Na3èIF6)
Ê èBSORPTION èND DISTRIBUTION
The major route of fluoride absorption is through GIT.
They may also be inhaled from air borne fluorides. Fluoride
which is ingested is absorbed mainly from stomach and
intestine mucosa. It has been shown that absorption is
inversely proportional to pH of the stomach content. From
there it is carried by blood and distributed to various tissues
like
Mineralizing tissues, teeth and bone
Salivary gland, Soft tissues
Ê FLUORIDE èND BLOOD PLèSMè
Blood plasma has been considered as central component
in the transportation of fluorides in body. Fluoride levels
peaks in 30 minutes and after 24 hrs it declines. There is no
homeostatic regulation of these levels.Thus,there is no
psychological plasma fluoride concentration. In plasma
fluorides exists in two forms;1)ionic 2) Non ionic
è wide range of normal plasma fluoride concentration
[0.7-2.4microns/ml] has been coined by various scientific
literatures.
Ê FLUORIDE IN SOFT TISSUES
Fluoride from the plasma is distributed to all the tissues
and organ of the body. The rate of delivery is dependent
on the blood flow in the tissues. Fluoride is concentrated at
high level in kidney tubules. The blood brain barrier
prevents passage of fluoride in to CNS , where the fluoride
concentration as about 20% of that of plasma, is seen in
adipose tissue. The fluoride concentration of plasma and
extra cellular fluid are higher than that of intracellular fluid.
Ê FLUORIDE IN HèRD TISSUES
èbout 99% of all fluorides in the human body are found in
calcified tissues such as bone and teeth
BONE
Fluoride is present to a great extent during active bone
formation and it eventually reaches a constant level. It is
present to a greater extent in cancellous bone. Bone
fluoride content increases rapidly in young people but as
fluoride balance is achieved the uptake becomes slower and
eventually reaches a steady state when fluoride intake is
constant.
 TEETH
Fluoride in teeth is present in the highest concentration in
cementum.èlso,developing enamel tends to absorb fluoride
actively due to its porous nature. The fluoride content of
tooth tissues reflects the biologically available fluoride at the
time of tooth formation, in the bulk of enamel.
Ê FLUORIDE IN PLèCENTè èND FOETUS
Earlier it had been thought that the placenta act as the
barrier between the maternal blood and the foetus.This is
not so ,fetal blood infact;contain 75% of maternal blood
fluoride concentration.
Ê FLUORIDE IN PLè UE
Dental plaque is the main storage source in oral activity .Its
concentration in plaque is many times higher than in saliva,
especially gingival crevicular fluid where it is 10% to 20%
more than plasma concentration of fluoride.
Ê FLUORIDE EXCRETION
10%-25% of daily intake of fluoride is not absorbed and is
excreted in faeces.The elimination of absorbed fluoride
occurs almost exclusively via the kidneys.Fluroide is also
present in sweat, feaces, tears, breast milk etc.
BIOMèRKERS OF FLUORIDE EXPOSURE

Ê Urine ,
Ê plasma,
Ê saliva,
Ê Teeth,Hair
Ê Nails

Total Body Fluoride Is Reflected By -

Ê Bones
Ê teeth
MECHèNISM OF èCTION

Fluoride role in decreasing the prevalence of caries has been

well accepted for many years

It is now determined that presence of fluoride in and on

enamel surfaces is the key to effectiveness of fluorides.
It is incorporated throughout the tooth crown formation
during development
 ROLE OF LOW FLUORIDE IN ORèL
ENVIRONMENT

Ê Brown co workers (1996) predicted that low concentration

of fluoride could enhance remineralusation.Since fluoride
ion is most effective at enamel saliva interfere, it is believed
that it is beneficial to provide fluoride ions at that interfere.
It provides and maintains caries at inactive state.
GOèLS OF FLUORIDE (F) èDMINISTRèTION

1. Do no harm 3. èrrest active decay

Fluorosis or
toxicity

2. Prevent decay on in tact dental

surfaces 4. Remineralize decalcified teeth

F
FLUORIDE èDMINISTRèTION
Ê SYSTEMèTIC FLUORIDE
Fluoride after ingestion can get absorbed and incorporated into
developing enamel and can benefit teeth before eruption .It also
benefits the teeth eruption, when it returns to mouth in saliva and
gingival exudates.
Ê COMMUNITY WèTER FLUROIDèTION
Community water fluoridation in the process adjusting the amount of
fluoride in a community water supply to an optimum level for the
preventation of dental caries.
Studies have shown that adjustment of fluoride concentration in
drinking water to the optimum level of 1 ppm is associated with
marked decrease in dental caries.
Ê FLUORIDE COMPOUNDS USED IN WèTER
FLUORIDèTION
Fluorspar
Sodium fluoride
Silicofluoride
Sodium silicofluoride
Hydrofluosilicic
èmmonium silicofluoridr
Ê E UIPMENTS USED IN WèTER
FLUORIDèTION
There are three systems of water fluoridation
Saturated system
Dry feeder system
Solution feeder system
BENEFITS
This method is preferred since some tooth surfaces receive
greater protection against caries than other.
Water fluoridation has both pre-eruptive and post-eruptive
effects.
SCHOOL WèTER FLUORIDèTION

Ê School water fluoridation is the adjustment of the fluoride

concentration of a schools water supply for caries
prevention
Ê School water was fluoridated to provide maximum
cariostatic effect in developing teeth. since children spend
only 6 to 8 hours in school, concentration of fluoride
should be 4 to 6 times more than that designated for
community water
DIETèRY FLUORIDE SUPPLEMENTS

Ê Dietary fluorides supplements are administered in the

following form:
Fluoridated milk: milk fluoridation is suggested as an
alternative to water fluoridation for caries prevention
Fluoridated salt: the addition of fluoride to table salt is a
feasible way to deliver systemic fluride,particularly in
countries that lack a widespread municipal water system
Fluoride in sugar: several studies have shown that adding
fluoride to sugar and sugar products has potentially reduced
the cariogenic effects of the sugar or fermentable
carbohydrates among population groups
Fluoride in citrus beverages:Citrus beverages may also be
considered as a potential vehicle for the administration of
fluoride as dietary supplements
Fluoride drops: was prescribed in prenatal supplements for
potential caries prevention in teeth where development
begins in intrauterine life and at birth

Fluoride drops with vitamins

Fluoride tablets/lozenges Fluoride tablets with vitamins

Fluoride oral rinse supplements. they provide both a systemic
and a topical effect. The patient swishes the solution
producing a topical effect ,and then swallows the
solution,providing alters systemic effect
TOPICèL FLUORIDE
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OTHER FORMS

Ê Fluoridated tooth picks

Ê Fluoridated chewing gums
Ê Saliva substitute containing fluoride
USED èT HOME
FLUORIDE DENTIFRICES
Fluoride containing tooth paste now accounts 85% dentifrices
market in the world
The council of dental therapeutics of the èDè CURRENTLY
Recognizes few caries preventive dentifrices with èDè seal.
they all contain between 1,000 and 15,00ppm fluoride
formulated from both sodium mono-fluorophosphate and
none contains stannous fluoride
èDVèNTèGES
They provide a frequent source of fluoride in low
concentration that can inhibit demineralization and enhance
remineralization
DENTIFRICE (TOOTHPèSTE,TP)

Pastes
Key ingredients in TP:
1. F salt
2. èbrasive

Gels:
1. Better interdental
penetration
2. More acceptable
to children
 DENTIFRICE

F salt in TP: MFP does not react with calcium

Na
abrasives (F is covalently bound) and
1. 0.2% NaF PO4 F has better uptake by enamel crystals.

2. 0.76% sodium
monofluorophosphate (MFP)
3. 0.4% stannous F
4. èmine F
F F
Sn
F salt (all reach 1000-1500 ppm F) SnF2 exhibits less shelf life and may
cause dental staining

Na 1 gram of TP = 1 mg F èmine F is not sold in the US. It

adsorbs to enamel and has anti-
F bacterial properties
F

The èDè requires that 60% of free F ion be

available over the shelf life of the TP. NaF and MFP lose
about 20% free F in 2 years.
 F USE CONSIDERèTIONS

S F
P
High
salivary
T flow
F awake

Brush S
F F F
before
F bedtime P F Low
F T salivary
F F F
flow
asleep
F
Evidence shows that increased F
use and F concentration Rinsing after brushing
increases bioavailability in
reduces F effectiveness by 50%.
stagnation sites.
Recommendations: Do not rinse
(Note: be aware of fluorosis
after brushing or rinse with a F
susceptible patients.)
rinse.
 HOME F RINSES

Daily Rinse: Weekly Rinse

0.2% NaF, 0.091% free F, 910

èCT ppm F, 9.1 mg F / dose.
PREVI-
PREVI-
DENT
0.05% NaF, 0.023% free F,
230 ppm F, 2.3 mg F / dose

Indications:
1. High caries risk
2. Exposed roots
PHOS- 3. Prevention programs
FLOR

0.02% èPF, 0.02% free F,

200 ppm F, 2 mg F / dose.
FLUORIDE TOXICITY
It is said that "GOOD THINGS SHOULD BE
TèKEN«.IN PROPER DOSES". This applies to wonder
element of dentistry i.e. fluorides. If taken in a quantity that
exceeds the normal doses,fluoride can prove to be
dangerous.Hence it is called ´è DOUBLE EDGE
SWORD ,and it should be recommended that a large can kill
within minutes.
Fluoride toxicity can be
èCUTE TOXICITY
CHRONIC TOXICITY
Ê èCUTE FLUORIDE TOXICITY
Fluoride toxicity occurs from ingestion of a large amount
of fluoride.This could happen because of ingestion of
fluoride containing products such as pesticides or dental
care products like mouth rinses or tablets,drops,etc.Ofthe
reported cases,90% cases occurred in children.
Over fluoridation of communal water supplies has led to
cases of fluoride poisoning and fatalities have been
reported.
Ê PROBèBLY TOXIC DOSE(PTD)
The probably toxic dose of fluoride is the minimum dose
that could cause serious or life threatening systemic signs
and symptoms and that should trigger immediate
therapeutic intervention and hospitalization. The exact dose
cannot be accurately stated but taking into account all the
reported doses which have caused complications,we can say
that an oral fluoride dose of 5.0mg/kg body weight should
be considered as PTD.This does not mean that doses below
5mg/kg weight are harmless.
The PTD is 5 mg F/kg body weight. For a 20 kg 5 to 6 year
old this would be 100 mg and for a 10 kg 2 year old, 50 mg.
F content of dental products or treatments may exceed
these values for young children. For example, a gel tray
containing 5 ml of èPF contains 61.5mg F (F is absorbed
more quickly when in acidic form.), 100ml of 0.2 or 0.4% F
mouth rinse contains 91 or 97mg F and a tube of
fluoridated toothpaste contains as much as 230mg F. Sub-
lethal toxic symptoms are manifested quickly after the dose
and consists of vomiting, excessive salivation, tearing and
mucous discharge, cold wet skin and convulsions with
higher doses.
TOXICITY OF FLUORIDE COMPOUND
Sodium fluoride and stannous fluoride are generally supposed to
have more potential of causing acute toxicity than
monofluorophosphate,calcium fluoride or cryolite.
SIGN èND SYMPTOMS
Nausea
Vomiting
Epigastric distress
Excess salivation
Diarrhoea
Mucus discharges from the nose and mouth
Ê Counter measures which should be administered
immediately are emetics, 1% calcium chloride, calcium
gluconate or milk. (Calcium reacts with F in the GI tract
and prevents its absorption. The most serious
consequences of F toxicity stem from reactions of cationic
electrolytes with systemic F.)
Headache
Sweating
Hypotension
Cardiac arrhythmias
Disturbances in electrolyte balance i.e. hypocalcemia
Hyperkalemia.
Barely detectable pulse
Respiratory and metabolic acidosis
Coma
 POTENTIèL HèRM

Probable toxic dose:

5 mg F / kg body weight
61.5
mg F/ 91
91--97 mg F/
èCT
5 ml container of F
mouthrinse

Topical F, 12,300
ppm F pH= 3.5

20 kg 6 year old, PTD=

100 mg F
Symptoms:
1. Vomiting
2. Excess salivary and
mucous discharge

230 mg F/ 3. Cold wet skin

tube toothpaste 4. Convulsion at higher
10 kg 2 year old PTD
dose
= 50 mg F
 POTENTIèL HèRM

è serious systemic consequence Counter Measures:

is binding of F to Ca which
needed for heart function. 1. Emetics
2. 1% calcium chloride
3. Calcium gluconate
4. milk
F

F F

Ca
F Ca
Divalent cations like
Ca cause Ca
Ca precipitation, of F
and prevent
absorbtion in the
F intestine. F
Ca Ca F Ca Ca F
F F Ca F F Ca
Ca Ca
 TREèTMENT
Ê èll attempts must be made to eliminate the toxic dose of
fluoride from the body and
Minimize the further absorption
Support vital signs
èdministration of an emetic if patient possesses a gag reflex i.e. if
he is not vomiting he is not unconscious and not having
convulsions.
Investigations of blood should be done for pH,palsma fluoride
concentration and serum chemistry profiles.
èn intravenous line should be secured and glucose to be
reversed hyperkalemia and calcium gluconate to maintain
sodium and calcium levels must be given.
Sodium bicarbonate or ringer·s lactate must also be given to:
Increase urinary flow
Decrease acidosis
Increases Ph and thus
Increases excretion of fluoride
Continuously monitoring of the patient till the normalcy is
attained, is must.
 CHRONIC FLUORIDE TOXICITY
Fluoride has been made the scapegoat for many accusations. It has
been reported to cause
èllergy
Carcinoma
Birth abnormalities
Mutation and other genetic disorders.
èfter an extensive research it is now thought there is no detectable
risk of cancer in humans associated with consumption of
optimally fluoridated water. Fluoride is not associated with
Down·s syndrome or any birth abnormality. èt present, there is
no indication ,which suggest that organ system are affected by
fluoride.
SKELETèL FLUOROSIS
This is also called osteofluorosis.è water fluoride level over
4ppm cause a mild variant but levels over 8ppm cause severe
skeletal fluorosis.
FEèTURES
Increase bone density
Change in bone contours
Irregular periosteal growth
Spinal column and pelvis show roughening and blurring of
trabeculae.
Bone appears as marble white shadow and the configuration is
woolly.The cortex of long bone is thick and dense and the
medullary cavity is diminished.
Ligamental and tendon calcification with vague pain in joints.
Stiffness and limitation of joint movements, immobilizing the
patient-crippling fluorisis.
èrthritic changes ,cataract,thyroid problems,tumors and
cysts,fractures,urinary and gallstones may be seen.
 DENTèL FLUOROSIS

Chronic consumption of high levels of fluoride from drinking

water results in dental fluorosis.
McKay described the condition as ´mottled enamel characterized
by' minute white flecks, yellow or brown area scattered irregularly
or streaked over the surface of a tooth ,or it maybe a condition
where the entire tooth surface is of dead paper white color·
In 1931,the US public health services appointed Trendely H.Dean
to pursue full time research on mottled enamel.
He formulated an index ,know as Dean·s fluorosis index, to
calibrate his findings.
 Dean·s fluorosis Index

 
0 NORMèL-enamel appears translucent ,smooth and
glossy
1 UESTIONèBLE-enamel shows white flecks to an
occasional white spot.
2 VERY MILD-small opaque paper white areas
scattered irregularly over the tooth surface.
3 MILD-the white opaque areas are more extensive but
not involving greater than 50% of enamel

4 MODERèTE- all enamel surfaces affected brown

stain is distinguishing marked attrition.
5 SEVERE-hypoplasia is marked. General shape of the
tooth is affected
mild moderate

pitting severe
Ê Fluorosis occurs when teeth are developing. The most critical ages
are from 0 to 6 years. èfter 8 years, risk of fluorosis is essentially
past. During the critical ages F intake in excess of 0.1mg/kg body
weight/day can lead to fluorosis. This is roughly 1mg/day for a 1 to
2 year old or 1.5 to 2 mg for a 5 year old. Remember that all forms
of F intake comprise the daily consumption. This includes water
intake (up to 1.5mg/day), foods (0.3 to 1.0mg) and especially
significant in young children, swallowed toothpaste. Children under
2 years swallow 50% of toothpaste during tooth brushing and at
5years, 25%, both of which may amount to 1mg F/day.
POTENTIèL HèRM

DMFT FLUOROSIS

10
9 severe
8
moderate
7
6
mild
5
4 slight
3
2 0.0 0.5 1.0 2.0 3.0 4.0

PPM F IN DRINKING WèTER

F in excess of 0.1mg/ kg body weight =

fluorosis
FLUOROSIS

Enamel prism
Excess F affects
mineralization of
developing teeth

Up to age 6 is the critical age for fluorosis. èfter age

8, risk is past.
 FLUOROSIS

Daily F intake of a 20 kg 4 year

olds with different water F
Maxium safe dose for a
2 year old = 1 mg F /
day 1 2 3 4 mg F

0.5 ppm
water F

1.2 ppm
water F

supplements toothpaste
Maxium safe dose for a fluids food
5 year old = 2 mg F /
day

F in excess of 0.1mg/ kg body weight = DW Banting

fluorosis JèDè
123:86,1991
FLUOROSIS

5 year olds swallow 25% of

toothpaste Children under 2 years
swallow 50% of toothpaste

1 to 3 grams

Toothpaste = 1 mg F /
gram (1000 ppmF) ´pea size amount (0.5g) is
recommenred for fluorosis susceptible
children.
Ê TREèTMENT
Dental fluorosis presents an aesthetic concerns for the patient
and hence aesthetic restorative techniques have been advocated.
For milder forms of fluorosis,rubbing the teeth with 18%
hydrocholoric acid(with or without heat)and treatment with
30%hydrogen peroxide is used
Croll(1989)suggested that these techniques can be enhanced by
microabrasion or grinding of the surface layer.
Severe forms require composite restoration of full ceramic crowns
METHODS OF
MINIMIZING TOXICITY
Ê The danger of acute toxicity is high in cases of tropical
fluoride treatment where the teeth are treated with the high
F containing solution or gel at one time. Hence,
Upright position of patient, head incline forward
Use of custom made trays.
Use of saliva ejector
Use of minimum amount of gel required is recommended.
DEFLUORIDèTION
Defluoridation is a scientific means to improve the quality of water
with high fluoride concentration by adjusting the optimum level
in drinking water
METHODS
èDSORPTION èND ION EXCHèNGE METHOD
Some substances adsorb fluoride ion by the surface and it can
exchange its negative ion such as OH group for fluoride ion.
Thus the concentration of fluoride in water decreases for
eg.activated alumina, fluidized activated alumina.
PRECIPITèTION METHOD
In high pH condition,co-precipitation of several elements in with
fluoride ions forms fluoride salts.for eg.alum,alum and lime
METHODS BèSED ON MEMBRèME SEPERèTION
In the industrialized world·reverse osmosis·process is well know.
èll elements in water get diminished after filtration.
INDIèN TECHNOLOGY FOR
DEFLUORIDèTION
Ê NèLGONDè TECHNI UE
This technique first developed in India in 1975,is the simplest, the
least expensive and the easiest to operate of all the other method
of Defluoridation.
USING LIME èND èLUM
The first community plant for removal of fluoride from drinking
water was constructed in the district of nalgonda in èndhra
Pradesh, in the town of kathri,thus the name of technology.
Ê PROCEDURE
RèPID MIX: rapid mix is an operation by which the coagulant
is rapidly and uniformly dispersed though the single or multiple
phase system.This helps in the formation of microflocs and
results in proper utlization of chemical coagulant,preventing
localization of concentration and premature formation of
hydroxides which lead to less utilization of coagulants.

FLOCCULèTION:
flocculation is the second stage in the formation of settable
particles(FLOCS)from destabilized colloidal sized particles and is
achieved by gentle and prolonged mixing.
SEDIMENTèTION: it is the seperation from the water by
gravitational setting of suspended particles that are heavier than
water.
FILTERèTION: this is the final step. The water is allowed to
stand for about an half an hour and the water collected is
utilized for drinking.
DOMESTIC USE
In rural areas this method is advised for domestic use of
defluroidation of drinking water as required. This advise is given
to mix water,lime and alum in a close big vessel and leave it
overnight,so that next morning the clean supernatent is
decantedfor use and is safe for consumption
èDVèNTèGES OF NèLGONDè TECHNI UE
This method can be used both at domestic and community levels.
Operation are possible manually.
The chemical are same as those used in municipal urban water
supply.
It is cost effective.
Designs are flexible to use at different locations.
Defluoridation meets with standard laid down by the Bureau of
Indian Standard(fluoride content less than 1mg/l).
Other techniques used are
Combined Nalgonda and calcined Magnesite technique
Prasanti technology
Other materials tried in India
Fish bone charcoal
Drumstick plant
èskali-extract mycetial biomass
Clay minerals
Tricalcium phosphate
COMBINED NèLGONDè èND CèLCINED MèGNESITE
TECHNI E
In this plant the Nalgonda tech­nique was passed through a filter
bed of calcined magnesite granules. Fluoride was absorbed by
the calcined magnesite granules, there was a rise in pH over 10.0
method is found impractical for rural regions .

PèRèSèNTI TECHNOLOGY:
In Indian villages this method of utilizing èctivated èlumina is
found to be most popularand cost effec­tive material for
defluoridation.
    !)
Was also used as an alternative to defluoridate drinking water as it is easily
accessible and it has been widely used to reduce water turbiditY because
of its excellent coagulating and clarify­ing properties.

 " # $ %

ability of this material from èspergillus riger to bind fluoride from
fluoride containing water but the mechanism is still not clear.
There is general agreement that when applied with the correct
technique they affect an overall reduction in caries attack rate
approximately that of water fluoridation. More recently fluoride
tablets, mouth washes, and dentifrices have been reported to
limit dental caries.
r
&  À ' ()   À

1. Textbook of pedodontics Shobha 2nd edition

Tandon
r

2 Textbook of pediatric S.G.Damle 2nd edition
dentistry
3 Principles and practice of èrathi Rao 1st edition
 pedodontics

 4 Pediatric dentistry Jimmy

R.Pinkham
4th edition

 5 Clinical pedodontics Finn 4th edition

 6 Textbook on fluorides èmrit Tiwari -
 7 Comprehensive pediatric Nikhil Marwah 1st edition
 dentistry
8 Fluorides in caries J J Murray 3rd edition
 prevention
 9 Preventive and Soben Peter 3rd edition
community dentistry