Fluoridation and calcification of teeth. What is deep fluoridation of teeth and how is the procedure performed? Is it possible to carry out fluoridation at home?

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Deep fluoridation method.ProposedA. Knappvost ’om (University Professor, Doctor of Physical-Chemical and Medical Sciences. Institute of Physical Chemistry with the Department of Biophysical Chemistry and Research in Dentistry, Hamburg, Germany)

Introduction

Thanks to the so-called deep fluoridation, which initiates a strong and long-lasting remineralization process, including in problem areas, not only prevention, but also non-invasive or mildly invasive therapy has become possible. This therapy is based on the developed theory of caries remineralization, initially called the theory of the protective layer, which has now received such great development that it makes it possible to give clear characteristics of remineralization as a process opposite to demineralization.

Microstructure of the softening zone of tooth enamel

Let's imagine the structure of enamel in an area measuring 1000 angstroms - 1 angstrom is approximately equal to the diameter of 1 atom. The data was obtained using the X-ray method using a radioactive isotope (Ca 40). Let's imagine a tiny section of an "enamel prism". The enamel is permeated with keratin fibers, to which prismatic apatite crystals about 250 angstroms long and about 50 angstroms thick are attached chemically and epitactically on one side. There is reason to believe that all apatite crystals of enamel are thus fused with keratin fibers. This means that with an average apatite crystal thickness of about 50 angstroms, the distance between the fibers is 100 angstroms (2 apatite crystals). According to the results of our research, the acidic agents of dental plaque do not act on the enamel frontally, but diffuse into the fibers and laterally peel off the apatite from them. The result is a very narrow corrosion funnel with a maximum entrance diameter of about 100 angstroms. With prolonged exposure to acids, the sides of the funnels collapse. As measurements have shown, the depth of the funnels is 10 microns. The erosion funnels are extremely narrow and become even more tapered with distance. This surface zone, about 10 microns thick, is the softening zone. In it, the processes of dissolution and remineralization occur more or less periodically in such a way that in the remineralization phase, physiological restoration of the enamel occurs with the assistance of fibers as centers of crystallization.

Remineralization

According to the theory we developed, remineralization occurs if the saliva in dental plaque is oversaturated with ions that form apatite (calcium, phosphate, hydroxide or fluorine). As observations show, the concentrations of Ca and PO 4 ions in saliva remain fairly constant at a sufficient level, while the concentration of OH - ions can decrease 1000 times, for example, at pH 4 in the interdental region. The processes of remineralization - demineralization are regulated by OH - ions. Fortunately, they can be replaced by structurally similar fluorine ions. As measurements show, at the usual concentration of fluoride in saliva, therefore, at a fluoride content in drinking water of about 0.2 to 0.3 mg per liter, the limiting pH value in saliva in dental plaque is 5.5 (critical pH of remineralization). Above this boundary, the process of remineralization occurs, below - demineralization. When the pH of saliva in dental plaque is below this value, it is possible to direct the process towards remineralization by compensating for the lack of OH ions with fluoride ions. The resulting apatite has a significantly higher fluorine content. Using radioactive phosphate, it was proven that the anti-caries preventive effect of fluorine is carried out only according to this scheme, and is not the result of replacing OH-ions with fluorine ions in solid apatite.

Evaluation of different fluoridation methods

Fluoridation of drinking water, often considered as an effective measure worthy of widespread dissemination, can, together with food fluoride, increase the concentration of fluoride ions in saliva to a maximum of 10 to the minus fifth power of mol/l, which is equivalent to OH ions pH 9. This concentration of fluoride can In the best case, compensate for the deficiency of OH ions in a very thin layer of dental plaque on the smooth surface of the tooth. To compensate for the deficiency of OH-ions in thicker plaque layers in problem areas, for example, in the interdental space with pH4, oral fluoride intake is insufficient and the intake of iodized table salt is absolutely insufficient. At first glance, the so-called local fluoridation with simple fluorides, such as sodium fluoride or amine fluoride, seems much more attractive. (This does not, however, apply to slightly soluble calcium fluoride). Treatment of enamel with these salts, which are part of varnishes or gels, leads to a chemical reaction with the enamel and the formation of relatively coarse-crystalline calcium fluoride, which lies freely on the surface of the enamel. Due to its very low solubility, the saturation concentration of ions on the enamel surface is 10 to the minus third power of mol/l. It is sufficient to compensate for the deficiency of OH ions at pH4. However, since these crystals are loosely located on the surface of the enamel, they are quickly removed by abrasion or rinsing of the mouth. The crystals do not penetrate inside the funnels of the softening zone, since they are much larger than the diameter of the funnel entrance. The effect of these fluorides is therefore too weak and short-lived to effectively stimulate the remineralization process.

Deep fluoridation

Deep fluoridation is understood as the chemical formation of highly dispersed calcium fluoride with an average particle diameter of 50 angstroms and having a significantly higher solubility in the pores of the softening zone. When treating enamel with sodium fluoride, no deep fluoridation occurs. Deep fluoridation is observed only as a result of sequential wetting of the enamel with a weakly acidic solution of magnesium fluoride silicate and subsequent quenching with an alkaline suspension of copper-calcium hydroxide. Subsequently, the fluorosilicate complex spontaneously decomposes to form crystals of fluorosilicate and polymerized silicic acid. Crystals of calcium fluoride lie deep in the pores in the silicic acid gel, protected from washing out. They release fluoride in high concentrations for a long time (more than 1 year), which promotes reliable remineralization, including in problem areas. In this case, apatite is formed, clearly enriched with fluorine, which, in the case of intact keratative fibers, leads to complete restoration of the carious area. If demineralization has gone so far that the edges of the corroded funnel are erased, the resulting defect reaches medium wavelengths of visible light (about 5000 angstroms). This is how the famous chalk spots arise. With keratin fibers still existing, even in these cases, remineralization apatite may grow on them. After deep fluoridation, the disappearance of chalk spots is often observed. As a result of the studies, a significant difference was noted in the effect of deep fluoridation with an enamel-sealing preparation with copper-calcium hydroxide from local fluoridation with a fluoridating preparation based on sodium or calcium fluoride.

The role of copper ions

Inorganic copper compounds play a very important, but unfortunately very little known role in dentistry, for example as an additive to phosphate cements. Among other aspects, its use in endodontics during depophoresis with copper-calcium hydroxide is relevant. According to Effinger research, copper ions exhibit strong bactericidal properties, especially against anaerobes. In addition, they extremely powerfully suppress the proteolytic activity of microorganisms. Particularly important is the longevity of their action, due to the catalytic oxidation of the resulting copper sulfide. How great the activity of copper ions is against microorganisms that cause caries of enamel and dentin is evident from the vast experience gained in the use of copper amalgam (Rebel), which was especially widely used in pediatric dentistry. Currently, amalgam is not used due to the release of metallic mercury. In these amalgams, metallic copper in solution was a base component in relation to mercury and formed with saliva a sparingly soluble alkaline salt of copper, which protected not only the tooth with a copper amalgam filling, but also adjacent teeth from caries. Copper ions also protected dentin from caries. Today, due to the negative attitude of people towards metals, it is necessary to draw the attention of patients that copper, like iron, although it is a heavy metal, is at the same time an essential trace element that plays an important role in metabolism. The concentration of copper in serum is approximately the same as iron, and it is an equally weak allergen. The liquid used for deep fluoridation of enamel contains copper fluoride silicate. The liquid for deep fluoridation of dentin contains copper in a significantly higher concentration. The combination of the effects of deep fluoridation, namely strong long-term remineralization and protection of keratin fibers from proteolysis, represents a non-invasive or, in case of advanced caries, mildly invasive caries therapy. This is especially important for baby teeth - gentle treatment of the dental substance and effective protection of the pulp.

Deep fluoridation of teeth is most often performed on children, but this procedure can also be extremely beneficial for adults. In just one visit to the dentist Using this technique, you can solve a lot of problems with tooth enamel.

What is fluoridation of tooth enamel?

Fluoridation is the saturation of the upper layers of the tooth with active components. There are different types of techniques, but the principle of their action is always the same: a special preparation with a high content of active substance is applied to the patient’s teeth, fluoride ions in contact with the enamel form calcium fluoride, the process helps strengthen hard tissue and prevent the development of a number of diseases.

The procedure is safe, requires minimal time and is painless, which is why it is actively used in pediatric dentistry.

Indications for dental fluoridation

The main task of fluoridation is to strengthen the enamel. This effect is necessary in the treatment of a huge number of diseases, for their prevention and even for improving the appearance of a smile.

Dentists prescribe the procedure in the following cases:

Increased sensitivity, strong reaction to hot or cold.
Presence of external enamel defects: scratches, chips.
Prevention of caries development in children and adults.
Treatment of the initial stage of caries on children's teeth.
Strengthening enamel after wearing braces.
Prevention of hypersensitivity after professional cleaning or bleaching.
Increasing the strength of a composite restoration or filling.

Most often, fluoridation is used to prevent problems with enamel, less often - to strengthen it. Fluoridation itself will not be able to restore the protective enamel layer, but in combination with other measures it gives good results.

When treating baby teeth, the procedure is also not a panacea. If a child’s enamel is actively deteriorating, then first of all you need to reconsider his diet and oral care. Fluoridation is only an additional measure.

Contraindications to dental fluoridation

Fluoride is a beneficial component for dental tissue, but if used incorrectly, it can be very dangerous. Excess fluoride in the body leads to fluorosis, With this disease, teeth are especially affected: stains appear on the enamel, and its sensitivity increases.

It turns out that fluoridation of enamel can lead to the opposite of the expected effect. Therefore, the procedure is prohibited if:

The patient has already been diagnosed with fluorosis.
A person consumes water with a high fluoride content.
The patient uses oral care products containing this component.

Another contraindication to the procedure is diabetes. This is explained by the fact that fluoride can negatively affect the absorption of sugar, and in diabetes this is already a problem. However, people with this disease still undergo enamel strengthening with fluoride. An element can harm her only if there is too much of it in the body.

Types of fluoridation

Relatively recently, fluoridation meant coating the enamel with a special varnish, but today there are several options for carrying out the procedure:

rapid fluoridation;
use of fluoride varnish;
deep fluoridation;
electrophoresis.

The effectiveness and indications for different procedures differ, and you will also have to pay differently for each service.

Rapid fluoridation

If you calculate all the time spent, it turns out that the name of this technique does not suit it at all. One procedure takes 5–10 minutes. Compared to other methods, it really doesn't last long. But to achieve the same result as after the same deep fluoridation, you need to undergo a course of 10 procedures - one every week.

Quick or simple fluoridation is more gentle than other methods. Therefore, it can be carried out even at home without the supervision of a specialist.

This treatment is usually done after wearing braces or recent whitening. Some experts recommend the procedure after professional plaque cleaning if it was unsuccessful and damaged the surface of the tooth.

To carry out rapid fluoridation, mouthguards and a special gel with an average content of fluoride and other useful components are needed. After gentle brushing of the teeth, a tray with gel is placed in the oral cavity. After 5–10 minutes, it is removed, and the remaining product is removed with water.

Express fluoridation of tooth enamelcan be performed in the dental office or at home. In the second case, a drug with a lower content of active substances is used so that the patient cannot harm himself.

Application of fluoride varnish

The simplest and fastest method of restoring enamel is to apply a fluoridating varnish. , with its help you can treat all teeth in just 2-3 minutes. The varnish not only strengthens the enamel, but also creates a protective layer on its surface that lasts on the teeth from several days to several weeks. All this time, the product protects the teeth from irritants and dyes, and in the same way it acts on filling compounds.

Most often, dental coating with fluoride varnish is carried out as an addition to other procedures:

If there are no contraindications, the dentist always uses fluoride varnish after in-office cleaning. This has become so commonplace that the procedure is not even paid for separately.

Deep fluoridation of tooth enamel

The greatest effect in strengthening and restoring enamel is provided by deep fluoridation of teeth. Electrophoresis also bears fruit, but it has many contraindications, and the procedure itself causes discomfort to the patient. Therefore, deep saturation of enamel with fluoride firmly holds first place among all similar techniques.

During this procedure, beneficial substances remain not only on the surface, but also penetrate far into the enamel. If the patient has hypersensitivity, such fluoridation can be performed once every 6 months - discomfort from cold or hot will not be felt until the next procedure.

Deep saturation with fluoride takes the most time, as it is carried out in several stages:

Professional cleaning is required. The choice between available techniques depends on the individual characteristics of the patient. Most often, specialists resort to ultrasonic cleaning.
The teeth are well dried with a stream of warm air.
The enamel is coated with a preparation containing a high content of calcium and magnesium fluoride, then dried again. This time they use special lamps.
Finally, a varnish with calcium hydroxide is applied to the enamel. It seals the first compound inside and allows it to restore the structure of the protective layer of the tooth even after the procedure is completed.

Deep fluoridation of tooth enamel takes 30–40 minutes; teeth cleaning is usually paid for separately.

Electrophoresis

This procedure is also carried out in two stages, in each of which different active substances are used. It is aimed not only at saturating the enamel with fluoride, but also at deep penetration of this substance. For this purpose, minimal electrical discharges are used. An electrode with a pad soaked in a calcium solution is placed on the patient’s teeth. The device delivers weak current discharges, which may be unpleasant for the patient, but it would be difficult to call the resulting sensations pain.

The duration of the current is selected individually and depends on the health of the enamel and the number of fluoridation procedures performed previously. The first time the effect lasts only a few minutes, then the time is gradually increased.

When the first stage is completed, the electrode pads are changed. This time a 2-4% sodium fluoride solution is used. After exposure to this substance, active chemical processes begin in the enamel, helping to strengthen it, and a protective layer is formed on the surface.

Fluoridation of teeth at home

After pastes with a high fluoride content became available in regular stores, dentists sounded the alarm. The number of people suffering from fluorosis has increased significantly. However, even today such products are still the only way to fluoride teeth at home. Only when using them you will have to follow some rules:

You need to choose toothpastes that contain sodium monofluorophosphate, tin fluoride or aluminum fluoride. These active ingredients are the most effective and safe.
The amount of active substance should not exceed 0.15%.
Fluoride-containing paste alternates with conventional products at least every other day.
A course of home fluoridation lasts no more than one month.
Between courses there is a break of 1.5–2 months.

In addition to pastes, special medications in the form of a gel, which contain a fairly large amount of active fluoride, are suitable for fluoridating enamel at home. These gels should be applied to all teeth immediately after cleansing.

Prices for fluoridation of teeth

Fluoridation of teeth is usually carried out comprehensively for the entire row. In Moscow, a quick procedure with mouth guards will cost 2.3–3 thousand rubles. for the entire course, deep fluoridation - from 2.7 to 4 thousand rubles. depending on the clinic. Electrophoresis usually costs 2–2.5 thousand rubles.

Coating enamel with fluoride varnish is the cheapest procedure. Usually it costs from 1 to 2 thousand rubles. for all the teeth. Treatment of one tooth costs from 100 to 400 rubles.

The cost of the procedure is very affordable, and the benefits from it can be enormous, so it doesn’t hurt to carry out fluoridation at least once a year.

There is debate about the benefits and harms of fluoridation. Some dentists present this procedure almost as a panacea for caries, while others claim that it further harms weakened enamel.

It is officially believed that fluoridation helps prevent caries and keep teeth healthy. This service is offered in every clinic to adults and children, sometimes even forced. Let's figure it out together: how the preventive effect is achieved, how the manipulation is carried out and whether it can be done at home yourself. We will also find out whether it makes sense to perform the procedure or is it just another way of pumping out money.

What is dental fluoridation?

Fluoride is one of the most important elements for teeth. It strengthens the enamel, making it resistant to acids and bacteria. Patients with its deficiency more often develop caries and pulpitis.

Normally, fluoride enters the body naturally - along with water (about 80% of total consumption) and food. But it is not always enough. In addition, certain pathological factors (systemic diseases, poor digestibility, pregnancy, etc.) contribute to its rapid consumption.

In such cases, fluoridation is recommended. This procedure involves saturating the teeth with fluoride-containing preparations. They are applied (impregnated) to the enamel using brushes or special trays, after which the compositions harden and form a protective film.

Fluoride strengthens enamel, making it resistant to bacteria and acids

Mechanism of action

Enamel fluoridation products contain various fluoride compounds in high concentrations. This is usually one of three elements:

sodium fluoride – NaF;
amino fluoride – AmF;
phosphate fluoride – APF.

When exposed to moisture and heat, fluoride compounds release fluoride ions, which bind to the main building element of the dental shell - hydroxyapatite. This is a calcium compound that makes up 75% of enamel.

As a result, a new element is formed - hydroxyfluorapatite or fluorohydroxyapatite. It is many times stronger and more resistant to acids than hydroxyapatite. Consequently, the enamel also becomes stronger. This mechanism of action is the preventive effect of fluoridation.

The procedure has another useful property. After applying fluorine-containing compounds, they form a layer of calcium fluoride on the surface of the crowns. It protects the enamel from the action of acids, and when the pH drops below 5.5, it decomposes, releasing calcium and fluoride ions, and saturates the dental tissues with them.

Thus, fluoride impregnation not only strengthens teeth, but also minimizes the harmful effects of lactic acid produced by cariogenic bacteria.

Enamel fluoridation products contain various fluoride compounds in high concentrations

When should fluoridation be done, indications?

But the manipulation will be especially useful:

with dental hyperesthesia - increased sensitivity to cold, hot, sour, sweet;
the presence of caries at the chalky heel stage;
before or after installing braces - to prevent demineralization of the enamel;
if the patient is predisposed to caries;
after whitening and professional teeth cleaning;
in the presence of non-carious pathologies: microcracks, wedge-shaped defects, thinning of enamel;
when the patient is diagnosed with acute fluoride deficiency;
during the period of change of milk teeth to molars;
with increased viscosity of saliva or insufficient secretion - in this case, the protective properties of the secretion are reduced.

Only treated teeth can be coated with fluoride.

Contraindications to the procedure

Despite its benefits, fluoridation can be harmful if not done correctly. The procedure is not performed if the patient:

allergy to the components of the fluoridating composition;
fluorosis – an excess of fluoride in the body;
diabetes mellitus - fluoride compounds interfere with the process of sugar absorption, which is already impaired in diabetics.

Also, fluoride impregnation is useless if caries has moved from the chalk spot stage to another phase: a dark spot, affecting enamel or dentin. In this case, full treatment is carried out.

Other factors are also taken into account. Thus, children do not always allow the manipulation to be performed: some are so afraid of doctors that it is impossible to persuade them to sit quietly in a chair for even 10 minutes. Therefore, special quick-drying solutions are used for children. But it’s not always possible to apply them either.

Place of residence is also important. In some regions, the soil is excessively saturated with fluoride; it already enters the body in excess along with water and food. The procedure is prohibited for residents of such areas.

Fluorosis is one of the contraindications to fluoridation

What are the advantages and disadvantages?

Fluoridation is a controversial procedure. It has both positive and negative sides.

Among the advantages are:

reduction in the development of caries with regular treatment every 3-6 months: by 30% when using preparations with 1% sodium fluoride and by 63% when using 5% solutions (according to the medical information portal 24stoma - https://24stoma.ru/fluorirovanie- zubov.html);
strengthening enamel;
minimizing the manifestations of hyperesthesia;
preventing the leaching of calcium from dental tissues;
protection against staining with pigments;
cure caries at the chalk spot stage;
duration of effect: complete leaching of elements with simple fluoridation occurs after 6 months, with deep fluoridation - after 2 years;
prevention of secondary caries after;
slight whitening effect - impregnation with fluoride-containing preparations somewhat lightens the enamel, which makes the smile more attractive.

But there are also significant disadvantages that must be taken into account before agreeing to fluoridation. These are 2 main nuances:

Risk of developing fluorosis. This disease is characterized by excessive accumulation of fluoride in the body, which leads to fragility of hard tissues. Moreover, not only teeth suffer, but all structures: bones also become more brittle, and fractures often occur.
Fluoride toxicity. When there is an excess of these substances, they disrupt the functioning of the body, aggravate endocrine diseases (including diabetes), lead to anemia and diseases of the nervous system.

Fluoridation reduces the risk of tooth decay with regular treatment every 3-6 months

Harm from the procedure

You may come across the opinion that fluoridation is harmful and even dangerous. Proponents of this theory point to 2 negative points:

In order for fluorohydroxyapatite to be produced, fluoride must bind to the main building element of teeth - calcium. As a result, the compositions “pull out” the element from the enamel and dentin, and do not strengthen, but, on the contrary, make the crowns more fragile.
Chance of fluorosis, which causes brittle bones. When using drugs, patients partially swallow them, which leads to an overdose of the element.

These statements are true, but with reservations. For normal teeth, the formation of hydroxyfluorapatite is not dangerous. But if they are significantly lacking in calcium, then the procedure will cause even more harm.

The picture is approximately the same with fluorosis. If you live in a region with normal or insufficient levels of fluoride in soil and water, manipulation is harmless and even beneficial. But with its excess, the risk of pathology is high.

Therefore, ideally, impregnation is carried out after testing and determining the level of fluoride in the blood. However, in practice, dentists recommend the service left and right, and even insist on it. Don't give in to their persuasion. It is precisely this kind of thoughtless imposition that is dangerous. There are certain indications for the procedure, and it is at best impractical to carry out it without clinical results.

As for the supposed spike in fluoride levels after the drugs are applied, these statements are false. According to studies published in the International Journal of Pediatric Dentistry and the Official Journal of the American Academy of Pediatrics, after the use of fluoride gels in children, the level of the element in the urine remained within normal limits. You can view the relevant publications using the following links: https://www.ncbi.nlm.nih.gov/pubmed/28105705, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143996/.

For several months after the procedure, buy fluoride-free toothpastes to avoid overdose

However, keep in mind that in most cases the natural intake of fluoride through water and food is sufficient. And as a preventive measure, fluoride-containing toothpastes will suffice. For children under 12 years of age, the level of fluoride compounds should be in the range of 500-1,000 ppm, for adolescents and adults - from 1,500 ppm (for daily products) to 2,500-5,000 ppm (for preventive and therapeutic gels).

If you do decide to undergo fluoridation, it is advisable to buy toothpastes without fluoride for a couple of months after the procedure to prevent an overdose.

Methods of carrying out

Fluoridation of teeth can be done at home or at the dentist. The first option is to independently use pastes, gels and varnishes with a safe fluoride content: it is higher than in daily hygiene products, but cannot cause harm.

But impregnation with fluoride preparations in the clinic is a professional procedure that is performed only by a specialist. It comes in 3 main types:

simple;
deep;
using electrophoresis.

Simple fluoridation

Simple impregnation is the cheapest. But with it, the element does not penetrate deep into the enamel. Therefore, fluoride is washed out faster, and repeated manipulation has to be repeated after 3-6 months.

A simple type of procedure is carried out in two versions:

Using varnish. They cover the enamel with a brush. In total you will need 3-4 sessions of 2-5 minutes each. There are different types of varnishes. When treating a child’s teeth, they prefer to use quick-drying compounds that harden immediately after application.
With the use of mouth guards. This method is called fast or express fluoridation, although it is more labor-intensive. First, impressions of the jaws are taken, then individual mouthguards are made from them. The products are filled with fluorine-containing compounds and placed on the jaws for 5-15 minutes, after which the remaining solution is rinsed with water. The full course includes 10-15 sessions, the frequency is once a week. The advantage of the fast method: after making the impression trays, you can do it yourself at home.

Mouth guards are filled with fluoride-containing compounds and placed on the jaws for 5-15 minutes

Simple types of procedures are common and familiar. They are often used in combination after professional cleaning, whitening, removal of braces, composite restoration, etc. Moreover, the manipulations are not always differentiated, but are indicated in the price list under a general name: so the patient may not know that he has had fluoridation.

What is deep fluoridation?

Deep fluoridation is a more labor-intensive, time-consuming and expensive procedure than simple fluoridation. However, it gives better results: fluorides penetrate deep into the enamel and are washed out for a long time. So you need to repeat the manipulation less often: at least once every 1.5-2 years, maximum once every 6 months.

The procedure is carried out in several stages:

Get professional cleaning done. This is mandatory, because Plaque and tartar prevent the penetration of beneficial substances.
Dry the surface of the crowns with a stream of warm air.
First, the enamel is coated with compounds containing fluorine, copper and magnesium. They form a protective film around the teeth. The units are dried using polymerization lamps.
Then apply a second layer - varnish with calcium hydroxide. It reacts with previous compounds, which promotes the production of fluoride ions. It also seals the resulting protective film and prevents it from being washed off.
Finally, the patient is asked to rinse his mouth with clean water to wash away excess drugs.

It takes 30-40 minutes to perform deep fluoridation. If the patient has a lot of tartar and pigmented deposits, it will take more time and the procedure may have to be performed in 2 visits.

In the deep type of procedure, compositions are used in which the concentration of fluorides is 5 times higher than in means for simple impregnation. Therefore, it helps to slow down and even completely stop the development of caries not only at the demineralization stage, but also when the disease has entered the dark spot phase within the enamel layer.

Deep fluoridation takes 30-40 minutes

Using electrophoresis

Fluoridation by electrophoresis is not very common. Although the procedure promotes the penetration of beneficial substances not only deep into the enamel, but also partially into the dentin, it is difficult to perform. In addition, it has a number of contraindications and side effects.

For the procedure, a low power current is used: its strength and duration of exposure are selected individually for each patient, depending on the condition of the enamel. First, electrodes with pads soaked in calcium hydroxide are placed on the teeth. A few minutes later, new gaskets are placed, this time with a 2-4% sodium fluoride solution.

The interaction of calcium and sodium strengthens the enamel and promotes the formation of a protective layer on the surface of the crowns.

An electrophoresis session lasts several minutes, with each visit the procedure time is extended. A total of 10 visits will be required.

With the permission of your dentist, you can use a paste containing fluoride at home.

Fluoridation of teeth at home

To save money, you can fluoride your teeth at home. Although a one-time use is inferior in effectiveness to professional procedures, the result with repeated use will be better. In addition, you won’t have to waste time going to the dentist.

Advice: before home procedures, have your teeth cleaned with ultrasound in the clinic. There is no point in applying fluoride-containing compounds to teeth with tartar and plaque.

The following products are used at home:

fluoride varnishes;
toothpastes with a high fluoride content (from 2,500 ppm and above);
special gels that are applied to crowns manually or using aligners.

When carrying out, adhere to the following rules:

varnishes and gels are applied only after brushing your teeth;
pastes with a high fluoride content are not used constantly: they are used for a maximum of 4 weeks, and take a break for 1.5-2 months;
Fluoride varnishes are also used in courses: no more than 3-4 coatings are carried out in a row;
the best pastes are those containing aluminum fluoride, tin or sodium monofluorophosphate;
During fluoridation, do not use other preparations containing fluoride, as well as drops, chewing gum, water and salt.

Fluocal contains sodium fluoride, which strengthens enamel and prevents the growth of bacteria

Drugs

Many fluoride-containing products are sold in pharmacies and online stores for self-use. When choosing, pay attention to the fluoride concentration: there is an interesting nuance here.

The fact is that the content of fluorides and active fluorine ions are different things. So, if the value on the package is indicated as a percentage, then we are talking about the concentration of a fluorine compound. But the designation ppm indicates precisely the concentration of fluoride ions.

Moreover, when the concentration of fluoride ions is calculated from the percentage of fluorine compounds, it will be more than 2 times lower. So, if a 5% sodium fluoride content is specified, the active fluorine content will be 2.26% (or 22,600 ppm).

The best products for use at home and in the clinic:

Colgate Duraphat. Available in 2 varieties: with a fluoride ion concentration of 2800 ppm and 5000 ppm. The first paste is suitable for children and adolescents from 10 to 15 years old, the second - for patients from 16 years old. Average price 430 rub.
Fluocal. Available in liquid and gel form. Contains sodium fluoride, which strengthens enamel and prevents bacterial growth. The downside is that it is difficult to apply: swabs are moistened with the solution and placed on the teeth for 3 minutes, after which you still need to treat the interdental spaces. Bottle cost: RUR 1,420. (liquid) and 2,150 rub. (gel).
Belak F. Used by dentists to strengthen children's teeth, prevent caries and treat it at the chalk spot stage. Contains potassium fluoride, which strengthens the enamel and forms a protective layer on crowns. They sell for an average of 120 rubles.
Belagel F. Fluoridating and remineralizing gel with a rich composition: fluorine, phosphorus, calcium, potassium, sodium, magnesium, chlorine. You can apply it with a brush, but it is better to use mouth guards. You can buy it for 120 rubles.
Nanofluor. The drug is in the form of a varnish with double action: intended for deep fluoridation and accelerated remineralization of crowns. Contains amino fluoride, sodium fluoride, natural resin, nanodispersed colloidal hydroxyapatite. Cost – 1,050 rub.
Fluoride varnish. The most popular product for home and professional use. Contains a new generation aminofluid: it forms a film around the units that protects teeth for a long time from destruction and cariogenic bacteria, reduces sensitivity, and prevents the proliferation of microbes. Sold for RUR 335.
MI Paste Plus. Paste-cream, whose main active ingredient is the Recaldent CPP-ACP complex. This is a patented substance from the manufacturer GC Corporation, made from milk casein and fluoride (content 900 ppm). The manufacturer claims that Recaldent CPP-ACP penetrates deeper into enamel and dentin than other fluoride compounds. The product is suitable for pregnant women, children over 6 years of age and those suffering from diabetes; it is contraindicated for patients with allergies to milk proteins. Available in fruit, mint and vanilla flavours. Costs on average 1,450 rubles.

The main active ingredient is the Recaldent CPP-ACP complex

Fluoridation and remineralization, are there any differences?

Fluoridation is often confused with remineralization. They are prescribed for the same purpose: strengthening enamel and preventing caries. However, the operating principle of the procedures is different.

During fluoridation, first of all, the enamel is strengthened and covered with a protective film, which prevents destruction and the influence of negative factors. And with remineralization, the teeth are simply saturated with useful elements.

Remineralizing preparations necessarily contain calcium. Also, their composition can be supplemented with phosphorus, fluorine (not always), magnesium, potassium, etc. If the product does not contain fluoride ions, then it is necessary to use fluoride-containing pastes for everyday cleaning: this will help calcium “fix” in the enamel.

Another difference between remineralization: a smaller range of indications. Manipulation is prescribed mainly for the treatment of foci of demineralization and the prevention of caries. In other cases, fluoridation is indicated.

Fluoridation and silver plating

Another procedure similar to fluoridation is silver plating. It also helps in the initial stages of caries development, but its mechanism of action is different.

Silvering is justified only in children 2-3 years old

When silvering, crowns are coated with a solution of silver nitrate. Such manipulation, unlike fluoridation and remineralization, does not strengthen teeth and does not help get rid of lesions, but only stops the development of caries.

Silvering is justified only in children 2-3 years old, who do not allow their teeth to be fully treated. And even then with reservations. Impregnation of silver nitrates leads to darkening of crowns. In addition, the drugs used are aggressive and can burn the pulp - the neurovascular bundle that supplies the unit. As a result, pulpitis will develop, whose treatment is several times more expensive and more difficult than caries.

The only advantage of silver plating is that it “slows down” caries in the dark spot stage and in the middle phase of development (with damage to the upper layers of dentin). Thus, the intervention makes it possible to delay treatment until the child allows the tooth to be fully treated, or until the physiological change of the “milk jug” to the root unit.

The cost of fluoridation, review of Moscow clinics

The price of the service varies depending on its type - simple or deep. Also keep in mind that some clinics indicate the cost for treating one tooth, others for one row of teeth, and others for both jaws.

The average price in Moscow for fluoridation of one tooth is 200-250 rubles, for treatment of one jaw 1,500-1,700 rubles, for the entire oral cavity – 3,000-3,500 rubles.

Do not forget that prices are usually quoted only for fluoridation. But professional cleaning, which necessarily precedes manipulation, is paid separately in most clinics. This increases the cost by 1,500-3,000 rubles.

Fluoride impregnation can be carried out in the following dental clinics in Moscow:

Dentistry	Price in rubles
All Yours!	200-460 rub. per tooth depending on the type of fluoridation and the availability of discounts
Vanstom	70 rub. application for one unit, 1,500 rub. for both jaws
Aesculapius	150 rub. per tooth, 1,500 rub. for one jaw, 4,000 rub. for a comprehensive procedure including hygienic cleaning
Crystal	1,000 rub. by the jaw
Dent-IST	RUB 2,500 for applications on all teeth, 6,000 rub. for the production of a mouthguard for impregnation on one jaw
Darmed Dental	1,000 rub.
Denta-Practician	200 rub. for deep fluoridation of one crown
Dentistry Avantis Professor Ryakhovsky A.N.	440 rub. for one tooth in children, 2,450 rubles. for the entire dentition
KDS Clinic	50 rub. for one tooth
LPS Denta	250 rub. for one crown

Fluoridation of teeth: before and after photos

The procedure slightly lightens the enamel. Therefore, in the photo, teeth look whiter after using fluoride-containing compounds.

White strong teeth - this is self-confidence, the dream of many Moscow residents! To have a beautiful and radiant smile, you need to take proper care of your oral cavity and regularly visit the dentist’s office. Improper brushing of teeth leads to the appearance of defects in the enamel. Is it possible to get rid of existing problems? Of course, dentistry keeps up with the times. To restore the integrity and beauty of the enamel, our dentists perform fluoridation of teeth; the price of the service starts from 150 rubles per tooth. The procedure is painless and suitable for adults and small patients. We invite you to your first consultation, it is free!

The essence of the procedure

Today, it is very important to coat teeth with fluoride varnish, the price of which is announced by specialists at the Aesculapius dental center after assessing the feasibility of carrying out restoration measures. What is the reason for the demand for the service? Fluoridation effectively eliminates the consequences of poor nutrition, bad habits, and improper brushing of teeth. The procedure blocks further destructive processes that are accompanied by pain, psychological discomfort, and bad breath. How does it happen? Our preventive dentistry specialists saturate the hard tissues of the oral cavity with active fluoride compounds. The main component is fluoride varnish. The substance has a viscous consistency and high penetrating properties. It can be applied to baby and molar teeth.

Restoration of enamel occurs due to the active influence of released ions. When particles come into contact with hard tooth tissues, calcium fluorides are formed. The result of the actions of specialists is restoration, stopping the destruction of enamel under the influence of carious plaques.

Why do Aesculapius dentists use substances that release fluoride ions? The trace element plays a key role in processes such as:

bone metabolism;
restoration of enamel;
formation of developing hard tissues.

If there is a lack of fluoride, the enamel turns yellow and becomes thinner. The consequence is also caries and other dental diseases. And fluoridation is advisable, since this microelement enters the body in insufficient quantities, except in cases where a person:

Leads a healthy lifestyle.
Sticks to proper nutrition.
Takes proper care of your oral cavity.
Visits the dentist regularly.

To avoid regressive processes, our dentists recommend fluoridation once a year/year and a half. The frequency is determined by the doctor individually after examining the oral cavity, after which he announces the final cost.
Analysis of advantages and disadvantages

Fluoridation of hard dental tissues is becoming the choice of many of our patients for the following reasons:

no need for pain relief and other preparatory measures;
efficiency of the procedure (about 90 minutes);
accessibility at any age;
no feeling of discomfort;
durability of the effect (from 1 year);
reliable enamel protection for 1.5 years;
high recovery efficiency.

Does fluoridation have any disadvantages? Some people do not consider this dental service to be perfect. The need for periodic repetition is the explanation. Aesculapius specialists also list the disadvantages as low effectiveness for large-scale carious lesions, as well as inappropriateness when there is an excess of fluoride in the body.

Indications and contraindications

Are you planning to visit our dental center to have specialists professionally perform deep fluoridation of tooth enamel? Doctors will begin the restorative procedure only after an examination. Fluoridation is indicated for:

the presence of yellow plaque on the teeth near the gums;
increased sensitivity of enamel;
initial stages of crown caries;
painful sensations during hygienic cleaning.

Dentists recommend using this service for patients after wearing braces and other dental corrective structures. Seriously ill patients with diabetes should refrain from regularly performing the technique of restoring the protective function of enamel. Fluoride reduces the body's absorption of sugar, thereby overloading the pancreas. The second contraindication is an excess of the above-mentioned microelement. In this case, fluoridation will result in a state of general poisoning. In case of individual intolerance to the components of the drug, the procedure is not carried out, so our specialists carefully compare all the pros and cons.

Fluoridation: types of techniques

How much does a safe enamel restoration service cost? The price of fluoridation becomes known after diagnosis. The cost depends on the technique of carrying out restoration measures. The doctor determines the most effective of them. Among them:

Simple. Measures to restore enamel are simple. To solve dental problems, special compounds are used. The procedure can be done at home. However, our experts do not recommend applying fluoride-containing products on your own without first having your teeth professionally cleaned. Simple fluoridation takes no more than 20 minutes.
Glubokoe. A multi-stage dental procedure, the features of which are described below. Our specialists have been successfully providing the service for more than 2 years and only if there is a positive prognosis.

We also carry out fluoridation using electrophoresis using calcium gluconate and specialized equipment.

Stages of saturation of teeth with fluoride compounds

After examining the oral cavity, specialists at the Esculapius dental center assess the relevance of fluoridation. In the absence of contraindications, the doctor carries out the following measures:

Professional cleaning of teeth from plaque and hard deposits.
Drying enamel using equipment.
Isolation of teeth from saliva.
Application of fluoride varnish.
Lightly rubbing the active substance into hard tissues with further short-term exposure.
Re-drying.
Treatment of enamel with calcium copper hydroxide.
Removal of active substance residues.

At the end of the procedure, the teeth look healthy and white. Mineralization is characterized by a long-lasting effect.

Benefits of deep fluoridation

According to the professional technique for restoring tooth enamel, Aesculapius dentists use an active substance based on magnesium fluoride silicate. Immediately after the procedure, increased sensitivity caused by thinning of the enamel disappears. Specialists apply the active viscous substance exclusively with a swab or brush. Deep fluoridation is also carried out on crowns. The calcium level remains the same. Deep fluoridation is good because it eliminates early stage caries. At home it is impossible to achieve such a magnificent effect as in the clinic.

The feasibility of fluoridation on children's teeth

Aesculapius dentists offer parents of young patients to use this service if necessary. Baby teeth especially need protection. Deep fluoridation of teeth does not cause tears in children. For young patients, the procedure does not pose any danger; as a result of the restoration measures, an extremely positive effect is observed. Fluoridation on children's teeth is no different in technology from the method according to which the enamel of adults is strengthened.

Doctors suggest young and adult patients use the service, as mentioned earlier, every 1-1.5 years. If treatment is necessary before fluoridation, it is wise not to ignore your dentist's recommendations. After the procedure, the doctor must tell the child and parents about the rules of oral care. Following the “instructions” is extremely important! It is necessary not only to regularly brush your teeth with high-quality toothpastes, but also to eat properly to avoid fluoride deficiency. The body will benefit from taking multivitamin complexes. Deep fluoridation of baby teeth with caries is the most correct professional way to protect the enamel from further destruction.

Cost of services and promotions "Aesculapius"

The price of fluoridation of teeth varies within 1500 rubles. For the jaw. Our doctors will announce the final cost after completing a free consultation. Upon examination, the feasibility of fluoridation becomes clear. The doctor needs to be told about chronic diseases; for example, fluoridation is contraindicated for some patients with diabetes. Sign up for a consultation now on the website.

“Aesculapius” has permanent promotions:

Crowns made of zirconium dioxide at a price of 9990 rubles.
Discount on surgical and therapeutic treatment on weekdays from 12 to 16.
Favorable implantation “day to day” (-10% of the price in the price list).
Aligners for correcting bites - from 30 thousand rubles.

Frequently Asked Questions

- What is dental fluoridation?

Fluoridation is the saturation of hard tooth tissues with fluoride compounds by applying various liquids to the enamel. The procedure has proven its effectiveness both when performed on baby teeth and in permanent dentition.

- Is there any harm from the procedures?

Fluoridation is completely harmless if the doctor follows all the manufacturer's instructions. Using a saliva ejector removes excess saliva and prevents the solution from being swallowed. At home, you should not use preparations for professional use, because it is impossible to ensure high-quality isolation of the mucous membranes from fluoride varnish or fluoride-containing gel.

- How often should it be done?

Deep fluoridation is done once every 1-2 years, and fluoride varnish application courses are recommended to be repeated every six months.

Take care of the protection and health of your teeth, come for a consultation!

The development of bacteria and the release of acids during their vital activity is the cause. If tooth enamel is predisposed to destruction, it is necessary to further strengthen it.

Fluoridation of teeth is a modern painless technique that is prescribed to both children and adults. Special solutions are applied and microglobules of calcium fluoride are formed on the surface of the tooth, which replenish fluoride reserves.

The main function of this type of fluoride prophylaxis is daily protection against the acidic environment produced by bacteria.

Indications for the procedure:

refinement of enamel;
prevention during development at the white spot stage;
hypersthesia();
harmful effects of chemical bleaching;
treatment of marginal periodontitis.

Contraindications to the procedure:

individual intolerance or allergy to the components of fluoride varnish;
epidemic, caused by prolonged consumption of water or food with a high fluoride content.

Mechanism of local fluoride prophylaxis

The teeth of all living creatures contain three types of apatites:

carboxyapatites - easily ground off and erased (in rodents);
hydroxyapatites – medium permeability (in humans);
fluorapatites are the strongest (in sharks).

The procedure ensures the interaction of fluorides with hydroxyapatite and the formation of fluorapatites. A stable connection reduces the permeability of the enamel and increases its resistance.

To increase acid resistance, partial conversion of hydroxyapatite to hydroxyfluorapatite is sufficient.

Fluoride inhibits enzymes that break down carbohydrates and inhibits the growth of microflora in the mouth. In addition, during the formation of teeth in childhood, fluorides are involved in the metabolism of enamel protein. At the same time, resistance to caries increases.

Conditions for successful fluoridation

The following rules must be followed:

exogenous (external) contact of the drug with the surface of the teeth;
holding for a certain time;
avoiding ingestion or penetration of the drug into the body through the mucous membrane;
increasing the intensity of diffusion of medicinal components into the tooth structure.

Features of the procedure in childhood

Children's rooms are often destroyed due to a passion for sweets. Maintaining oral hygiene and a proper diet is not always enough.

When fluoridating baby teeth, children aged 1–3 years apply the gel separately to each tooth. Seniors undergo the procedure in the same way as adults throughout the mouth; it is completely harmless to the body.

Since children do not like frequent visits to the dentist, it is easier to do deep fluoridation. This method will allow you to remineralize tissue in one go. The frequency of fluoride prophylaxis for adults and children is once every six months.

Depth matters

Deep and regular fluoridation of teeth is used. When examining the patient, the doctor assesses the complexity of the enamel condition and determines the necessary technique.

Application of conventional technique

Simple fluoridation involves regular administration of fluoride and replenishment of its reserves in the form of microcrystals. An impression-spoon is individually prepared and filled with a material with a high fluoride content.

A tray with gel is applied to the teeth and left for 10–20 minutes. The preventive course lasts 10–15 procedures. The first procedures are carried out by a dentist; later manipulations can be performed independently at home.

With this method, it is possible to use the same impression to repeat the express method after a break.

There is another option for conventional fluoridation - coating the surface with fluorine varnish. The drug contains a composition of resins, cedar balsam, and sodium fluoride. Apply the varnish with a brush to all teeth, and then dry it with a stream of air. The course lasts 4 times a month.

A thin film that does not refract light forms on the teeth, which is invisible to others.

Everything at once

Deep fluoridation was invented by the German professor Knappvost. The option is more reliable and effective than simple fluoridation.

The method allows for deep migration of fluoride ions into the crystal lattice of the tooth. There they are converted into a molecular state and deposited as complex conglomerates.

Experts say that calcium fluoride incorporated into hard tissues is a potential protective barrier against caries.

This impregnation increases the strength of teeth by 10 times, due to a higher concentration of ions. Unlike the usual one, this method is quick and one-time use. Dentists recommend repeating the procedure once a year.

How is deep fluoridation carried out?

Before the process of deep fluoride prophylaxis, there is a need to clean teeth from and, which can delay the penetration of fluoride. The interdental spaces are also thoroughly cleaned.

The procedure includes several stages:

drying teeth;
application of enamel sealing agent (hold for 2 minutes);
air drying;
quenching with a solution of copper and calcium hydroxide;
mouth rinse.

A chemical reaction occurs and a high concentration of ions in the solution provokes the precipitation of hydroxyapatite. The growth of fluoride microcrystals begins, which fill microcracks in the enamel. In the depths of the pores, crystals are retained for 6 months. up to 2 years and continue to release fluoride ions.

Fluorapatite is formed, providing optimal restoration of the enamel structure. At the same time, copper has a permanent bactericidal effect, which increases anti-caries protection.

There are many advantages, minus one - the price

Successful fluoridation gives a person the following bonuses:

foci of initial caries are completely remineralized;
not only enamel is protected, but also dentin;
clinical effectiveness provides prolonged action;
Fluoridation of a carious cavity before filling reduces the incidence of secondary caries.

The only disadvantage of fluoridation is the cost of the procedure. But the cost of fluoride prophylaxis is much lower than the cost of dental treatment.

Teeth before and after fluoridation - not so noticeable from the outside, but the result is there

A few words about harmfulness

Fluoride ions are found in the earth's crust and can enter groundwater. Depending on the region of residence, a person receives fluoride mainly from drinking water.

Excess fluoride causes intoxication of the body. can cause serious problems for teeth. But the fluoridation procedure itself is absolutely harmless and cannot cause fluorosis.

The chemicals in fluoride-containing material only bring benefits, restoring the hardness of the enamel. Doctors advise fluoridation from childhood, and then problems with caries can be avoided. Dental tissue strengthening can also be done during pregnancy.

Saturate your teeth with fluoride at home

Toothpastes with fluoride are also capable of locally saturating the enamel with fluoride ions, but to a much lesser extent.

The use of such pastes has the ability to combat stone and plaque deposits.

The optimal amount of fluoride in a daily used toothpaste should be 1300–1500 ppm. This means that the concentration of active ions is 0.13–0.15%. The fluoride content is indicated in the composition on the packaging.

After applying and spreading the paste, you need to hold it in your mouth for 1 minute, then spit it out and rinse your mouth a little. Then fluoride is concentrated in saliva and the oral cavity, and salivary enzymes release fluoride within another hour.

After using fluoride-containing toothpastes, it is advisable not to eat for an hour.

Another method that can be used at home is to use a fluoride gel mouthguard. A ten-time daily procedure takes only 15 minutes, and the effect helps eliminate the possibility of developing caries for at least a year.

Authentication of teeth at home using fluoride varnish:

What people say

Fluoridation of teeth is gaining popularity, as confirmed by numerous reviews.

After fluoridation, tooth sensitivity has decreased significantly. The reaction to the winter cold has completely passed, and I don’t even have a sore taste for apples.

Alina, 33

The remineralization procedure performed by fluoridation really gives positive results. Previously, my child developed caries in the interdental space, but now we have not thought about filling for several years.

Karina, 24

How much will it cost?

The cost depends on the technology used and the desired effect:

For application of fluoride varnish in different clinics you will have to spend from 50 to 400 rubles per tooth.
Deep fluoridation the most expensive, but a single procedure gives a long-lasting effect. The price of the technology ranges from 120 to 600 rubles. But do not forget that disease prevention costs much less than treatment.

Efficacy varies depending on the technique, the fluoride carrier, its clearance, the concentration of active ions, duration and frequency of application. Dental care and preventive measures to prevent caries are an integral part of the life of a successful person.