Fluoride (DentaGel) is used to prevent dental carries and make teeth stronger by increasing mineralization and preventing them from lysis by acid.

Fluoride Uses:

• It is used to prevent dental caries

Fluoride Dose in Adults

Fluoride Cream or paste:

• Clinpro 5000 paste, Control Rx 1.1%, Denta 5000 Plus:
  • Once a day, It is used to brush teeth with paste with help of a thin ribbon for at least 2 minutes.
  • Brush teeth once a day regardless of the fluoride content of drinking water
• Prevident 5000 Sensitive:
  • Twice a day, brush with a strip of 1 inch of toothpaste for at least 1 minute.
  •  Rinse mouth thoroughly, after brushing teeth.

Fluoride Dental rinse or gel:

• ACT Restoring 0.02% rinse, ACT Total Care 0.02% rinse:
  • Use it twice a day after brushing, rinse 10 ml for 1 minute, then spit out.
  • Dont's
    • Do not eat or drink for 30 minutes after treatment
    • Do not rinse the mouth for 30 minutes after treatment
    • Do not swallow
• ACT 0.05% rinse, Phos-Flur Rinse:
  • Use it once a day, after brushing, rinse 10 mL around and between teeth for 1 minute, then spit out.
  • Dont's
    • Do not eat or drink for 30 minutes after treatment
    • Do not rinse the mouth for 30 minutes after treatment
    • Do not swallow
• Cavirinse, PreviDent rinse:
  • Once a week, rinse for the duration of at least 1 minute with 10 mL vigorously around and between teeth, then spit out. Preferably it should be used at bedtime, after brushing of teeth. Do not eat, drink, swallow or rinse after at least 130minute
• Gel-Kam rinse:
  • Use after diluting the solution, rinse with 15 mL for 1 minute on daily basis, then spit out.

Fluoride Lozenges:

• Lozi-FlurOne lozenge:
  • It can be used daily

Fluoride Dose in Childrens

Adequate Intake (AI):

• Infants, Children, and Adolescents: Oral:

  • 1 - 6 months: 0.01 mg/day; if <6 months of age: no additional supplementation recommended
  • 7 - 12 months: 0.05 mg/day
  • 1 - 3 years: 0.07 mg/day
  • 4 - 8 years: 0.1 mg/day
  • 9 - 13 years: 0.2 mg/day
  • 14 - 18 years: 0.3 mg/day

Fluoride for the prevention of dental caries:

• Systemic therapy:

  • Drops/tablets (Fluorabon, Fluor-A-Day, Fluoritab, Flura-drops):
    • Oral: Content of fluoride in drinking water should be known and the oral daily dose adjusted accordingly:
    • Birth - 6 months: Not required regardless of the fluoride content of drinking water
    • 6 months - 3 years:
      • <0.3 ppm: 0.25 mg once a day
      • ≥0.3 ppm: Not required
    • 3 to 6 years:
      • <0.3 ppm: 0.5 mg once a day
      • 0.3 to 0.6 ppm: 0.25 mg once a day
      • >0.6 ppm: Not required
    • 6 to 16 years:
      • <0.3 ppm: 1 mg once a day
      • 0.3 to 0.6 ppm: 0.5 mg once a day
      • >0.6 ppm: Not required

  • Lozenges (Lozi-Flur):

    • Children ≥6 years and Adolescents:
      • Oral: 1 lozenge daily; Dissolve slowly in the mouth and swallow with saliva.

Note: Should not be used where the content of fluoride in drinking water is <0.3 ppm.

• Topical therapy:Dental rinse:

Note: Do not eat, drink, or rinse mouth for 30 minutes after treatment; do not swallow.

• Acidulated phosphate fluoride rinse (Phos-Flur):

  • Children ≥6 years and Adolescents: Topical: 10 mL once a day after brushing; swish between teeth for 1 minute, then spit out.

• Sodium fluoride: Topical:

  • 02% Sodium fluoride (ACT Restoring, ACT Total Care):
    • Children ≥6 years and Adolescents: 10 ml swish and spit twice a day after brushing
  • 05% Sodium fluoride (ACT Anticavity Rinse, ACT Kids):
    • Children ≥6 years and Adolescents: 10 ml swish and spit once a day after brushing
  • 2% Neutral sodium fluoride (CaviRinse, PreviDent Rinse):
    • Children ≥6 years and Adolescents: 10 ml swish and spit once a week, preferably at bedtime after brushing.
  • Note: CaviRinse labeling recommends children and adolescents 6 - 16 years rinse with water immediately following treatment.

• Stannous fluoride 0.63% (Gel-Kam):

  • Children ≥12 years and Adolescents: Topical: After diluting solution as directed, rinse with 15 mL for 1 minute, then spit out; repeat with the remaining solution. Use at least once a  day.
  • Gel:

    • Stannous fluoride 0.4% (Just for Kids):

      • Children ≥6 years and Adolescents:
        • Topical: Once a day after brushing, apply a pea-sized amount of gel to teeth and brush thoroughly.
        • Allow the gel to remain on teeth for a minimum duration of 1 minute before spitting out. Do not eat or drink for 30 minutes after use.
  • Paste:

    • Sodium fluoride 1.1%: Topical:

      • Clinpro 5000, Control Rx, Denta 5000 Plus:
        • Children ≥6 years and Adolescents: Once a day, preferably at bedtime brush teeth with a small amount (pea-sized) toothpaste for a minimum duration of 2 minutes; after brushing rinse mouth thoroughly with water.
      • PreviDent 5000 Sensitive:
        • Children ≥12 years and Adolescents: Twice a day, brush teeth with a 1-inch strip of toothpaste for a minimum duration of 1 minute. After brushing, rinse the mouth thoroughly.

  • Dental varnish:

    • 5% Sodium Fluoride (2.26% Fluoride ion): Infants (after primary tooth eruption), Children and Adolescents
    • Topical: Apply a thin layer to the surfaces of teeth at least every 3 - 6 months
  • Note: It must be professionally applied; According to USPSTF recommendations It can be applied by primary care practitioners to the primary teeth of all infants and children starting at the age of primary tooth eruption through 5 years of age

Pregnancy Risk Factor B

• Fluoride can cross the placenta, and is found in the fetal circulation
• Studies on animal reproduction have not shown any adverse effects.
• Studies have shown that areas with higher fluoride levels are less likely to experience side effects than those with lower fluoride.
• Later in life, skeletal fluorosis can be caused by prolonged exposure.

Fluoride use during breastfeeding:

• Breast milk may contain a lower level of fluoride than breast milk, but the fluoride content in drinking water doesn't significantly impact its presence in breastmilk.
• For nursing mothers, the manufacturer recommends caution.

Use in Renal disease:

No dosage adjustment has been recommended.

Use in Liver disease:

No dosage adjustment has been recommended.

Side effects of Fluodride (DentaGel)

• Dermatologic:

  • Skin rash

• Gastrointestinal:

  • Dental discoloration (with products containing stannous fluoride; temporary),
  • Nausea

• Hypersensitivity:

  • Hypersensitivity reaction

Contraindications to Fluoride (DentaGel):

Fluor-A Day:

• Fluoride levels in water that exceed 0.6 ppm are considered contraindicated for patients suffering from arthralgia or GI ulceration, chronic renal failure, severe osteomalacia, and chronic renal insufficiency.

Fluorabon

• Fluoride levels in drinking water that exceed 0.6ppm

Fluoritab

• If the patient has fluorosis of the teeth.

Flura-Drops, Loziflur:

• Fluoride levels in drinking water that exceed 0.3ppm

Warnings and precautions

• Dental fluorosis, osseous and dental fluorosis:

  • Fluoridation levels above 0.6ppm are more likely to cause dental fluorosis.
  • Do not take more than the recommended dose.

Monitoring Parameters:

None Mentioned.

How to administer Fluoride (DentaGel)?

• Once a day products are usually used at bedtime.
• Do not swallow and rinse after toothbrush. Specific product labeling should be consulted in detail.

Clinpro 5000 paste, Control Rx 1.1%, Denta 5000 Plus:

• After brushing expectorate.

Fluor-A-Day:

• Tablets: Dissolve in mouth or chew before swallowing
• Drops: Can be given mixed with juice or water. Avoid dairy products within 1 hour of use.

Fluorabon:

• Drops can be used by mixing with non-dairy food, or can be used undiluted

Flura-Drops:

• Drops can be used by mixing with non-dairy food, or can be used undiluted. Dairy products should be avoided dairy products after 1 hour of use.

Lozi-Flur:

• Dissolve in mouth and swallow with saliva

Prevident 5000 Sensitive:

• Brush teeth for a minimum duration of 1 minute and rinse mouth thoroughly with water.

Mechanism of action of Fluoride (DentaGel):

• Its mechanism of action is
  • Encourages the re-mineralization decalcified enamel
  • Inhibits cariogenic microbial processes in dental plaque
  • Acid dissolution increases tooth resistance

Absorption:

• • Oral: 50% absorption from the GI tract. Dairy products may delay absorption

Distribution:

• 99% in calcified tissue

Excretion:

• Through Urine

International Brands of Fluoride:

• Act Kids
• Act Restoring
• Act Total Care Dry Mouth
• Act Total Care Sensitive
• Act Total Care
• Act
• CaviRinse
• Clinpro 5000
• ControlRx
• Denta 5000 Plus
• DentaGel
• Fluor-A-Day
• Fluorabon
• Fluoridex
• Fluoridex Daily Renewal
• Fluoridex Enhanced Whitening
• Fluorinse
• Fluoritab
• Flura-Drops
• Gel-Kam Rinse
• Gel-Kam
• Just For Kids
• Lozi-Flur
• NeutraCare
• NeutraGard Advanced
• Omni Gel
• OrthoWash
• parodontax
• PerioMed
• Phos-Flur
• Phos-Flur Rinse
• PreviDent
• PreviDent 5000 Booster
• PreviDent 5000 Booster Plus
• PreviDent 5000 Dry Mouth
• PreviDent 5000 Plus
• Sensodyne Repair & Protect
• StanGard Perio
• Fluor-A-Day
• AFI-Fluor
• Arthrofluor
• Biogam F
• Bobrusie
• Carident
• Dentalfluoro
• Dentan
• Dentocar
• Duraphat
• Floam
• Floran
• Fludent
• Fluodel
• Fluodont
• Fluodontyl
• Fluoen
• Fluogum
• Fluonatril
• Fluoplexe
• Fluor
• Fluor Crinex
• Fluor Kin
• Fluor Lacer
• Fluor Microsol
• Fluor Oligosol
• Fluor Unicophar
• Fluor-A-Day
• FluorRetard
• Fluor-S.M.B.
• Fluoretas
• Fluorette
• Fluoretten
• Fluorex
• Fluorid Gel DENTSPLY DeTrey
• Fluorilette
• Fluoros
• Fluortabletjes
• Fluorvitin
• Fluossen
• Fluotrat
• Flura
• Flux
• Gammadyn F
• Koreberon
• Medusit
• NAF
• Nafluor
• NaFril
• Natrium Fluoratum
• Natriumfluorid Baer
• Odontocromil
• Oligogranul Fluor
• Oligosol F
• Oligostim Fluor
• Oratol F
• Ospur F
• Ossin
• Osteofluor
• Otofluor
• Pharma-Fluor
• Procal
• Prodent Fluor
• Protectfluor
• Rumafluor
• Sanogyl
• Sensifluor
• Sodio Fluoruro
• Solfluor
• Teeth Tough
• Vinafluor
• Vitamon Fluor
• Zymafluor

Fluoride Brand Names in Pakistan:

It is available in toothpastes as one of the main ingredients.