Friday, March 30, 2012

No Advantages for Low-Fluoride Toothpaste in Preventing Tooth Decay or Fluorosis

A low fluoride toothpaste from Australia

According to a new presentation at the AADR.

Low-fluoride toothpastes do not reduce the risk for fluorosis but increase the risk for caries in very young children, according to a meta-analysis presented here at the American Association for Dental Research (AADR) 2012 Annual Meeting.

"There is no evidence to support the use of low-fluoride toothpaste in preschoolers," said principal investigator Ana Santos, DDS, MS, PhD, a professor of dentistry at the University of the State of Rio de Janeiro, Brazil.

Recommendations from professional organizations around the world vary widely in the concentration of fluoride recommended for preschool children's toothpastes, with some recommending "low" concentrations — below 600 ppm — and others recommending "standard" concentrations of 1000 to 1500 ppm, Dr. Santos said.

Toothpastes with less than 600 ppm of fluoride are available in many countries, including Europe, Australia, and Brazil, whereas in others, including the United States, fluoride toothpastes must contain a higher concentration.

The debate about fluoride concentrations in toothpaste is intensifying as more fluoride has been introduced in community water supplies and mild fluorosis is diagnosed in more children.

"In Brazil, we are in the middle of a discussion because it's very difficult to convince people that all children should use standard toothpaste," said Dr. Santos.

Toothpaste is a major source of fluoride in young children. "As we know, children tend to swallow a substantial amount of toothpaste when brushing," said Dr. Santos.

Although low-fluoride toothpaste is not available in the United States, some standards-setting groups in the United States are debating whether to allow it, session moderator Clifton Carey, PhD, professor of cariology at the University of Colorado, Denver, who is involved in the discussions, told Medscape Medical News. "The FDA [US Food and Drug Administration] is awaiting clinical data," he said.

Dental caries are bad enough, but if parents fear fluorosis more than tooth decay, then there will be a market for this toothpaste in the United states. But....if it is ineffective against preventing fluorosis, then....

But, I doubt the major toothpaste manufacturers like Proctor and Gamble for Crest and Colgate will want to cannibalize their own market of regular fluoridated toothpastes for such a limited and likely ineffective to prevent tooth decay market.

A niche company or imported toothpaste might be able to gather a foothold.

But, why pay more for fluoride at all, if the amount is ineffective in preventing tooth decay or fluorosis?

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