Talk:Fluoride therapy/Archive 1

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Misleading Primary Claim Needs Rewriting
The primary sentence "Fluoride therapy has been proven to have a beneficial effect on the prevention of dental caries.[10]" needs to be rewritten as it is demonstrably false and does not reflect the article cited.

Reading the cited article, it does not say anything has been "proven" at all.

In fact it highlights how the current recommendations on Fluoride are problematic and should be reexamined - meaning reduced use of Fluoride.

It states "Clinical Implications. The current recommendations for use of fluoride supplements during the first six years of life should be re-examined."

Here's quote from the summary of the actual article cited:

"Conclusions. There is weak and inconsistent evidence that the use of fluoride supplements prevents dental caries in primary teeth."

Let me repeat - "weak and inconsistent evidence." After dozens of experiments, proof remains leagues away from the idea of "proven" as used in the Wiki article primary sentence. Proven in a scientific context means "with certainty" or "persuasive." Neither of those are even close to the actual science article's statement -- "weak and inconsistent evidence."

Perhaps Draicone could rewrite this statement? Thank you.

Missing or Misleading Side Effect Section
The cited article goes on to state:

"Mild-to-moderate dental fluorosis is a significant side effect."

"Significant side effect"

Nowhere does the Wiki article reflect that caution.

Perhaps Draicone could rewrite this section ? Thank you.

Wikify
not sure where to put it, the table Fluoride conversion chart could use an explanation.... — Preceding unsigned comment added by 186.77.145.193 (talk) 03:13, 21 May 2013 (UTC) Beginning to wikify. Have checked for copyright violations. --Draicone (talk)
 * Finished wikifying, but this article needs serious cleanup from someone with experience in the field. --Draicone (talk) 01:25, 10 July 2006 (UTC)

There are NO citations whatsoever. The neutrality of this section should be disputed.

Hypothyroidism
There needs to be a section dealing with thyroid issues, as fluoride in any amounts accumulates in the gland. Erstwhile, removing iodized bio-mechanical molecules. —Preceding unsigned comment added by 173.24.164.249 (talk) 00:14, 17 February 2010 (UTC)

Unsafe?
This page will confuse people because it deals mostly with topical fluoride but then throws in water fluoridation without justification. Could you please add the following sentence as the second sentence in the page:

Fluoride is often use as a topical dental treatment but fluoride is not safe to randomly consume.

Thanks LisaChris 00:34, 7 January 2006 (UTC)
 * Added with a minor rewording. --Draicone (talk) 01:11, 10 July 2006 (UTC)

I have removed the wikification template. --Draicone (talk) 08:50, 12 July 2006 (UTC)

There are those who believe that fluoride is detrimental to human health and should not be used at all. I am not an expert in this field, but I think that, although it is a "minority opinion," it should be adequately addressed in this article.--Dlgwiki 18:36, 13 July 2006 (UTC)


 * Since anti-fluoridation views are a minority opinion, it is better to address those particular points of view adequately in water fluoridation controversy, which is what that article accomplishes. Very frequently, these anti-fluoride arguments are made in the context of water fluoridation, and therefore those views fit nicely into that article. I do not see any reason to cover that opinion in this article, especially since it disagrees with the majority of health and research organizations. - Dozenist talk  22:28, 13 July 2006 (UTC)

It's not only water fluoridation that is controversial, also dental treatment and prevention with fluoride so why did you remove the part that adressed that? Are you benefiting whom doing this?

The words Joel Griffiths Flouride in a google search should provide the answer you seek, if you seek a negative and informative light on flouride. We are talking about money here, not science. —Preceding unsigned comment added by 174.47.116.249 (talk) 19:33, 6 April 2010 (UTC)

Dental treatment
The section on fluoride treatment at the dentist needs much more. Some dentists routinely treat all patients with high-concentration foam in trays. This can add $25 USD to each cleaning visit. What chemicals are used? What concentrations? What are major brands/products? What are pros/cons of such treatment? To what extent can same benefits/results be obtained at home? How much cheaper would that be? 69.87.200.131 15:42, 15 December 2006 (UTC)

This might be a good place to start as far as deriving citations, recognizing of course that it is biased against flouride: —Preceding unsigned comment added by BlauNacht (talk • contribs) 19:48, 26 May 2008 (UTC)

Micro Level
Can someone please add more things so as to explain more about what is happening at the micro level?

I want to know how flouride attracts calcium into the tooth specifically as is claimed in the article, and what levels cause hypothyroidism, and what occurs on the micro level if your 9 month old kid decides that your toothpaste tastes good and eats the whole tube's worth (assuming it's a new tube of a leading brand). —Preceding unsigned comment added by 174.47.116.249 (talk) 19:23, 6 April 2010 (UTC)

toothpaste details and data needed
The article currently reads like an ADA propaganda pamphlet (and disgustingly US-POV). And rather devoid of meaningful details.

What if a person wants to get the most benefit from a fluoride toothpaste? What would be the best way to use it? How many times a day? How long to leave it in, "soaking" the tooth surface? What sources provide what real data to support what treatment schedules?

What if a person was willing to use fluoride toothpaste, but wanted only "topical" treatment, and wanted to avoid "systemic"? Is it enough to just spit out the toothpaste, or should the mouth also be rinsed?

How many times would fluoride toothpaste have to be used, in what way, to be about equal to one expensive fluoride treatment at the dentist?

How many fluoride treatments at the dentist are optimally recommended per year, by who, for who; what are the data that support these recommendations? -69.87.204.120 14:14, 3 May 2007 (UTC)

"Most toothpaste today contains 0.1% (1000 ppm) fluoride, usually in the form of sodium monofluorophosphate (MFP);" I don't know about the US, but this is not true in Canada. Here, most toothpaste contains around 0.24% sodium fluoride. Some contains 0.76% sodium monofluorophosphate, and one brand has stannous fluoride. 70.24.141.109 (talk) 18:16, 30 April 2009 (UTC)

Varnish
Sources? Most brands of fluoride varnish are 5% NaF, so someone might want to add that.

I've had both varnish and gel, and I would say that the gel has a much more pleasant taste. The varnish has a very objectionable taste for about an hour after application.

Here's some more info if someone would like to add. http://health2k.state.nv.us/oral/FVManual.pdf http://www.ada.org/prof/resources/topics/science_fluoride_varnish.asp http://www.sciencedaily.com/releases/2000/04/000413145117.htm

Source with same wording
The "benefits of fluoride therapy" section is largely copy-paste from this website:

http://www.animated-teeth.com/tooth_decay/t4_tooth_decay_fluoride.htm

Just thought you might want to know.

--128.192.185.240 (talk) 15:16, 16 March 2008 (UTC)

Reliable sources
I reverted Petergkeyes edits because the sources do not adhere to WP:RS. The sources, fluoridation.com and fluoride alert, are groups that hold a minority view and are challenging the scientific establishment. In any case, WP:RS states, "Articles should rely on reliable, third-party published sources with a reputation for fact-checking and accuracy." Those sources clearly do not fit that description. - Dozenist talk  12:31, 18 May 2008 (UTC)

To site the above, the "scientific establishment" declared in 1933 that flouride is a great rat poison. It's old news. This was challenged in 1940 by ALCOA hired scientists. —Preceding unsigned comment added by 174.47.116.249 (talk) 19:27, 6 April 2010 (UTC)

Hi Dozenist. Twice now you have removed my citations of the New York Times and the Journal of the American Dental Association. Fluoride Action Network and nofluoride.com are merely the messengers for these sources. I am not sure what reference from fluoridation.com you refer to. Do you not believe that the New York Times published a story on William Kennerly's fatal fluoride overdose? If you are doubtful of that fact, what should be done to indicate to you that it is a real New York Times article?

Likewise with the JAMA article. It is a real article - I have seen a hard copy of that edition of the Journal. I intend to reverse your removal of my valid citations. Petergkeyes (talk) 02:05, 19 May 2008 (UTC)


 * If these articles exist, then quote them. Quoting from a advocacy website, is quoting that website, not the original article.  See WP:RS for more information.  Shot info (talk) 10:10, 23 May 2008 (UTC)

Health risks pov
I've pov-tagged the section given that the sources are cherry-picked by extremely biased sources and in most cases there has yet to be any effort to apply basic WP:NPOV guidelines to the presentation of the material. Overall, we're giving undue weight to fringe opinions. --Ronz (talk) 16:34, 20 May 2008 (UTC)
 * Um...biased sources? Have you not heard of the National Research Council previously? Anyway, I read the book and took its general findings. If you can find things that don't belong, that's fine. But there's no more credible source in the United States than the NRC. If you cannot point to particulars, I will take off that POV. If you object to that, then I will ask for a Request for Comment, because I know there are Wikipedians who have heard of the NRC. Impin | {talk - contribs} 17:57, 20 May 2008 (UTC)
 * The first paragraph of the section is unreferenced. The second by the source I'm concerned about.  The POV tag belongs for these alone.  --Ronz (talk) 03:42, 21 May 2008 (UTC)
 * I also believe the POV tag should remain for the reasons stated above. Additionally, the section would be improved if it have more published, reliable secondary sources as references. - Dozenist  talk  13:10, 21 May 2008 (UTC)

The intro to the health risks section has now been cited via the Mayo Clinic. I would advise removing the POV tag. I invite Dozenist, Ronz and anyone else to help improve this page by providing reliable information and citations for the health risks involved with fluoride therapy. Petergkeyes (talk) 00:06, 22 May 2008 (UTC)

Dozenist didn't like the Mayo citation for the particular statement. It was a rather weak way to start in on health risks. Stating what fluoride is not is rather different than outlining the health risks of fluoride therapy. So I deleted this sentence: "Fluoride is not a vitamin or a necessary mineral, and aside from making the teeth less susceptible to cavities at low levels, it has negative effects on the body when consumed." It is a hot button sentence bound to get everybody all upset, and I believe the section is much stronger without it.

The sentence on the overdose looks nice and concise. But I think it should state that it was fluoride therapy in the dentist's chair that killed the boy, rather than some other form of ingestion, such as eating rat poison or toothpaste. That might force it into two sentences. Petergkeyes (talk) 04:57, 22 May 2008 (UTC)
 * I want to point out as I stated in the edit history that the Mayo citation did not reflect the statement in the article. Since the statement has been removed from the article, this is no longer even a concern. Note that instead of solely deleting the citation, I added the information from the citation to a different location in the article. - Dozenist  talk  13:16, 22 May 2008 (UTC)

I’m thinking the Health risk section should be lower on the page with it clearly stated that all risk factor are from improper use. The health risks are at levels above the recommended rate. Yes someone can die if they take enough of it. Yes young kids can die if they take cold medicine, or any other medication. It is the improper use that in the concern. The recommended amount added to drinking water changes do to climate. Some areas need to actively reduce the naturally occurring fluoride levels in the drinking water. 98.198.24.78 (talk) 05:24, 10 October 2008 (UTC)

Raised the linking to full-text issue
Hi Shot info, I've raised your issue over at here at WT:CITE. ImpIn | {talk - contribs} 17:21, 23 May 2008 (UTC)
 * Easy, point to the source, not to the source "hosted" by a dubious source. It's all in WP:RS.  Shot info (talk) 00:51, 24 May 2008 (UTC)
 * Show me where it says that. ImpIn | {talk - contribs} 01:01, 24 May 2008 (UTC)
 * WP:RS Shot info (talk) 11:14, 25 May 2008 (UTC)
 * You already linked to that. I don't see the passage. ImpIn | {talk - contribs} 11:26, 25 May 2008 (UTC)

The full text version of the NYT article has been restored. It is good to see the official NYT truncated version, but the information provided in the complete text is crucial. Petergkeyes (talk) 05:06, 25 May 2008 (UTC)

Follow my link to WT:CITE. Boracay Bill raises the fair point that this work is likely copyrighted, and shouldn't be linked to. ImpIn | {talk - contribs} 11:26, 25 May 2008 (UTC)

How about this link:. --—— Gadget850 (Ed)  talk  -  15:39, 27 May 2008 (UTC)

Any logic behind order in 'Delivery' section?
Any logic behind the order the different methods are presented in Fluoride_therapy?

Also, is ' Indications for fluoride therapy' meant to be a subsection of 'Delivery'? Tremello22 (talk) 20:00, 4 June 2009 (UTC)
 * You might not be active anymore but it doesn't look like there is any order. There also doesn't have to be but some order could be applied.Hardkhora (talk) 15:23, 20 March 2014 (UTC)

Section 3.8: Indications for fluoride therapy
I thought I would provide the citation for the literature that directs evidence based planning & practice of fluoride therapy at the University of Alberta, Faculty of Dentistry. Hope this is helpful in the development of this article.
 * American Dental Association Council on Scientific Affairs: Professionally applied topical fluoride: Evidence-based clinical recommendations.  JADA 2006;137(8):1151-1159.--4tiggy (talk) 02:13, 7 August 2011 (UTC)

cavities again
We have two recent, excellent reviews. Here is what they say(emphasis added):


 * The ten Cate source says: "The fluoride levels in the oral cavity are generally relatively low as fluoride is cleared from the mouth due to salivary secretion and swallowing. Therefore the effect of fluoride after using oral care products on bacteria is limited. Bacterial growth and metabolism are affected by fluoride concentrations exceeding about 10 ppm. Such fluoride levels are limited to a very short period after using a fluoride product. Fluoride containing products may be effective as antimicrobials but in those cases this is generally attributable to other components, such as the fluoride counter ions (amine, stannous), preservatives, surfactants or antimicrobials added specifically for that purpose (zinc salts, Triclosan, essential oil extracts, etc.). Regarding its mode of action in caries prevention the consensus today is that fluoride is mainly effective by enhancing the remineralisation of initial caries defects and by inhibiting the demineralisation that would lead to caries initiation or progression. Fluoride thus shifts the 'demin-remin balance' from net demineralisation, in the case of caries active patients, towards net remineralisation."

The Rošin-Grget source says: "In spite of extensive literature on the antimicrobial effects of fluoride on oral microflora,today there is very little consensus that the anticaries effect of fluoride is related to inhibition of oral bacteria.."

I think hardkhora is misunderstanding the English here. What that means, is that very few people believe that the anticaries effect of fluoride is related to inhibition of oral bacteria.

There is a clear consensus on how Fl works. It is enhancing remineralization; any action on bacteria is not a big deal. The current text is NPOV and accurate. To write that "there exists no consensus on the effects of fluoride on oral bacteria." is simply not true. Jytdog (talk) 13:14, 3 April 2014 (UTC)
 * I'll have to read through more as this is a new article to me. I'll provide a full response later.Hardkhora (talk) 22:01, 4 April 2014 (UTC)
 * I didn't add any sources to the article in this edit... Jytdog (talk) 11:01, 5 April 2014 (UTC)
 * Ah, I just read the title and didn't recall it.


 * The whole quote is important : "In spite of extensive literature on the antimicrobial effects of fluoride on oral microflora, today there is very little consensus that the anticaries effect of fluoride is related to inhibition of oral bacteria. The current evidence indicates that fluoride has a multitude of direct and indirect effects on bacterial cells, some of which may have a significant influence on the acid –producing microorganisms in dental plaque (50)." The English in this leads me to believe that the door isn't so shut as you say it it. I bolded for emphasis.
 * : "The fluoride levels in the oral cavity are generally relatively low as fluoride is cleared from the mouth due to salivary secretion and swallowing. Therefore the effect of fluoride after using oral care products on bacteria is limited. Bacterial growth and metabolism are affected by fluoride concentrations exceeding about 10 ppm. Such fluoride levels are limited to a very short period after using a fluoride product. Fluoride containing products may be effective as antimicrobials but in those cases this is generally attributable to other components, such as the fluoride counter ions (amine, stannous), preservatives, surfactants or antimicrobials added specifically for that purpose (zinc salts, Triclosan, essential oil extracts, etc.).12 Regarding its mode of action in caries prevention the consensus today is that fluoride is mainly effective by enhancing the remineralisation of initial caries defects and by inhibiting the demineralisation that would lead to caries initiation or progression. Fluoride thus shifts the ‘demin-remin balance’ from net demineralisation, in the case of caries active patients, towards net remineralisation. 9 It should be emphasised that fluoride is effective when present in the oral cavity and not after it has been swallowed." Also from the same author a few years earlier 2011  he states something similar. I bolded for emphasis.
 * My point is that I made it very clear it is not the sole or consensus that it is the only affect, nor even a major one. I'll be willing to compromise if you can tell me a better location to reference this information? I think for now, it makes sense where I first put it. If the review articles feel it is important to talk about than I don't think it so unimporant that people can't find the information on Wikipedia.
 * Can you tell me why this bothers you so much? "There have been large amounts of investigation and papers written on the antimicrobial effects of fluoride on oral micro flora, but there exists no consensus on the effects of fluoride on oral bacteria.[3][4] It is believed that the in vivo capabilities require levels as high as 10 ppm F, which only last for brief periods with orally applied topical fluoride[6] Evidence does point to many direct and indirect effects on bacterial cells by fluoride[7][8]" I don't say there is no consensus on the method of action for cavity prevention. Rather I'm saying that the effects of fluoride on oral bacteria are not agreed on, because like in the second quote I use they aren't sure if there is a cause since it is seen in vitro but requires high levels in vivo as I pointed out as well.
 * You changed it to: "Fluoride's effect on oral microflora does not play an important role in fluoride's effectiveness against cavities." Removing all of the other context talking about why there is no imporant role. I think that other information is important.
 * What if we changed it to this: "The consensus for fluorides major method of action for its anti-cavity abilities are believed to by enhancing the remineralization. Fluoride's effect on oral microflora does not play an important role in fluoride's effectiveness against cavities. There have been large amounts of investigation and papers written on the antimicrobial effects of fluoride on oral micro flora, but there exists no consensus on the effects of fluoride on oral bacteria in vivo because the effects are usually believed to be caused by other components, including fluoride counter ions (amine, stannous), preservatives, surfactants, and/or antimicrobials specifically for their antimicrobial effect (zinc salts, Triclosan, essential oil extracts, etc.)..[3][4] It is believed that the in vivo capabilities require levels as high as 10 ppm F, which only last for brief periods with orally applied topical fluoride[6] Evidence in vitro does point to many direct and indirect effects on bacterial cells by fluoride[7][8]"?Hardkhora (talk) 18:44, 7 April 2014 (UTC)
 * can you please tell me, concisely, what you think the following means: "today there is very little consensus that the anticaries effect of fluoride is related to inhibition of oral bacteria". It is strangely worded, and this does seem to be near the core of our disagreement. 19:03, 7 April 2014 (UTC)
 * I would be happy to, I take, "today there is very little consensus that the anticaries effect of fluoride is related to inhibition of oral bacteria" as saying that sentence to mean that there is not a consensus that the effects of fluoride's anticarier affects are related to inhibiting oral bacteria...that because fluoride works to prevent cavities it doesn’t necessarily prevent oral flora. If you disagree, would you please let me know what you think it means. I’ll await further response.Hardkhora (talk) 19:24, 7 April 2014 (UTC)
 * that still unclear. What I wrote in our article (which you cite above) is what I think it means ("Fluoride's effect on oral microflora does not play an important role in fluoride's effectiveness against cavities.") Can you please say yours more clearly and concisely? If it is helpful, you can contrast with mine.  But please be concise. Thanks. Jytdog (talk) 19:35, 7 April 2014 (UTC)
 * I don't see the argument then. I don't think this is at the core of our disagreement. If you read my last suggestion for what we could change it to I include your sentence. As good faith I'll try to explain again in very simple terms, it is not believed that Fluoride is an effective anti-micro flora in the mouth for preventing cavities, but it isn't clear if it does play a role in being an antimicrobial element in the mouth. If still unclear, please provide an example with explanation for why you don't understand. It would help if you answered my previous points as well; I bulleted them so you can deal with each one at a time.Hardkhora (talk) 20:03, 7 April 2014 (UTC)
 * here is what I don't get - since fluoride's anti-caries effect is not due to anti-micro flora activites, why would we discuss it any length, beyond simply saying that it is not important? (real question) We give WEIGHT based on importance...Jytdog (talk) 21:20, 7 April 2014 (UTC)
 * OK, i added a bit in plain English. does that satisfy you? Jytdog (talk) 11:18, 8 April 2014 (UTC)
 * It isn't about satisfying me, but that is a lot better. I added a little of the detail you took out. It is as important in science why something doesn’t work as why it does. You need to know why things do or don’t work to be able to progress and make good choices.Hardkhora (talk) 17:26, 8 April 2014 (UTC)
 * About PPM, I suggest you look at other parts of wikipedia, such as https://en.wikipedia.org/wiki/Boron_nitride or a myride of other pages that use specific number when talking about chemicals or anything of the like. Please give me a good reason not to include simple information that relates to the topic.Hardkhora (talk) 18:33, 8 April 2014 (UTC)

Mechanism
User:Yobol(talk) you reverted my recent edit that was: A primary study looked at fluoride's effects on oral microflora and this study concluded that fluoride may not solely interact as an antimicrobial agent, rather additionally acting to reduce bacterial adhesion to teeth along with the action of decreasing of demineralization. Further investigation will need to be done to verify these claims.

I think this does follow MEDRS beause when I read: "The rare edits that rely on primary sources should have minimal WP:WEIGHT, should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In the rare cases when they are used, primary sources should not be cited in support of a conclusion that is not clearly made by the authors" and the section Respect secondary sources https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)#Respect_secondary_sources)

My edit follows those criteria. Please help me understand why you think it doesn't.Hardkhora (talk) 21:49, 28 April 2014 (UTC)
 * "Primary sources should generally not be used for medical content.". There is no reason to give WP:UNDUE weight to this speculative material here. If you can find similar material placed in context by high quality secondary sources, we can judge how much weight it deserves and if it can come in at that time. Yobol (talk) 20:55, 29 April 2014 (UTC)
 * I read the same thing as you did, which is why I cited WP:MEDRS as well. Why do you see this as WP:UNDUE weight? Reading the WP:MEDRS it seems inline which the rules/guidelines. There is no mention of such a MOA in secondary sources yet, which is why I mention the secondary/primary source contradiction policy. The source doesn't contradict secondary sources. The MOA mentioned is new and novel, and I tried my best to explain it in plain English as per the guideline, and I also tried my best to make sure the weight was clear also per the guideline. I have worked with you in the past and know I can be wrong, but this still seems like it all fits together per the WP:MEDRS. As with my conversation with Jytdog where he didn't understand what PPM was, please look at the information I want to add again, are you maybe not understanding it?Hardkhora (talk) 18:29, 2 May 2014 (UTC)

5000ppm fluoride vs 12500 ppm fluoride toothpaste? en.wikipedia.org/wiki/Fluoride_therapy#Toothpaste
5000ppm: For example 3M ClinPro has 5000ppm fluoride. Officially one can use it one time per day, but probably one can safely use it 3 times per day because a competing brand Colgate says their 5000ppm fluoride toothpaste can be used 3 times per day.

12500ppm: Does one get any additional benefit by brushing with 12,500 ppm fluoride toothpaste once per week or once per 2 weeks? I am mainly interested in Proximal Caries = InterDental Caries. https://www.gebro.com/en/produkte/elmex-dental-gel/ "Active substance: Amine fluoride, Sodium fluoride". Elmex says you should use it only once per week. Some dentists tell their patients that once per 2 weeks is enough.

ee1518 (talk) 12:52, 15 April 2016 (UTC)

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Dosage
While this article does a good job at discussing different fluoride delivery methods and concentrations, I think dosage related to age should be added. From 6 months-adult the dosage amounts should be included and the most effective way to receive fluoride. Also, what can happen systemically and tooth related if too much or too little fluoride is ingested. — Preceding unsigned comment added by Sarndt17 (talk • contribs) 01:04, 30 July 2018 (UTC)