Projects

Fluorides and oral health

Fluorides and oral health is a designated research area in HSCI. We collaborate with national and international centres to support the World Health Organisation’s international mandate and programme priorities. The following four examples give some insight into HSCI’s work, which has involved collaborations with other leaders in the field.

Fluorides and oral health

We developed a gold standard for measuring fluoride in biological and non-biological samples (1). This led us to develop a Standard Operating Procedure which has been used by many national dairies, and a database that lists the fluoride content of foods and drinks commonly used in the UK by infants and children.

Mouthwashes are increasingly used alongside toothpastes in oral hygiene regimes. We tested the potential benefit of using fluoridated toothpaste and mouthwash in combination. Our study (2) contributed to a position paper in the British Dental Journal (3), since cited by the British Dental Association (4).

From a public health perspective, it is very important to observe if a population receives optimal exposure to fluoride. WHO recommends monitoring of fluoride supplementation programmes to ensure that total fluoride ingestion from all sources is appropriate. We developed experimentally based models to allow estimation of total daily fluoride intake and retention by analysing urine (5). This was taken up by WHO, whose document (Monitoring of Renal Fluoride Excretion in Community Preventive Programmes on Oral Health, 1999) has been a valuable source to the WHO Global Oral Health Programme.

In the light of this work, WHO recommended a formal review of their guidelines on monitoring of renal fluoride excretion in 2011; and HSCI member Dr Vida Zohoori, a Reader in Oral Public Health and Nutrition, is on their expert revision panel.

In a project commissioned by the UK National Fluoridated Milk Group (NFMG), we investigated the urinary excretion of fluoride associated with milk fluoridation. We designed a study to provide a robust evidence base for consultants in dental public health and other health professionals to determine whether the amount of fluoride added to school milk should be changed. As a result of our study (6-8), the NFMG suggested that the amount should be increased from 0.5 mg F to 0.8 mg F.

These examples go some way towards illustrating the impact of our work.

References

  1. Martinez-Mier et al, 2011
  2. Duckworth et al, 2009
  3. Pitts et al, 2012
  4. "The value of mouthwash to orthodontic patients" (April 2013).
  5. Villa et al, 2010
  6. Maguire et al, 2013;
  7. Zohoori et al, 2012;
  8. Walls et al, 2012

Database of the fluoride content of selected drinks and foods in the UK