Sodium Fluoride
From Pharmacopedia
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Sodium fluoride
Many; topical professional/OTC and Rx oral
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Summary
Classes
Common uses
Dental caries prevention0, Dentin hypersensitivity (high-concentration topical)0
Pharmacy
Starting dose
OTC dentifrice/rinse 0.05-0.5% fluoride daily; Rx 1.1% sodium fluoride toothpaste/gel daily; supplements (where local water non-fluoridated) age-titrated 0.25-1 mg/d
Preparations
Toothpaste, rinse, gel, varnish (topical); 0.25, 0.5, 1 mg tablets and drops (Rx supplements where appropriate)
US FDA Max
Topical: per formulation; oral supplement age-dependent
Pharmacology
Routes
Topical, oral
Onset
Caries reduction over months to years of consistent use
Duration
Hours per topical application
Half-life
~6 hours plasma; long bone retention
Bioavailability
Topical: local effect on enamel; systemic supplementation has high oral bioavailability with skeletal accumulation
Pregnancy
Safe at routine fluoride levels.[citation needed]
Legal status
OTC (most dentifrice and rinse) and Rx-only (high-concentration paste/gel, supplements) in US
Purported mechanism
Topical fluoride is incorporated into enamel hydroxyapatite to form fluorapatite, which is more resistant to acid demineralization; it also inhibits cariogenic bacterial enolase and glycolysis, reducing acid production.0 Systemic fluoride (water fluoridation, supplements during tooth development) is incorporated into developing enamel, providing pre-eruptive caries protection. Dental fluorosis (mottling) is the chief sign of excess during tooth development; skeletal fluorosis is the chronic systemic toxicity at very high cumulative doses.