SOD FLUORIDE
Fluoride; Polyvitamin
Indications: Caries, dental, prevention; Nutrition, supplement
DESCRIPTION:
CLINICAL PHARMACOLOGY:
It is well established that fluoridation of the water supply (1 ppm fluoride) during the period of tooth development leads to a significant decrease in the incidence of dental caries.
Fluoride; polyvitamin 0.5 mg tablets provide sodium fluoride (0.5 mg fluoride) and ten essential vitamins in a chewable tablet. Because the tablets are chewable, they provide a topical as well as systemic source of fluoride.1,2
Hydroxyapatite is the principal crystal for all calcified tissue in the human body. The fluoride ion reacts with the hydroxyapatite in the tooth as it is formed to produce the more caries-resistant crystal, fluorapatite. The reaction may be expressed by the equation:3
Ca10(PO4)6(OH)2 + 2F- Ca10(PO4)6F2 + 2 OH-
(Hydroxyapatite) (Fluorapatite)
Three Stages of Fluoride Deposition in Tooth Enamel Can Be Distinguished:3
1. Small amounts (reflecting the low levels of fluoride in tissue fluids) are incorporated into the enamel crystals while they are being formed.
2. After enamel has been laid down, fluoride deposition continues in the surface enamel. Diffusion of fluoride from the surface inward is apparently restricted.
3. After eruption, the surface enamel acquires fluoride from water, food, supplementary fluoride, and smaller amounts from saliva.
INDICATIONS AND USAGE:
Chewable Tablets and Drops
Supplementation of the diet with ten essential vitamins for the chewable tablets, nine for the drops.
Supplementation of the diet with fluoride for caries prophylaxis, and with the 0.25 mg chewable tablets only: for children 4 to 6 years of age where the drinking water contains 0.3 through 0.6 ppm of fluoride.4
Fluoride; polyvitamin supplies significant amounts of vitamins A, C, D, E, thiamin, riboflavin, niacin, vitamin B6, vitamin B12, and folate to supplement the diet, and to help assure that nutritional deficiencies of these vitamins will not develop. Thus, in a single easy-to-use preparation, children (and infants for the drops) obtain 10 essential vitamins (for the chewable tablets, 9 for the drops) and the important mineral, fluoride.
The American Academy of Pediatrics recommends that children up to age 16, in areas where drinking water contains less than optimal levels of fluoride, receive daily fluoride supplementation.
Chewable Tablets
Fluoride; polyvitamin 0.5 mg chewable tablets provide fluoride in tablet form for children 4 to 6 years of age where the drinking water has a fluoride content less than 0.3 ppm, and for children 6 years of age and above where the drinking water contains 0.3 through 0.6 ppm of fluoride.4
Fluoride; polyvitamin 1.0 mg chewable tablets were developed to provide fluoride in tablet form for children 6 to 16 years of age in areas where the water fluoride level is less than 0.3 ppm.4
Children using fluoride; polyvitamin chewable tablets regularly should receive semiannual dental examinations. The regular brushing of teeth and attention to good oral hygiene practices are also essential.
Drops
Fluoride; polyvitamin drops provide fluoride in drop form for children ages 3-6 years in areas where the drinking water contains less than 0.3 ppm fluoride; and for children 6 years of age and older in areas where the drinking water contains 0.3 through 0.6 ppm of fluoride. Each 1.0 ml supplies sodium fluoride (0.5 mg fluoride) plus nine essential vitamins.
Additional Information for the 0.5 mg Drops Only
A comprehensive 51/2 year series of studies of the effectiveness of fluoride; multivitamin and fluoride; polyvitamin products in caries protection has been published.1,2,5,6 Children in this continuing study lived in an area where the water supply contained only 0.05 ppm fluoride. The subjects were divided into two groups, one which used only non-fluoridated Vi-Sol vitamin products, and the other fluoride; multivitamin and fluoride; polyvitamin products.
The 3-year interim report showed 63% fewer carious surfaces in primary teeth and 43% fewer carious surfaces in permanent teeth of the children taking fluoride; multivitamin products.
After 4 years the studies continued to support the effectiveness of fluoride; multivitamins and fluoride; polyvitamins, showing a reduction in carious surfaces of 68% in primary teeth and 46% in permanent teeth.2
Results at the end of 51/2 years further confirmed the previous findings and indicated that significant reductions in dental caries are apparent with the continued use of fluoride; multivitamin products.5
WARNINGS:
As in the case of all medications, keep out of the reach of children.
The chewable tablets should be chewed. The chewable tablets are not recommended for children under age 4 due to risk of choking.
PRECAUTIONS:
The suggested dose should not be exceeded, since dental fluorosis may result from continued ingestion of large amounts of fluoride.
Before Prescribing Fluoride; Polyvitamin:
1. Determine the fluoride content of the drinking water from all major sources.
2. Make sure the child is not receiving significant amounts of fluoride from other sources such as medications and swallowed toothpaste.
3. Periodically check to make sure that the child does not develop significant dental fluorosis.
Additional Information for Drops: Fluoride; polyvitamin drops should be dispensed in the original plastic container, since contact with glass leads to instability and precipitation. (The amount of sodium fluoride in the 50-ml size is well below the maximum to be dispensed at 1 time according to recommendations of the American Dental Association.
ADVERSE REACTIONS:
Allergic rash and other idiosyncrasies have been rarely reported.
REFERENCES:
1. Hennon DK, Stookey GK, Muhler JC. The clinical anticariogenic effectiveness of supplementary fluoride-vitamin preparations -- Results at the end of three years. J Dentistry for Children. 1966;33:3-12.
2. Hennon DK, Stookey GK, Muhler JC. The clinical anticariogenic effectiveness of supplementary fluoride-vitamin preparations -- Results at the end of four years. J Dentistry for Children. 1967;34:439-443.
3. Brudevold F, McCann HG. Fluoride and caries control -- Mechanism of action. In: Nizel AE, ed. The Science of Nutrition and Its Application in Clinical Dentistry. Philadelphia: WB Saunders Co.; 1966;331-347.
4. American Academy of Pediatrics, Committee on Nutrition. Fluoride Supplementation for Children: Interim Policy Recommendations. Pediatrics. 1995;95:777.
5. Hennon DK, Stookey GK, Muhler JC. The clinical anticariogenic effectiveness of supplementary fluoride-vitamin preparations--Results at the end of five and a half years. Phar and Ther in Dent. 1970;1:1.
6. Hennon DK, Stookey GK, Beiswanger BB. Fluoride-vitamin supplements: Effects on dental caries and fluorosis when used in areas with suboptimum fluoride in the water supply. J Am Dent Assoc. 1977;95:965.