title: Mechanism and timing of fluoride effects on developing enamel.
abstract: Fluoride appears to specifically interact with mineralizing tissues, causing an alteration of the mineralization process. In enamel, fluorosis results in a subsurface hypomineralization. This hypomineralized enamel appears to be directly related to a delay in the removal of amelogenins at the early-maturation stage of enamel formation. The specific cause for this delay is not known, although existing evidence points to reduced proteolytic activity of proteinases that hydrolyze amelogenin. This delay in hydrolysis of amelogenins could be due to a direct effect of fluoride on proteinase secretion or proteolytic activity, or to a reduced effectiveness of the proteinase due to other changes in the protein or mineral of the fluorosed enamel matrix. The formation of dental fluorosis is highly dependent on the dose, duration, and timing of fluoride exposure. The early-maturation stage of enamel formation appears to be particularly sensitive to the effects of fluoride on enamel formation. Although the risk of enamel fluorosis is minimal with exposure only during the secretory stage, this risk is greatest when exposure occurs in both secretory and maturation stages of enamel formation. The risk of fluorosis appears to be best related to the total cumulative fluoride exposure to the developing dentition.
authors.affiliation: Department of Pediatric Dentistry, University of California San Francisco 94143-0512, USA. pkdb@itsa.ucsf.edu
authors.forename: P K
authors.initials: PK
authors.lastname: Den Besten
mesh_terms: D000566:Amelogenesis / Q000187:drug effects*; D053523:Amelogenin; D000818:Animals; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003743:Dental Enamel / Q000187:drug effects*; D003744:Dental Enamel Hypoplasia / Q000139:chemically induced / Q000378:metabolism; D003746:Dental Enamel Proteins / Q000187:drug effects / Q000378:metabolism; D004195:Disease Models, Animal; D004658:Enamel Organ / Q000187:drug effects / Q000378:metabolism; D005459:Fluorides / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D011480:Protease Inhibitors / Q000494:pharmacology; D012307:Risk Factors; D013997:Time Factors; D014074:Tooth Calcification / Q000187:drug effects
chemical_list: D053523:Amelogenin; D002327:Cariostatic Agents; D003746:Dental Enamel Proteins; D011480:Protease Inhibitors; D005459:Fluorides