Fluoride passes from the mother to fetal teeth. Much of the fluoride is taken up in secretory enamel, probably by the forming mineral apatite crystals. Some is retained with residual proteins. The low concentration of fluoride in the inner enamel is incorporated mainly during the secretory stage, while the enhanced concentration in the surface enamel is produced during the much longer maturation stage. Mature, hard enamel is generally absent during fetal life. The clinical question is whether prenatal fluoride imparts an additional benefit to the universally accepted effect of postnatal fluoride. In general, surface enamel fluoride levels of deciduous teeth increase with increasing pre- and postnatal fluoride administration. A consistent level of caries protection has been reported with pre- and postnatal administration of fluoride unrelated to the acquisition of fluoride in the surface enamel.
Many children develop enamel opacities in their deciduous dentition related by various factors to enamel mineralization disturbances in drinking water areas even low in fluoride. Accumulation of fluoride due to an increased fluoride intake is a feature of fluorosed enamel in the deciduous as well as permanent dentition. The resulting mature fluorosed enamel retains a relatively high proportion of immature matrix proteins onto the crystal surface. The degree of fluorosis of the deciduous dentition is less compared with that of the permanent dentition, due probably to a partial protection afforded by the maternal loss of fluoride, formerly known as the "placental barrier".
Get full access to this article
View all access options for this article.
References
1.
Aasenden, R. and Peebles, T. (1974): Effects of Supplementation from Birth on Human Deciduous and Permanent Teeth, Arch Oral Biol19 : 321-326.
2.
Angmar-Mansson, B. and Whitford, G.M. (1982): Plasma Fluoride Levels and Enamel Fluorosis in the Rat, Caries Res16: 334-339.
3.
Angmar-Mansson, B. and Whitford, G.M. (1984): Enamel Fluorosis Related to Plasma F Levels in the Rat, Caries Res18: 25-32.
4.
Armstrong, W.D.; Singer, L.; and Makowski, E.L. (1970): Placental Transfer of Fluoride and Calcium, Am J Obstet Gynecol107: 432-434.
5.
Bawden, J.W. (1984): Enamel Pathology; Discussion. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam, New York, Oxford : Elsevier Science Publishers B.V., pp. 379-413.
6.
Bawden, J.W.; Crenshaw, M.; Takano, Y.; and Hammarstrom, L. (1982): Enamel Organ Morphology, Function, and Transport-Ion Transport through the Enamel Organ-An Update, J Dent Res61 (Sp Iss): 1552-1554.
7.
Brown, W.E.; Chow, L.C.; Siew, C.; and Gruninger, S. (1984): Acidic Calcium Phosphate Precursors in Formation of Enamel Mineral. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam, New York , Oxford: Elsevier Science Publishers B.V., pp. 8-13.
8.
Caldera, R.; Chavinie, J.; Laurent, A.M.; Fermanian, J.; and Tortrat, D. (1986): Etude Preliminaire sur le Passage Transplacentaire du Fluor. A Propos de 41 Couples Mere-Enfant, J Gynecol Obstet Biol Reprod15: 731-735.
9.
Crabb, H.S.M. and Darling, A.1. (1962): The Pattern of Progressive Mineralization in Human Dental Enamel, London: Pergamon Press, pp. 77-93.
10.
Cutress, T.W. (1972): The Inorganic Composition and Solubility of Dental Enamel from Several Specific Population Groups, Arch Oral Biol17: 93-109.
11.
Dean, H.T. (1934): Classification of Mottled Enamel Diagnosis, J Am Dent Assoc21: 1421-1426.
12.
DePaola, P.F.; Brudevold, F.; Aasenden, R.; Moreno, E.C.; Englander, H.R.; Bakhos, Y.; Bookstein, F.; and Warram, J. (1975): A Pilot Study of the Relationship between Caries Experience and Surface Enamel Fluoride in Man, Arch Oral Biol20: 859-864.
13.
Deutsch, D. and Gedalia, I. (1982): Fluoride Concentration in Human Fetal Enamel, Caries Res16: 428-432.
14.
Eastoe, J.E. (1984): Enamel Pathology; Discussion. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam , New York, Oxford; Elsevier Science Publishers B.V., pp. 379-413.
15.
Eastoe, J.E. and Fejerskov, O. (1984): Composition of Mature Enamel Proteins from Fluorosed Teeth. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam, New York, Oxford: Elsevier Science Publishers B.V., pp. 326-330.
16.
Englander, H.R. and Mellberg, J.R. (1976): Failure to Demonstrate an Association between Enamel Fluoride Concentration and Dental Caries in the Deciduous Dentition , J Dent Res55: 707.
17.
Fanning, E.A.; Cellier, K.M.; Leadbeater, M.M.; and Somer-Ville, C.M. (1975): South Australian Kindergarten Children. Fluoride Tablet Supplements and Dental Caries, Aust Dent J20: 7-9.
18.
Fejerskov, O. (1984): Enamel Pathology; Discussion. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam , New York, Oxford: Elsevier Science Publishers B.V., pp. 379-413.
19.
Fejerskov, O.; Richards, A.; and Josephsen, K. (1983): Pathogenesis and Biochemical Findings of Dental Fluorosis in Various Species. In: Fluoride Effects on Vegetation, Animals and Humans, J.L. Shupe, H.B. Peterson, and N.C. Leone, Eds. Salt Lake City: Paragon Press, Inc., pp. 312-326.
20.
Fejerskov, 0.; Stephen, K.W.; Richards, A.; and Speirs, R. (1987): Combined Effect of Systemic and Topical Fluoride Treatments on Human Deciduous Teeth-Case Studies, Caries Res21: 452-459.
21.
Fejerskov, 0.; Thylstrup, A.; and Larsen, M.J. (1977): Dental Fluorosis. Clinical and Histological Features and Possible Pathogenic Mechanisms, Scand J Dent Res85: 510-534.
22.
Forsman, B. (1974): Dental Fluorosis and Caries in High-Fluoride Districts in Sweden, Community Dent Oral Epidemiol2: 132-148.
23.
Forsman, B. (1977): Early Supply of Fluoride and Enamel Fluorosis , Scand J Dent Res85: 22-30.
24.
Fridell, R.A.; Lussi, A.; Crenshaw, M.A.; and Bawden, J.W. (1988): The in vitro Uptake of Fluoride by Secretory and Maturation Stage Bovine Enamel, J Dent Res67: 487-490.
25.
Gedalia, I. (1970): Distribution in Placenta and Fetus. In: Fluorides and Human Health, Monograph Series No. 59, Geneva : WHO, pp. 128-134.
26.
Gedalia, I.; Brzezinski, A.; Portuguese, N.; and Bercovici, B. (1964): The Fluoride Content of Teeth and Bones of Human Foetuses, Arch Oral Biol9: 331-340.
27.
Gedalia, I.; Goldhaber, P.; and Golub, L. (1970): In vitro Uptake of Fluoride in Sodium Fluoride-treated Vital Mice Calvaria, J Dent Res49: 1553.
28.
Gedalia, 1.; Median, S.; Mann, J.; Deutsch, D.; Badner, V.; and Gron, P. (1985): Fluoride Drop Supplementation and its Effect on Surface Enamel Fluoride Concentration and DMFT and deft Rates in Israeli Kibbutz Children, J Int Assoc Dent Child16: 13-16.
29.
Gedalia, I. and Yardeni, J. (1957): Fluoride in Teeth of Israeli Children in Relation to Fluorine in Domestic Waters and to Dental Caries Prevalence, J Dent Res36: 203-207.
30.
Glenn, F.B.; Glenn, W.D.; and Duncan, R.C. (1982): Fluoride Tablet Supplementation during Pregnancy for Caries Immunity: A Study of the Offspring Produced, Am J Obstet Gynecol143: 560-564.
31.
Grobler, S.R. and Louw, A.J. (1986): Enamel-Fluoride Levels in Deciduous and Permanent Teeth of Children in High, Medium and Low Fluoride Areas, Arch Oral Biol31: 423-426.
32.
Guy, W.S.; Taves, D.R.; and Brey, W.S., Jr. (1976): Organic Fluorocompounds in Human Plasma: Prevalence and Characterization, Am Chem Soc Symp Ser28: 117-134.
33.
Hiller, C.R.; Robinson, C.; and Weatherell, J.A. (1975): Variations in the Composition of Developing Rat Incisor Enamel, Calcif Tissue Res18: 1-12.
34.
Iijima, Y. and Katayama, T. (1985): Fluoride Concentration in Deciduous Enamel in High- and Low-Fluoride Areas, Caries Res19: 262-265.
35.
Kunzel, W.; Schaper, R.; Schamschula, R.G.; and Taylor, C.E. (1985): Effekt Pra- und Postnataler Fluoridebelastung auf den Fluoridgehalt des Milch-zahnschmelzes, Zahn-, Mund-Kieferheilkd73: 3-9.
36.
LeGeros, R.Z.; Glenn, F.B.; Lee, D.D.; and Glenn, W.D. (1985): Some Physico-chemical Properties of Deciduous Enamel of Children with and without Pre-natal Fluoride Supplementation (PNF) , J Dent Res64: 465-469.
37.
Lussi, A.; Fridell, R.A.,; Crenshaw, M.A.; and Bawden, J.W. (1988): Absence of in-vitro Fluoride-Binding by the Organic Matrix of Developing Bovine Enamel, Arch Oral Biol33: 531-533.
38.
Mortimer, K.V. (1970): The Relationship of Deciduous Enamel Structure to Dental Disease, Caries Res4: 206-223.
39.
Robinson, C. (1984): Enamel Pathology; Discussion. In: Tooth Enamel IV, R.W. Feamhead and S. Suga, Eds., Amsterdam , New York, Oxford: Elsevier Science Publishers B.V., pp. 379-413.
40.
Robinson, C. and Kirkham, J. (1984): Enamel Matrix Components, Alterations during Development and Possible Interactions with the Mineral Phase. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam, New York, Oxford: Elsevier Science Publishers B.V., pp. 261-265.
41.
Small, B.W. and Murray, J.J. (1978): Enamel Opacities Prevalence Classification and Aetiological Considerations, J Dentistry6: 33-42.
42.
Speirs, R.L. (1978): Fluoride Concentration in Tooth Germs of Permanent Teeth of the Domestic Pig, Arch Oral Biol23: 1019-1021.
43.
Speirs, R.L. (1980): Retention of Fluoride by Enamel during Maturation in Unerupted Permanent Teeth of the Domestic Pig, Arch Oral Biol25: 805-808.
44.
Speirs, R.L. (1983): The Value of Prenatally Administered Fluoride , Dental Update3: 43-51.
45.
Suckling, G.W. (1984): Enamel Pathology; Discussion. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam , New York, Oxford: Elsevier Science Publishers B.V., pp. 379-413.
46.
Suga, S. (1984): Enamel Pathology: Discussion. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam , New York, Oxford: Elsevier Science Publishers B.V., pp. 379-413.
47.
Suttie, J.W.; Clay, A.B.; and Shearer, T.R. (1985): Dental Fluorosis in Bovine Temporary Teeth, Am J Vet Res46: 404-408.
48.
Tanabe, T.; Aoba, T.; Moreno, E.C.; and Fukae, M. (1988): Effect of Fluoride in the Apatite Lattice on Adsorption of Enamel Proteins onto Calcium Apatites, Dent Res67: 536-542.
49.
Taylor, C.E.; Schamschula, R.G.; Barnard, P.D.; Agus, H.M.; and Un, P.S.H. (1983): Fluoride Concentration in Deciduous Enamel, J Dent Res62: 673, Abst. No. 213.
50.
Termine, J.D.; Belcourt, A.B.; Christner, P.J.; Conn, K.M.; and Nylen, M. (1980): Properties of Dissociatively Extracted Fetal Tooth Matrix Proteins. I. Principal Molecular Species in Developing Bovine Enamel, J Biol Chem255: 9760-9768.
51.
Thylstrup, A. (1981): Is there a Biological Rationale for Prenatal Fluoride Administration?, J Dent Child48: 103-108.
52.
Thylstrup, A. and Fejerskov, O. (1978): Clinical Appearance and Surface Distribution of Dental Fluorosis in Permanent Teeth in Relation to Histologic Changes, Community Dent Oral Epidemiol6: 315-328.
53.
Thylstrup, A.; Fejerskov, 0.; Bruun, C.; and Kann, J. (1979): Enamel Changes and Dental Caries in 7-year-old Children Given Fluoride Tablets from Shortly after Birth, Caries Res13: 265-276.
54.
Thylstrup, A.; Fejerskov, O.; and Mosha, H.J. (1978): A Polarized Light and Microradiographic Study of Enamel in Human Primary Teeth from a High Fluoride Area, Arch Oral Biol23: 373-380.
55.
Triller, M. (1984): Enamel Pathology; Discussion. In: Tooth Enamel IV, R.W. Fearnhead and S. Suga, Eds., Amsterdam , New York, Oxford: Elsevier Science Publishers B.V., pp. 379-413.
56.
Weatherell, J.A.; Deutsch, D.; Robinson, C.; and Hallsworth, A.S. (1975): Fluoride Concentrations in Developing Enamel, Nature (Lond)256: 230-232.
57.
Weatherell, J.A.; Deutsch, D.; Robinson, C.; and Hallsworth, A.S. (1977): Assimilation of Fluoride by Enamel throughout the Life of the Tooth, Caries Res11: 85-115.
