Interprofessional contact and consultation among dentists, physicians, and pharmacists can help to optimize patient care. Because pharmacists are readily accessible to the public, their influence is essential for the appropriate prescribing and continued use of systemic fluoride supplements.
Pharmacists should be familiar with various aspects of fluoride therapy, such as mechanisms of caries inhibition, dosages associated with acute and chronic toxicity, and recommended daily dosage levels. The impact of breastfeeding, multiple sources of water intake, and changing age of the patient must be considered in determining proper systemic fluoride dosage.
Pharmacists should consult with both physicians and dentists to coordinate water fluoride assay and prescribing responsibilities. They also can help to educate both prescribers and patients. Because of frequent patient contact and access to medication records, pharmacists can encourage and monitor patient compliance. Fluoride prescriptions and results of water fluoride assays should be documented on the patients' computerized or card profiles. In addition, pharmacists can counsel patients about the fluoride ion content of various home-use products and make recommendations to ensure that an optimal level of fluoride ingestion is maintained.
American Dental Association/American Pharmaceutical Association Liaison Committee. The dentist and the pharmacist. Chicago, IL: American Dental Association, 1983: 1.
2.
Dental sealants in the prevention of tooth decay. Proceedings of National Institutes of Health Consensus Development Conference. J Dent Educ1984; 48 (suppl 2): 18–31.
KeyesPEnglanderHR. Fluoride therapy in the treatment of dentomicrobial plaque diseases. J Am Soc Prev Dent1975; 5 (1): 16–21, 36–45.
5.
LevySM. Expansion of the proper use of systemic fluoride supplements. J Am Dent Assoc1986; 112: 30–4.
6.
ArnoldFAJrDeanHTJayPKnutsonJW. Effect of fluoridated public water supplies on dental caries prevalence. Public Health Rep1956; 71: 652–8.
7.
KleinSPBohannanHMBellRMThe cost and effectiveness of school-based preventive dental care. Am J Public Health1985; 75: 382–91.
8.
AstDBFitzgeraldB. Effectiveness of water fluoridation. J Am Dent Assoc1962; 65: 581–7.
9.
Fluoridation Census 1980. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, 1984.
10.
HastreiterRJ. Fluoridation conflict: a history and conceptual synthesis. J Am Dent Assoc1983; 106: 486–90.
11.
YiamouyiannisJBurkD. Fluoridation and cancer. Age-dependence of cancer mortality related to artificial fluoridation. Fluoride Q Rep1977; 10: 102–24.
12.
KramDSchneiderELSingerLMartinGR. The effects of high and low fluoride diets on the frequencies of sister chromatid exchanges. Mutat Res1978; 57: 51–5.
13.
MartinGRBrownKSMathesonDWLack of cytogenetic effects in mice or mutations in salmonella receiving sodium fluoride. Mutat Res1979; 66: 159–67.
14.
NewbrunE. Water fluoridation and fluoridation supplements in caries prevention. J Calif Dent Assoc1980; 8: 38–47.
15.
HorowitzHSHeifetzSBLawFE. Effect of school water fluoridation on dental caries: a final result in Elk Lake, Pennsylvania after 12 years. J Am Dent Assoc1972; 84: 832–8.
16.
AasendenRPeeblesTC. Effects of fluoride supplementation from birth on human deciduous and permanent teeth. Arch Oral Biol1974; 19: 321–6.
17.
InfantePF. Dietary fluoride intake from supplements and communal water supplies. Am J Dis Child1975; 129: 835–7.
18.
MargolisFJReamesHRFreshmanETen-year prospective study of deciduous and permanent dentition. Am J Dis Child1975; 129: 794–800.
19.
DriscollWSHorowitzHS. A discussion of optimal dosage for dietary supplementation. J Am Dent Assoc1978; 96: 1050–3.
20.
Bureau of Economic Research and Statistics. Prescribing and dispensing habits of dentists. Chicago: American Dental Association, 1975.
21.
GiftHCMiltonBBWalshV. The role of the health professional in the delivery of caries prevention. Chicago: American Dental Association Health Foundation, 1983.
22.
MargolisFJBurtBAScharkMAFluoride supplements for children—a survey of physicians' prescription practices. Am J Dis Child1980; 134: 865–8.
23.
SiegelCGutgesellME. Fluoride supplementation in Harris County, Texas. Am J Dis Child1982; 136: 61–3.
24.
LevySMRozierRGBawdenJW. An investigation of fluoride supplement use by North Carolina dentists (abstract). 113th annual meeting of the American Public Health Association, Washington, DC, Nov. 17–21, 1985: 89.
25.
RigilanoJCFriedlerEMEhemannLJ. Fluoride prescribing patterns among primary care physicians. J Fam Pract1985; 21: 381–5.
26.
WatsonML. The opposition to fluoride programs: report of a survey. J Public Health Dent1985; 45: 142–5.
27.
TraskPA. Orthodontic positioner used for home fluoride treatments. Am J Orthod1975; 67: 677–82.
28.
LoescheWJ. Topical fluorides as an antibacterial agent. J Prev Dent1977; 4 (1): 21–6.
29.
HodgeJC. Metabolism of fluorides. JAMA1961; 177: 313–6.
30.
BuonocoreMGRipaLW. Pharmacologic and therapeutic aspects of fluoride. J Prev Dent1974; 1: 12–23.
31.
HeifetzSBHorowitzHS. The amounts of fluoride in current fluoride therapies: safety considerations for children. J Dent Child1984; 51: 257–69.
32.
BhussryBRDemoleVHodgeHCToxic effects of larger doses of fluoride. In: Fluorides and human health. Geneva: World Health Organization, 1970: 225–31.
33.
EichlerHGLenzKFuhrmannMHrvbyK. Accidental ingestion of NaF tablets by children—report of a poison control center and one case. Int J Clin Pharmacol Ther Toxicol1982; 20: 334–8.
34.
GosselinREHodgeHESmithRPFluoride clinical toxicology of commercial products. 4th ed. Baltimore: Williams and Wilkins, 1976: 159–63.
BaylessJMTinanoffN. Diagnosis and treatment of acute fluoride toxicity. J Am Dent Assoc1985; 110: 209–11.
40.
HodgeHCSmithFA. Biological properties of inorganic fluorides. In: SimmoneJH, ed. Fluorine chemistry, vol. IV. New York: Academic Press, 1963: 2–365.
41.
MillerIJ. Fluorides and dental fluorosis. Int Dent J1982; 32: 135–47.
42.
DeanHT. Epidemiological studies in the United States. In: MoutonFR, ed. Dental caries and fluorine. Lancaster: Science Press,1946: 5–31.
43.
WhitfordGM. Fluorides: mechanisms of action, efficacy, and safety. In: Dental caries prevention in public health programs. Washington, D.C.: Government Printing Office, 1981; DHEW Publication no. (NIH) 81-2235.
44.
HorowitzHS. Alternative methods of delivering fluorides: an update. Dent Hyg1983; 57: 37–43.
45.
Fluoride compounds. In: Council on Dental Therapeutics. Accepted dental therapeutics. 40th ed.Chicago: American Dental Association, 1984: 395–420.
46.
WeiSHY, ed. Clinical uses of fluorides. Philadelphia: Lea and Febiger, 1985.
47.
BawdenJW. Topical fluorides … use the right ones the right way. NC Dent Gaz1983; 5: 6–7.
48.
GiftHCHoermanKC. Attitudes of dentists and physicians toward the use of dietary fluoride supplements. J Dent Child1985; 52: 215–68.
49.
Pamphlet. Oral health for you and your baby. Iowa City, 1A: University of Iowa, Department of Pediatric Dentistry, 1985.
50.
DriscollWS. What we know and don't know about dietary fluoride supplements—the research basis. J Dent Child1985; 52: 259–64.
51.
HorowitzAM. Appropriate prescribing and use of dietary fluoride supplements: the role of pharmacists. Pharm Times1985; 51: 27–31.
52.
DriscollWSHorowitzHSMeyersRJPrevalence of dental caries and dental fluorosis in areas with optimal and above-optimal water fluoride concentrations. J Am Dent Assoc1983; 107: 42–7.
53.
SegretoVACollinsEMCamannDSmithCT. A current study of mottled enamel in Texas. J Am Dent Assoc1984; 108: 56–9.
54.
LeverettDH. Fluorides and the changing prevalence of dental caries. Science1982; 217: 26–30.
55.
HorowitzHSDriscollWSMyersRJA new method for assessing the prevalence of dental fluorosis—the tooth surface index of fluorosis. J Am Dent Assoc1984; 109: 37–41.
56.
GalaganDJVermillionJR. Determining optimum fluoride concentrations. Public Health Rep1957; 72: 491–3.
57.
RichardsLFWestmorelandWWTashiroMDetermining optimum fluoride levels for community water supplies in relation to temperature. J Am Dent Assoc1967; 74: 389–97.
58.
GorsuchA. Maximum contaminant levels for fluoride. Federal Register. Dec. 1, 1981; 46 (230): 58345–6.
59.
ClarkNCorbinS. The evolution of standards for naturally occurring fluorides: an example of scientific due process. Public Health Rep1983; 98: 53–6.
60.
ShapiroJR. Report to the surgeon general by the Ad Hoc Committee on the Non-Dental Health Effects of Fluoride in Drinking Water. Sept. 26, 1983.
61.
Environmental Protection Agency. National primary drinking water regulations; fluoride; final rule and proposed rule. Federal Register, Nov. 14, 1985; 50 (220): 47142–71.
62.
LevySMBawdenJWRozierRG. Fluoride analyses of patient water supplies requested by North Carolina health professionals. Am J Public Health1984; 74: 1412–4.
EricssonY. Fluoride excretion in human saliva and milk. Caries Res1969; 3: 159–66.
65.
JohnsonJJrBawdenJW. Fluoride content of commercially available infant formulas (abstract). J Dent Res1986; 65: 183.
66.
GlennFB. The rationale for the administration of a NaF tablet supplement during pregnancy and postnatally in a private practice setting. J Dent Child1981; 48: 18–22.
67.
DriscollWS. A review of clinical research on the use of prenatal fluoride administration for prevention of dental caries. J Dent Child1981; 48: 109–17.
FanningEACellierKMLeadbeaterMMSommervilleCM. South Australian kindergarten children: fluoride tablet supplements and dental caries. Aust Dent J1975; 20: 7–9.
