Comparative Perceptions of Fluoride Toxicity in Oral Hygiene Products: Insights from the General Population and Healthcare Professionals
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Questionnaire
2.3. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Total N = 1129 | Fluoride Knowledge Score | ||
---|---|---|---|---|
Median (95% CI) | p-Values | |||
Sex | Man | 261 (23.1) | 5.00 (3.75–4.41) | 0.002 * |
Woman | 868 (76.9) | 5.00 (4.50–4.85) | ||
Age group (years) | 18–30 | 598 (53.0) | 5.00 (4.38–4.81) a | ≤0.001 * |
31–45 | 316 (28.0) | 5.00 (4.59–5.15) b | ||
46–60 | 147 (13.0) | 5.00 (3.75–4.57) | ||
≥61 | 68 (6.0) | 3.50 (2.71–3.96) a,b | ||
Education level | High school | 413 (36.6) | 4.00 (3.57–4.10) a,b | ≤0.001 * |
Bachelor’s degree | 92 (8.1) | 4.00 (3.21–4.29) c,d | ||
Master’s degree | 569 (50.4) | 6.00 (4.92–5.31) a,c | ||
MSc/PhD | 55 (4.9) | 6.00 (4.45–5.80) b,d | ||
Employment | Unemployed | 46 (4.1) | 2.00 (2.07–3.88) a | ≤0.001 * |
Student | 300 (26.6) | 5.00 (4.34–4.96) b | ||
Employed | 735 (65.1) | 5.00 (4.55–4.91) a,c | ||
Retired | 48 (4.3) | 2.00 (1.67–3.12) b,c | ||
Field of employment/education | Dentistry | 309 (27.4) | 7.00 (6.26–6.65) a,b,c | ≤0.001 * |
Medicine | 375 (33.2) | 5.00 (4.01–4.47) a,d,e | ||
Pharmacy | 176 (15.6) | 5.00 (4.68–5.36) b,d,e,f | ||
General population | 269 (23.8) | 2.00 (2.13–2.73) c,e,f | ||
Socioeconomic status | Above average | 254 (22.5) | 6.00 (5.07–5.63) a,b | ≤0.001 * |
Average | 806 (71.4) | 5.00 (4.24–4.61) b,c | ||
Below average | 69 (6.1) | 3.00 (2.17–3.54) a,c |
Characteristic | Total (N = 1129) | Dentistry (N = 309) | Medicine (N = 375) | Pharmacy (N = 176) | General Population (N = 269) | |
---|---|---|---|---|---|---|
Awareness of the effect of fluoride in reducing the frequency of caries | Yes | 887 (78.6) | 303 (98.1) | 311 (82.9) | 157 (89.2) | 116 (43.1) |
No | 242 (21.4) | 6 (1.9) | 64 (17.1) | 19 (10.8) | 153 (56.9) | |
Usage of fluoride toothpaste in daily tooth brushing routine | Yes | 770 (68.2) | 264 (85.4) | 268 (71.5) | 132 (75.0) | 115 (42.8) |
No | 139 (12.3) | 32 (10.4) | 40 (10.7) | 19 (10.8) | 48 (17.8) | |
Not sure | 220 (19.5) | 13 (4.2) | 67 (17.9) | 25 (14.2) | 106 (39.4) | |
Most commonly used chemical compound of fluoride | Aminofluoride (C₂₇H₆₀F₂N₂O₃) | 60 (5.3) | 39 (12.6) | 12 (3.2) | 6 (3.4) | 3 (1.1) |
Sodium fluoride (NaF) | 276 (24.4) | 146 (47.2) | 73 (19.5) | 43 (24.4) | 14 (5.2) | |
Sodium monofluorophosphate (Na₂PFO₃) | 28 (2.5) | 15 (4.9) | 4 (1.1) | 7 (4.0) | 2 (0.7) | |
Tin fluoride (SnF₂) | 15 (1.3) | 7 (2.3) | 3 (0.8) | 3 (1.7) | 2 (0.7) | |
Calcium fluoride (CaF₂) | 21 (1.9) | 4 (1.3) | 7 (1.9) | 5 (2.8) | 5 (1.9) | |
Not using fluoride | 55 (4.9) | 15 (4.9) | 16 (4.3) | 10 (5.7) | 14 (5.2) | |
Do not know | 674 (59.7) | 83 (26.9) | 260 (69.3) | 102 (58.0) | 229 (85.1) | |
Amount of fluoride in parts per million (ppm) in the toothpaste | High (above 1500 ppm) | 24 (2.1) | 15 (4.8) | 6 (1.6) | 2 (1.1) | 1 (0.4) |
Standard (1000–1500 ppm) | 292 (25.9) | 183 (59.2) | 52 (13.9) | 38 (21.6) | 19 (7.0) | |
Low (500 ppm) | 38 (3.3) | 13 (4.2) | 12 (3.2) | 10 (5.7) | 3 (1.1) | |
Not using fluoride toothpaste | 53 (4.7) | 15 (4.9) | 18 (4.8) | 10 (5.7) | 10 (3.7) | |
Do not know | 722 (64.0) | 83 (26.9) | 287 (76.5) | 116 (65.9) | 236 (87.7) | |
Usage of fluoride mouthwash | Daily | 75 (6.6) | 19 (6.1) | 22 (5.9) | 8 (4.5) | 26 (9.7) |
Once a week | 82 (7.3) | 37 (12.0) | 23 (6.1) | 4 (2.3) | 18 (6.7) | |
Uncertain about fluoride content | 100 (8.9) | 5 (1.6) | 42 (11.2) | 17 (9.7) | 36 (13.4) | |
Uncertain about fluoride concentration | 96 (8.5) | 27 (8.7) | 33 (8.8) | 10 (5.7) | 26 (9.7) | |
Not using fluoride mouthwash | 776 (68.7) | 221 (71.5) | 255 (68.0) | 137 (77.8) | 163 (60.6) | |
Usage of other sources of fluoride | Not using other sources | 677 (60.0) | 182 (58.9) | 217 (57.9) | 117 (66.5) | 161 (59.9) |
Varnish | 7 (0.6) | 3 (1.0) | 1 (0.3) | 0 (0) | 3 (1.1) | |
Gel, cream or foam | 21 (1.9) | 5 (1.6) | 5 (1.3) | 2 (1.1) | 9 (3.3) | |
Milk | 149 (13.2) | 40 (12.9) | 48 (12.8) | 19 (10.8) | 42 (15.6) | |
Water | 73 (6.5) | 19 (6.1) | 25 (6.7) | 11 (6.3) | 18 (6.7) | |
Salt | 114 (10.1) | 28 (9.1) | 39 (10.4) | 20 (11.4) | 27 (10.0) | |
Supplements | 14 (1.2) | 5 (1.6) | 5 (1.3) | 1 (0.6) | 3 (1.1) | |
Restorative materials | 25 (2.2) | 8 (2.6) | 9 (2.4) | 2 (1.1) | 6 (2.2) | |
Other | 4 (0.4) | 2 (0.6) | 0 (0) | 1 (0.6) | 1 (0.4) |
Question (Answer “Yes”) | Total (N = 1129) | Dentistry (N = 309) | Medicine (N = 375) | Pharmacy (N = 176) | General Population (N = 269) |
---|---|---|---|---|---|
Fluorides are common ingredients in pharmaceutical products for oral hygiene due to their recognized effect in the prevention of tooth decay. | 728 (64.5) | 255 (82.5) | 236 (62.9) | 131 (74.4) | 106 (39.4) |
Brushing twice a day with fluoride toothpaste lowers the risk of dental caries. | 826 (73.2) | 276 (89.3) | 279 (74.4) | 137 (77.8) | 134 (49.8) |
Fluoride can greatly help dental health by strengthening the tooth enamel, making it more resistant to tooth decay. | 708 (62.7) | 278 (90.0) | 215 (57.3) | 117 (66.5) | 98 (36.4) |
Fluoride prevents early dental caries by reducing bacterial metabolism, thus reducing acid production and hence demineralization. | 493 (43.7) | 195 (63.1) | 155 (41.3) | 83 (47.2) | 60 (22.3) |
Fluorides may be added to toothpastes in several different forms, such as sodium fluoride, sodium monofluorophosphate, tin fluoride, or in the form of different amines. | 591 (52.3) | 255 (82.5) | 176 (46.9) | 112 (63.6) | 48 (17.8) |
Depending on various factors, for example, concentration, frequency of use, and age of the user, fluoride can be detrimental or beneficial. | 671 (59.4) | 270 (87.4) | 206 (54.9) | 122 (69.3) | 73 (27.1) |
Fluoride toothpaste should be introduced with the eruption of the first tooth. Children under 3 years old are advised to use a small smear of toothpaste, while those aged 3 and older who can spit reliably should use a pea-sized amount. | 594 (52.6) | 244 (79.0) | 177 (47.2) | 105 (59.7) | 68 (25.3) |
Spitting out toothpaste without rinsing allows fluoride to remain in the mouth, continuing its effectiveness. | 512 (45.3) | 221 (71.5) | 147 (39.2) | 77 (43.8) | 67 (24.9) |
Ingredient | Assessed Toxicity among Respondents | ||||
---|---|---|---|---|---|
Total (N = 1129) | Dentistry (N = 309) | Medicine (N = 375) | Pharmacy (N = 176) | General Population (N = 269) | |
Fluoride | 349 (30.9) | 133 (43.0) | 114 (30.4) | 69 (39.2) | 33 (12.3) |
Alcohol | 794 (70.3) | 245 (79.3) | 285 (76.0) | 126 (71.6) | 138 (51.3) |
Triclosan | 286 (25.3) | 110 (35.6) | 88 (23.5) | 57 (32.4) | 31 (11.5) |
Parabens | 566 (50.1) | 181 (58.6) | 221 (58.9) | 110 (62.5) | 54 (20.1) |
Sodium lauryl sulfate | 353 (31.3) | 127 (41.1) | 102 (27.2) | 72 (40.9) | 52 (19.3) |
Chlorhexidine | 269 (23.8) | 83 (26.9) | 108 (28.8) | 53 (30.1) | 25 (9.3) |
Zinc salts | 170 (15.1) | 55 (17.8) | 68 (18.1) | 32 (18.2) | 15 (5.6) |
Propylene glycol | 229 (20.3) | 67 (21.7) | 97 (25.9) | 47 (26.7) | 18 (6.7) |
Artificial dyes | 600 (53.1) | 170 (55.0) | 242 (64.5) | 96 (54.5) | 92 (34.2) |
Sodium benzoate | 277 (24.5) | 89 (28.8) | 108 (28.8) | 50 (28.4) | 30 (11.2) |
Artificial sweeteners | 569 (50.4) | 154 (49.8) | 224 (59.7) | 90 (51.1) | 101 (37.5) |
Cocamidopropyl betaine | 192 (17.0) | 59 (19.1) | 85 (22.7) | 31 (17.6) | 17 (6.3) |
Hydrogen peroxide | 438 (38.8) | 144 (46.6) | 170 (45.3) | 85 (48.3) | 39 (14.5) |
Diethanolamine (DEA) | 257 (22.8) | 78 (25.2) | 102 (27.2) | 52 (29.5) | 25 (9.3) |
Cetylpyridinium chloride (CPC) | 246 (21.8) | 73 (23.6) | 101 (26.9) | 47 (26.7) | 25 (9.3) |
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Badrov, M.; Gavic, L.; Seselja Perisin, A.; Zeljezic, D.; Vladislavic, J.; Puizina Mladinic, E.; Tadin, A. Comparative Perceptions of Fluoride Toxicity in Oral Hygiene Products: Insights from the General Population and Healthcare Professionals. Clin. Pract. 2024, 14, 1827-1841. https://doi.org/10.3390/clinpract14050146
Badrov M, Gavic L, Seselja Perisin A, Zeljezic D, Vladislavic J, Puizina Mladinic E, Tadin A. Comparative Perceptions of Fluoride Toxicity in Oral Hygiene Products: Insights from the General Population and Healthcare Professionals. Clinics and Practice. 2024; 14(5):1827-1841. https://doi.org/10.3390/clinpract14050146
Chicago/Turabian StyleBadrov, Marija, Lidia Gavic, Ana Seselja Perisin, Davor Zeljezic, Jasen Vladislavic, Ema Puizina Mladinic, and Antonija Tadin. 2024. "Comparative Perceptions of Fluoride Toxicity in Oral Hygiene Products: Insights from the General Population and Healthcare Professionals" Clinics and Practice 14, no. 5: 1827-1841. https://doi.org/10.3390/clinpract14050146