Topical Fluoride Application in Early Childhood

Dental caries is one of the most common oral health problems from an early age. One effective preventive strategy is the use of topical fluoride to strengthen enamel and suppress the growth of caries-causing bacteria in dental plaque. A study conducted by Agustin Lis Setyorini, a student at FKG UGM, under the supervision of drg. Rinaldi Budi Utomo, MS., Sp.KGA (K), entitled “The Effect of 1% Sodium Fluoride Topical Application on Salivary Fluoride Levels and Streptococcus Alpha Bacterial Colonies in Dental Plaque: A Study in Girls Aged 6–8 Years at Pesantren Bin Baz”, evaluated the effect of 1% sodium fluoride (NaF) in girls aged 6–8 years. 

Research Method

• Subjects: 16 girls aged 6–8 years at Pesantren Bin Baz. 
• Intervention: Topical application of 1% NaF solution using the Knutson method, 4 times at weekly intervals. 
• Measurements:
  • Salivary fluoride levels (before intervention, after 4 applications, and 3 months after application). 
  • Number of Streptococcus alpha bacterial colonies in dental plaque at the same time points.
• Tools & Methods: DR2000 spectrophotometry for fluoride measurement; dilution method for bacterial colony counts. 

Results

• Salivary fluoride levels
  • Before application: ± 0.03856 ppm 
  • After 4 applications: ± 0.08538 ppm 
  • Three months after application: ± 0.02585 ppm 
• Streptococcus alpha colony count Streptococcus alpha
  • Before application: ± 21.787 × 10⁵ CFU/ml 
  • After 4 applications: ± 15.494 × 10⁵ CFU/ml 
  • Three months after application: ± 24.219 × 10⁵ CFU/m 
• Significance: Changes in fluoride levels and bacterial colony counts after 1% topical fluoride application were statistically significant (p < 0.05). 

Interpretation & Mechanism

• The increase in salivary fluoride levels after topical application indicates that 1% NaF can be absorbed or released in the oral environment (saliva) for a certain period. Fluoride in saliva is important for enamel remineralization and protection against acids produced by plaque bacteria.
• The reduction in Streptococcus alpha colonies after fluoride application demonstrates its antibacterial effect, which can inhibit bacterial growth contributing to plaque formation and acid production that causes enamel demineralization.
• The relatively high fluoride level after four applications did not persist at the same level three months later, indicating that protective effects need to be maintained through periodic applications.

Advantages of Topical Fluoride Application in Early Childhood

1. Caries Prevention
   Topical fluoride increases salivary fluoride levels and reduces caries-causing bacteria, minimizing the risk of tooth decay.
2. Relatively Easy & Low-Cost Intervention
   A 1% NaF solution can be routinely applied by dental professionals using simple methods, making it suitable for children in environments such as boarding schools or primary schools.
3. Proven Short-Term Effect
   The study shows that after several applications, significant effects on salivary fluoride and plaque bacteria are observed.

Limitations & Considerations

1. Diminishing Long-Term Effect
   Three months after application, fluoride levels and bacterial suppression decreased, indicating the need for repeated applications. 
2. Individual Response Variability
   Differences in oral hygiene, diet, and saliva conditions can affect the level of benefit obtained.
3. Study Design Limitations
   This was a quasi-experimental single-group study with a relatively small sample size (16 children) and only a 3-month follow-up.
4. Not All Caries Risk Factors Assessed
   Factors such as diet, toothbrushing frequency, and fluoride exposure from other sources (water, toothpaste) were not deeply analyzed.

***

Topical application of 1% fluoride in children aged 6–8 years can increase salivary fluoride levels and suppress Streptococcus alpha colonies in dental plaque, supporting caries prevention in children. To maintain this effect, fluoride application should be performed periodically. While promising, individual variation and other risk factors must be considered to maximize benefits. Streptococcus alpha dalam plak gigi, yang mendukung pencegahan karies pada anak. Untuk mempertahankan efek ini, aplikasi fluoride perlu dilakukan secara berkala. Meskipun metode ini menjanjikan, perlu dipertimbangkan variasi individu serta faktor risiko lainnya agar manfaatnya maksimal.

References
SETYORINI, Agustin Lis, drg. Rinaldi Budi Utomo, MS., Sp.KGA(K), Pengaruh topikal aplikasi sodium fluoride 1 persen terhadap kadar fluor dalam saliva dan jumlah koloni bakteri streptococcus alpha pada plak gigi :: Kajian pada anak perempuan umur 6-8 tahun di Pesantren Bin Baz, https://etd.repository.ugm.ac.id/penelitian/detail/48709

Author: Rizky B. Hendrawan | Photo: Freepik