Journal of Dental Research, Vol 69, 426-429, Copyright © 1990 by International & American Associations for Dental Research Online Journals
Studies of human gastric mucosa after application of 0.42% fluoride gel
C. J. Spak, S. Sjostedt, L. Eleborg, B. Veress, L. Perbeck and J. Ekstrand
Department of Cariology, School of Dentistry, Karolinska Institutet, Huddinge, Sweden.
Dental prophylaxis with APF gels (1.23%) may cause gastric distress as a
side-effect. This gastric irritation is probably due to a direct toxic
effect of fluoride (F), swallowed in conjunction with the treatment, on the
gastric mucosa. The aim of the present study was to investigate
whether--and to what extent--a dental treatment with 3 g of a 0.42%-F gel
could affect the gastric mucosa due to inadvertent swallowing of the gel.
Ten subjects underwent a control gastroscopy, and two weeks later, a second
gastroscopy was performed two h after a F gel treatment. During the
gastroscopy, the mucosa was examined and the injuries graded according to
an arbitrary scale. Four biopsies of the antral and corpus regions of the
stomach were taken and evaluated histologically. The mean (+/- SD) amount
of F retained after the application was 5.1 +/- 2.1 mg, i.e., 40% of the
applied amount of F. Petechiae and erosions were found in the mucosa in
seven of the ten patients. The histopathological evaluation revealed
changes in nine of ten patients, with the surface epithelium as the most
affected component of the mucosa. The present study clearly shows that a
treatment with a F gel of rather low F concentration may result in injuries
to the gastric mucosa. The importance of current recommended guidelines so
that the amount of F swallowed during a gel application can be minimized is
emphasized. From a toxicological standpoint, the use of a low-F gel instead
of a 1.23%-F gel in small children is recommended for avoidance of adverse
gastric effects.
