Milk fluoridation

Despite these positive features, milk fluoridation is used in only a limited number of places, and both water- and salt-fluoridation are more widely employed. 

B.A. Burt, T.M. Marthaler, Fluoride tablets, salt fluoridation and milk fluoridation, in O. Fejerskov, J. Ekstrand, B.A. Burts (Eds.), Fluoride in Dentistry, 2nd edition, Munksgaard, Copenhagen, 1996. 

J.W. Stamm, Milk fluoridation as a public health measure, J. Can. Dent. Assoc. 38 (1972) 446-448. 

G.N. Pakhomov, K. Ivanova, I.J. Moller, M. Vrabcheva, Dental caries-reducing effects of a milk fluoridation project in Bulgaria, J. Public Health Dent. 55 (1995) 234-237. 

Formerly, the administration of fluoridated milk to children was considered to be a suitable means of increasing their intake of fluoride however, little quantitative information is available on the efficacy of this delivery system in the prevention of dental caries [17]. Encouraging results have been reported with milk fluoridation however, Twetman [139] recently commented that there is still a dearth of studies providing high-quality evidence of its effects. 

The fluoride content of human milk i.s slightly under 0.01 mg/liter (0.5 iiAi), Milk fluoride levels are not much influenced by changes in dietary intake, even though plasma levels may vary widely. The fluoride content of cow milk is usually under 0.05 mg/liter. Commercially available milk-based and soy-based formulas contain 0.13 to 0.30 mg F/litcr. The recommended upper limit in infant formulas is 0.4 mg F/liter. 

The enrichment program followed in the United States is (/) the enrichment of flour, bread, and degerminated and white rice using thiamin [59-43-8] C 2H y N O S, riboflavin [83-88-5] C2yH2QN4Na02P, niacin [59-67-6] CgH N02, and iron [7439-89-6]-, (2) the retention or restoration of thiamin, riboflavin, niacin, and iron in processed food cereals (J) the addition of vitamin D [67-97-0] to milk, fluid skimmed milk, and nonfat dry milk (4) the addition of vitamin A [68-26-8], C2qH2qO, to margarine, fluid skimmed milk, and nonfat dry milk (5) the addition of iodine [7553-56-2] to table salt and (6) the addition of fluoride [16984-48-8] to areas in which the water supply has a low fluoride content (74). 

Dabeka RW, McKenzie AD. 1987. Lead, cadmium, and fluoride levels in market milk and infant formulas in Canada. J Assoc Off Anal Chem 7 754-775. 

CCP in milk is mentioned in connection with casein above (Section VI.C). Fluorapatite is a major constituent of phosphate rocks, and a constituent, probably important, of human tooth enamel for those whose drinking water contains significant amounts of naturally occurring or added fluoride. Fluorapatite is significantly less soluble than hydroxyapatite - the relationship between the solubilities of fluorapatite and hydroxyapatite parallels (but is much less extreme than) that between calcium fluoride (Ksp — 3.9 x 10 11 mol3 dm-9) and calcium hydroxide (Ksp = 7.9 x 10 6 mol3 dm 9). Calcium diphosphate, Ca2P207, is believed to be the least soluble of the calcium phosphates. 

K.W. Stephen, I.T. Boyle, D. Campbell, S. McNee, P. Boyle, Five-year double-blind fluoridated milk study in Scotland, Commun. Dent. Oral Epidemiol. 12 (1984) 223-229. 

Z. Toth, Z. Gintner, J. Banoczy, P.C. Phillips, The effect of fluoridated milk on human dental enamel in an in vitro demineralization model. Caries Res. 31 (1997) 212-215. 

J. Pratten, R. Bedi, M. Wilson, An in vitro study of the effect of fluoridated milk on oral bacterial biofilms, Appl. Environ. Microbiol. 66 (2000) 1720-1723. 

Fluoride in diet, fluoride supplements, dental products and fluoridated salt and milk... 

Because of the low natural levels of fluoride in some water supplies and correspondingly high levels of dental caries, many authorities worldwide have permitted, or instigated, fluoridation of water supplies, although this has met some opposition, partly because of the potential health or dental effects including fluorosis. In order to prevent dental caries, fluoride is deliberately added to salt or milk in some countries. 

The fluoride content of human breast milk usually follows the natural daily fluoride intake during the first 6 months of life. This is especially important when comparing the daily fluoride intake by formula-fed and breastfed infants. In humans, fluoride is poorly transferred from plasma to breast milk [88,89]. A wide range (2-50 pg/L) of fluoride in breast milk has been reported [88-90], although considerably higher levels, exceeding 200 pg/L, have also been reported [91]. The wide range of concentrations reported in human milk can apparently be ascribed to analytical problems at low levels of fluoride. 

FLUORIDE IN DIET, FLUORIDE SUPPLEMENTS, DENTAL PRODUCTS AND FLUORIDATED SALT AND MILK... 

Drinking water, beverages and dental products containing fluoride are regarded as the main contributors to oral fluoride intake in humans. Food has, more recently, been recognized as a possible important source of fluoride intake. In some countries, fluoride is added to salt and milk. 

The concentration of fluoride in human milk generally ranges from 2 to 50 pg/L [88-91], The concentration in milk of cows fed with a normal diet was 0.103 mg/L and 0.283 mg/L in those fed on contaminated pastures [123]. 

The concentrations of fluoride in ready-to-feed formulas in the United States and Canada range from 0.1 to 0.3 mg/L while the fluoride concentrations of powdered or liquid-concentrate infant formulas depend mainly on the concentration of fluoride in the water used to reconstitute the product [8], A study on the concentration of fluoride in infant formula reconstituted with water in Australia revealed concentrations from 0.031 to 0.532 mg/L of fluoride for formulas reconstituted with water not containing fluoride, 0.131 to 0.632 mg/L of fluoride for formulas reconstituted with water containing 0.1 mg/L of fluoride and 1.031 to 1.532 mg/L if formulas were reconstituted with water containing 1.1 mg/L of fluoride [124]. Concentrations of fluoride in 10 samples of powdered milk formulas in Brazil ranged from 0.01 to 0.75 mg/L for those prepared with deionized water, from 0.02 to 1.37 mg/L for those prepared with bottled mineral water containing... 

Intake of fluoride of breastfed infants, that are not included in this table, are usually negligible, because fluoride is poorly transferred from plasma to breast milk [88,89],... 

K. Trautner, J. Einwag, Influence of milk and food on fluoride bioavailability from NaF and Na2FP03 in man, J. Dent. Res. 68 (1989) 72-77. 

C.J. Spak, J. Ekstrand, D. Zylberstein, Bioavailability of fluoride added to baby formula and milk. Carles Res. 16 (1982) 249-256. 

J. Ekstrand, M. Ehrnebo, Influence of milk products on fluoride bioavailability in man, Eur. J. Clin. Pharmacol. 16 (1979) 211-215. 

C.J. Spak, L.l. Hardell, P. De Chateau, Fluoride in human milk, Acta Paediatr. Scand. 72(1983) 699-701. 

S. Twetman, T. Nederfors, L.G. Petersson, Fluoride concentration in whole saliva and separate gland secretions in schoolchildren after intake of fluoridated milk. Caries Res. 32 (1998) 412-416. 

O. Backer Dirks, J.M.P.A. Jongeling-Eijndhoven, T.D. Flissebaalje, I. Gedalia, Total and free ionic fluoride in human and cows milk as determined by gas-liquid-chroma-tography and fluoride electrode. Caries Res. 8 (1974) 181-186. 

S. Twetman, Fluoridated milk may be beneficial to schoolchildren by helping prevent caries, Evid. Based Dent. 6 (2005) 88. 

S. Esala, E. Vuori, L. Niinisto, Determination of nanogram amounts of fluorine in breast milk by ashing-diffusion method and the fluoride electrode, Mikrochim. Acta I (1983) 155-165. 

Acid phosphomonoesterase (EC 3.1.3.2). Milk contains an acid phosphatase which has a pH optimum at 4.0 and is very heat stable (LTLT pasteurization causes only 10-20% inactivation and 30 min at 88°C is required for full inactivation). Denaturation of acid phosphatase under UHT conditions follows first-order kinetics. When heated in milk at pH 6.7, the enzyme retains significant activity following HTST pasteurization but does not survive in-bottle sterilization or UHT treatment. The enzyme is not activated by Mg2+ (as is alkaline phosphatase), but it is slightly activated by Mn2+ and is very effectively inhibited by fluoride. The level of acid phosphatase activity in milk is only about 2% that of alkaline phosphatase activity reaches a sharp maximum 5-6 days post-partum, then decreases and remains at a low level to the end of lactation. 

Milk acid phosphatase has been purified to homogeneity by various forms of chromaotgraphy, including affinity chromatography purification up to 40 000-fold has been claimed. The enzyme shows broad specificity on phosphate esters, including the phosphoseryl residues of casein. It has a molecular mass of about 42 kDa and an isoelectric point of 7.9. Many forms of inorganic phosphate are competitive inhibitors, while fluoride is a powerful non-competitive inhibitor. The enzyme is a glycoprotein and its amino acid composition is known. Milk acid phosphatase shows some similarity to the phosphoprotein phosphatase of spleen but differs from it in a number of characteristics. 

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