Fluoride Toothpaste and SUS-Brazil: Analysis of toothpastes purchased and distributed across the 26 municipalities of the Piracicaba Health Region (DRS-X)

• Grant number: 23/14794-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2024
• End date: September 30, 2025
• Field of knowledge: Health Sciences - Dentistry - Social and Preventive Dentistry
• Principal Investigator: Antônio Pedro Ricomini Filho
• Grantee: Luísa Batista Cavalcante Ribeiro
• Host Institution: Faculdade de Odontologia de Piracicaba (FOP). Universidade Estadual de Campinas (UNICAMP). Piracicaba , SP, Brazil

Abstract

In Brazil, most toothpastes are formulated containing calcium carbonate (CaCO3) as an abrasive and sodium monofluorophosphate (Na2FPO3; MFP) as an active ingredient against cavities. This formulation has a low cost and is often acquired through tenders by the Unified Health System (SUS) and distributed to the population. However, over time, the MFP ion undergoes hydrolysis, and the fluoride binds to the abrasive, losing its anti-cavity effectiveness. Resolution 530 of the National Health Surveillance Agency (ANVISA) of 08/04/2021, limits the maximum amount of fluoride in toothpastes to 1,500 ppm F (mg F/kg), but does not specify the minimum level of soluble fluoride necessary for throughout the product's validity. To have an anti-cavity effect, a minimum of 1,000 ppm soluble F is recommended, however, many toothpastes distributed by the SUS do not meet this recommendation. Studies have revealed deficiencies in the concentration of fluoride in products distributed by the SUS, which compromises the control of cavities in the population. Therefore, the objective of this study will be to obtain and evaluate the concentration of total fluoride (TF) and total soluble fluoride (TSF) of fluoridated toothpastes purchased and distributed throughout the 26 municipalities of the Piracicaba Health Region (DRS-X). The project intends to obtain donations of samples of toothpastes distributed by the SUS from the 26 municipalities in the region, as well as the respective bidding notices, in order to analyze the formulations and the concentration of soluble fluoride present. After collection, the toothpastes will be coded, and their information will be organized in a table. The concentrations of total fluoride (TF), total soluble fluoride (FST), ionic fluoride (IF) and insoluble fluoride (Fins) will be analyzed together with two control toothpastes. The samples will be subjected to analysis using an ion-specific electrode coupled to an ion analyzer. Calibration standards with varying fluoride concentrations will be used to verify the precision and accuracy of the analysis. After analyzing the samples, reports will be prepared and made available to managers in each municipality. The data obtained will be analyzed in a descriptive way, being presented at national and international conferences, disseminated to health managers, discussed in undergraduate and postgraduate classes, as well as presented to society through digital media. The data obtained will also be presented to the Ministry of Health and ANVISA.