Interview with Maiko Suzuki
Maiko Suzuki is a professor at Ohio University whose research deals with specifically how fluorosis manifests in the teeth. We contacted her and asked if she was interested in participating in a short Skype interview. She was immensely helpful in specifically understanding how fluorosis occurs. We asked her a few questions, and here are the summaries of her responses:
1. How does excess fluoride exposure interact with cells to cause fluorosis?
I think fluoride diffuses into cells. In an acidic environment surrounding cells, approximately 25-fold more HF is formed at pH 6.0 as compared to pH 7.4. The low pH environment facilitates the entry of toxic HF into ameloblasts to enhance fluoride-induced cell stress. Acid promotes the conversion of fluoride into highly toxic HF that can easily penetrate the cell membrane.
2. How does dental fluorosis manifest in the enamel?
Enamel fluorosis is enamel developmental disorder. Fluoride causes dental fluorosis against only children, not adults. Mineral content is reduced and higher protein content compared to normal enamel. Tooth is mottled discolored and porous and more susceptible to decay. Color is changed to chalky white. Compared to normal enamel, enamel hardness is reduced and more susceptible to decay.
3. How do cells protect themselves from stress induced by excess fluoride?
We demonstrated fluoride induces an adaptive response. We found fluoride activates Sirtuin 1 as an adaptive response against fluoride-induced oxidative stress. Fluoride increased reactive oxygen species, ROS and ROS causes oxidative damage such as DNA damage and mitochondrial damage, but simultaneously, ROS activates SIRT1 to protect cells against fluoride-induced DNA damage and apoptosis. But this adaptive response caused by fluoride itself during enamel development is not enough to protect cells, so, eventually it results in ameloblasts impairment.
Following our interview with Maiko Suzuki, we created a short educational video to showcase the information we learned about fluorosis.