The Effect of Sodium Fluoride on Diabetic Wound Healing

Fluoride has significant effects on mineralized tissues, bone, and teeth, and fluoridated water and toothpaste have produced a great public health success in the reduction and prevention of dental caries. Another known fact is that impaired wound healing occurs in diabetic patients, for reasons that are still incompletely understood.

Objectives: In this study we investigated the effect of exogenous sodium fluoride (NaF) on the rate of wound healing of human diabetic gingival fibroblasts (HDGF) in an established in vitro model.

Methods: HDGF cells were isolated and cultured from diabetic patients. A 3 mm wound was created in confluent HDGF cultures. The cells were maintained in BioWhittaker UltraCULTURE medium containing 6% fetal bovine serum with 0 to 4800 ppm fluoride. The cells were stained on days 3, 6 and 9 with hematoxylin and eosin. The wound fill was measured microscopically using NIH Image Analysis.

Results: With 0, 600, 1200, 2400, 3600 and 4800 ppm of NaF, the wound fill on day 3 was 18.9%, 19.9%, 22.9%, , 19.7%, 18.2% and 19.5%, respectively; on day 6, the wound fill was 49.6%, 46.6%, 45.0%, 43.8%, 43.5% and 42.9% ; on day 9 the wound fill was 67.8%, 65.1%, 47.8%, 49.9%, 48.6% and 39.1% , respectively. NaF doses of 1200 ppm or above reduced the percentage of wound fill by day 9 in statistically significant fashion (P< 0.05). Commercially available toothpastes contain 1500 or 2400 ppm NaF.

Conclusions: These results suggest that long term use of toothpaste containing 1200 ppm or more NaF may delay wound healing in diabetic patients.