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Manganese is required for the synthesis of the mucopolysaccharides of cartilage, glucose utilisation, steroid biosynthesis and for the activity of pyruvate carboxylase. It is bound to arginase of the liver and activates many enzymes.
Sodium fluoride is indicated for the prevention of dental caries in adolescents and adults, particularly amongst patients at risk from multiple caries (coronal and/or root caries). The primary mode of the caries preventative action of fluoride is post-eruptive, i.e topical action. Systemic fluoride supplements are believed also to act mainly topically (i.e during ingestion, via saliva).
Selenium is an essential trace element. In human, selenium compounds are glutathione peroxidase and a selenium protein P found in the plasma. Deficiency of selenium has been associated with an endemic form of cardiomyopathy, Keshan disease and with Kaschin-Beck disease, an endemic osteoarthropathy which causes a severe deformity of the joints.