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Oral Micro #1 > #4 Fluoride and Dental Caries > Flashcards

#4 Fluoride and Dental Caries Flashcards

1
Q

In the U.S, when was the effect of fluoride noted?

A

1930s’

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2
Q

What is the downside of fluoride?

A

Fluorosis when swallowed

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3
Q

What causes fluorosis?

A

Ingesting excess fluoride during the (secretory) pre-eruptive stage of teeth. *concern with children b/c little fluoride is incorporated not the enamel during the pre-eruptive maturation phase.

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4
Q

During the secretory stage, ameloblasts do what?

A

Lay down the protein matrix fro the rod crystal structurre and the rods begin to form.

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5
Q

During the pre-eruptive maturation stage the ameloblasts do what?

A

Fill in the crystal structure with mineral.

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6
Q

What are the symptoms of Fluorosis?

A
  • Disruptions in crystal formation that appear chalky white.
  • Weak enamel
  • Fractures in the weakened enamel
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7
Q

Does fluoride make the body of the tooth strong?

A

No! It just strengthens the outer layer of enamel.

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8
Q

Why are topical products lower risk than water fluorination?

A

Because less fluoride is ingested.

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9
Q

What level of Fluoride is safe to ingest?

A

None technically

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10
Q

What is the percentage composition of enamel?

A

87% mineral (hydroxyapatite)
11% water
2% organic matrix

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11
Q

What is post-eruptive enamel maturation?

A

A process in which the impurities in newly formed teeth (Carbonate, sodium, other ions) are perfected as it is exposed to calcium and phosphate in the salvia as well as fluoride.

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12
Q

In post-eruptive enamel maturation what materials are replaced with what?

A
  • Phosphate replaces carbonate
  • Calcium replaces sodium
  • Fluoride replaces hydroxyl
  • These replacements make hydroxyapatite less soluble and therefore, stronger.
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13
Q

Hydroxyapatite dissolves if pH drops below ______.

A
  1. 5 * the lower it goes the more it dissolves

- Acids remove component ions from hydroxy apatite and leaves the structure unsaturated and weaker.

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14
Q

What occurs when fluoride is present under acids conditions?

A

Hydroxyapatite dissolves and re-precipitates as Fluorhydroxyapatite (what doesn’t kill you makes you stronger!)

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15
Q

The pH must be above _____ for fluoride to be available?

A

above 4.5

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16
Q

When pH rises above ______ Fluoride ions enhance remineralization of enamel and dentin.

A

above 5.5

17
Q

_______ causes dissolution of enamel.

A

Lactic acid

18
Q

T or F, white spot lesions are always low in fluoride.

A

False, they can be high in floured because of demin-remin cycles. In fact they usually contain higher surface level of F than surround areas.

19
Q

How is it possible that you can end up with a hard stable surface layer of enamel and a demineralized subsurface zone?

A

Subsurface hydroxyapatite is dissolved while fluorhyrdoxyapatite is formed on the surface.

20
Q

Areas covered by plaque have ______ levels of fluoride.

A

Higher

21
Q

Worn area, of abrasion or erosion have ___ levels of Fluoride.

A

Lower

22
Q

When topical fluoride concentrations are low (50ppm) where is fluorhydroxyapatite formed?

A

on the outermost layers of enamel

23
Q

When topical fluoride conc. are high (above 100ppm) what occurs?

A

calcium fluoride precipitates and acid helps with he deposition of calcium fluoride, because calcium ions are made available *APF deposits more F than NaF)

24
Q

CaF2 deposition is increased by what 4 things?

A
  1. increasing F concentration
  2. Increasing exposure time
  3. lowering pH
  4. Protecting-limit rinsing or cover with varnish
25
Q

Saliva is supersaturated with ____ and _____ so teeth don’t dissolve.

A

Calcium and Phosphate

26
Q

Mild fluorosis is perceived cosmetically attractive to most people.

A

Because teeth are slightly whiter

27
Q

What teeth are at greatest risk to F during development?

A

Max. central incisors

28
Q

What is the formula for fluoride exposure?

A

Kg (bodyweight) x 0.1mg/kg

29
Q

What antibacterial benefits does fluoride have?

A
  • F binds to sites that would normally bind OH and inhibits enzymes and regulatory proteins
  • Bacteria do not develop a resistance to F
  • Inhibition of annuals well documented
  • Does not have inhibitory effects at higher pH so does not affect growth of bacteria at normal pH.
30
Q

What ppm F is regular toothpaste?

A

about 1000 ppm

31
Q

What conc. of F requires a prescription?

A

anything over 1000 ppm *5000ppm toothpaste Rx available

32
Q

_______ is the only variety compatible with chalk based formula.

A

MFP

33
Q

______ requires more expensive silica based formula.

A

NaF2

34
Q

What is the ppm of OTC fluoride rinse?

A

200 ppm *toothpaste is better! 25% reduction in caries

35
Q

2.2% F and 40% reduction in caries

A

Fluoride varnish

36
Q

1.23% acidulated phosphate fluoride, 0.9% F and 30% reduction of caries

A

Fluoride gel and foam

Oral Micro #1 (12 decks)

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