7 - Community based fluoride delivery Flashcards
Is topical or systemic fluoride more effective?
- topical is agreed to be more effective
- systemic is ineffective and passive
How does fluoride prevent caries?
- promotes remineralisation
- fluroapatite is formed and is less susceptible to demineralisation
- fluoride affects bacterial metabolic pathways which reduces the amount of acid produced
Describe the oral reservoir for fluoride.
- small
- fluoride from toothbrushing disappears quickly
- two types, mineral deposits (FAP) and biologically bound calcium fluoride
What are examples of community fluoride therapy?
- water fluoridation
- school based brushing
- varnish
- (salt, milk, tablets, rinsing)
What are practice based fluoride therapies?
- varnish
- gel/foam
- slow release
What are home based fluoride therapies?
- toothpaste
- mouth rinse
- (tablets)
What are the benefits of salt fluoridation?
- choice
- passive delivery
What are the disadvantages of salt fluoridation?
Risk of CV disease
What are the advantages of fluoridated milk?
- natural healthy drink
- important part of children’s diet
What are the disadvantages of fluoridated milk?
- distribution delayed until school
- not all children drink milk
- increased cost
When are fluoride tablets or drops used?
- at risk children over 6 years
- those with additional needs/special care requirements
- carries a fluorosis risk
What are the advantages of fluoridated mouthwashes?
- commonly available
- daily rinsing more effective than stronger weekly rinsing
- good compliance
What are acidulated mouth rinses?
- mouth rinse with low pH
- stimulates mild demineralisation on surface
- allows fluoride to get into teeth
- fluoride is more bioavailable due to low pH
What are APFs?
- acidulated phosphate fluoride gels
- professionally applied with fluoride conc of 12,300ppm
- require special equipment to apply (including trays)
- uncommon
What is duraphat?
- fluoride varnish with conc of 22,600ppm
- sustained contact due to resin setting on teeth, slow release of fluoride and calcium fluoride to tooth surface
- professionally applied
How often is duraphat applied?
- 4x yearly for at risk
- 2x yearly for standard
What factors impact the efficacy of fluoride toothpaste?
- concentration
- frequency of application
- rinsing behaviours
- when brushing occurs
How does fluoride concentration affect caries reduction?
- increased conc decreases caries
- 6-7% reduction for every 500ppm
How does frequency of toothbrushing affect caries reduction?
More frequent brushing reduces caries
How does rinsing behaviour affect caries reduction?
- rinsing after brushing teeth increases caries
- rinsing removes the fluoride on the surface of the tooth and remove the protective barrier it provides
What are optimal brushing habits?
- twice daily
- no rinsing
- 1500ppm toothpaste
What is the advice on toothbrushing for pre-school children?
- 1500ppm
- smear of toothpaste
- parental supervision and help
What are the risks of fluoride use?
- fluorosis of teeth (mottled enamel)
- acute toxicity if ingested
- chronic toxicity (fluorosis)
