Cariology Duraphat

Question 1

Justify the use of Duraphat compared with other fluoride varnishes

Answer 1

In a meta-analysis, it was found through pooled estimates that Duraphat:

• Results in 43% less DMFS, compared with APF 28%
• Results in 37% less demf (primary teeth)

Question 2

Justify the safety of Duraphat compared with other fluoride varnishes
- Mention the toxic dose

Answer 2

• Toxic dose: 5mg/ kg
• If swallowed, it generally have a blood plasma level that is the same as 1000 ppm toothpaste due to the fact that even through the fluoride concentration is higher, it less bio-available than gels, foams or liquids (slow release)
• In comparison, if an APF gel is swallowed, blood plasma levels are 5 x more than 1000 ppm (more volatile than Duraphat, that is why we use Duraphat instead)

Question 3

State the amount of fluoride in Duraphat

Answer 3

• 22600 ppm

Question 4

Describe why Fluoride varnish should be applied on sound homologous tooth surfaces

Answer 4

• The evidence shows that between 10%- 34%of clinical lesions may not show on a radiograph particularly for at risk patients
• Carious lesions on surfaces were significantly associated with lesions developing on the contra-lateral surface and the corresponding surface on the opposing jaw
• If we treat the 16, we will also treat the 26, 36 and 46

Question 5

State the clinical contraindications for Durphat

Answer 5

DURAPHAT 
• Allergy to colophony 
• Severe asthma 
• Ulcerative gingivitis or stomatitis 
• Sensitive tummies (may experience nausea)

Question 6

State the clinical contraindications for MI varnish

Answer 6

MI varnish (CPP-ACP)
• Caesin (milk protein allergies)
• Ulcerative ginigivitis or stomatitis