CHAPTER 34: FLOURIDES Flashcards by Steph Dimares

Fluoride is necessary for optimum oral health at all ages and is made available at the tooth surface by two general means:

SYSTEMICALLLY
( by way of the circulation to developing teeth. PRE ERUPTIVE)

TOPICALLY
(directly to the exposed surfaces of teeth erupted into the oral cavity1 (posteruptive exposure).

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Most flouride is absorbed within how many minutes?

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Fluoride that is not absorbed in the stomach will be absorbed by the__________

small intestine

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Approximately 99% of fluoride in the body is located where?

mineralized tissues

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Concentrations of fluoride are highest at the surfaces next to the ______ fluid supplying the fluoride.

tissue

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Most fluoride is excreted through the _______ in the urine, with a small amount excreted by the sweat glands and ____

feces

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Fluoride is deposited during the formation of the ____ , starting at the ______ junction, after the enamel matrix has been laid down by the ameloblasts.

enamel

dentinoenamel

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The hydroxyapatite crystalline structure becomes ________ , which is (less/more) soluble than apatite crystal.

flourapetite

less soluble

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a form of hypomineralization that results from systemic ingestion of an excess amount of fluoride during tooth development.

dental flourosis

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During mineralization, the enamel is highly receptive to ______ ions.

free flouride

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After mineralization is complete and (before/after) eruption, fluoride deposition continues in the surface of the enamel.

before

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After eruption and throughout the life span of the teeth, the concentration of fluoride on the outermost surface of the enamel is dependent on:

Daily topical sources of fluoride

to prevent demineralization and encourage remineralization for prevention of dental caries.

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Uptake is most rapid on the enamel surface during the____ years after _____

first

eruption

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Fluoride concentration is greatest on the surface next to the source of fluoride.

t or f

true

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Uptake of fluoride depends on the level of fluoride in the ___ _____and the length of time of exposure.

oral environment

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Demineralized enamel that has been remineralized in the presence of fluoride will have a _____ concentration of fluoride than sound enamel.

greater

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flouride level may be _____ in dentin than in enamel

greater

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newly formed dentin absorbs flouride slowly

t or f

false. it absorbs flouride rapidly

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The level of fluoride in cementum is ____ and _____ with exposure.

high

increases

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are reservoirs for fluoride; ___ carries minerals available for remineralization when needed.

saliva and biolfilm

saliva

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Fluoride enhances _______ forming a condensed layer on the crystal surface, which attracts _______ & _____ ions.

remineralization

phosphate & calcium

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Dental biofilm may contain __ -__ ppm fluoride. The content varies greatly and is constantly changing.

5-50ppm

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three basic topical effects of fluoride to prevent dental caries:

Inhibit demineralization.
Enhance remineralization of incipient lesions.
Inhibit bacterial activity by inhibiting enolase ( an enzyme needed by bacteria to metabolize carbohydrates.)

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an enzyme needed by bacteria to metabolize carbohydrates

enolase

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the adjustment of the natural fluoride ion content in a municipal water supply to the optimum physiologic concentration that will maximize caries prevention and limit enamel fluorosis.

flourodation

Early in the 20th century, Dr. McKay began his extensive studies to find the cause of “brown stain,” which later was called mottled enamel and now is known as ?

dental flourosis

level of fluoride in the water optimum for dental caries prevention averages _ ppm in moderate climates. Clinically objectionable dental fluorosis is associated with levels well over _ ppm.

1ppm 2ppm

recommendation for the optimal concentration of water fluoridation to __ ppm for all communities, regardless of climate.

0.7PPM

Compounds from which the fluoride ion is derived are naturally occurring and are mined in various parts of the world. Examples of common sources are :

fluorspar, cryolite, apatite.

Criteria for acceptance of a fluoride compound for fluoridation include:

- Solubility - Relatively inexpensive. - Readily available

Fluoridated water is a (systemic/topical) source of fluoride for developing teeth and a ____ source of fluoride on the surfaces of erupted teeth throughout life

systemic | topical

Estimates have shown the reduction in caries due to water fluoridation alone (factoring out other sources of topical fluoride) among adults of all ages is __%

27%

______ teeth, particularly maxillary, receive more protection from fluoride than do ______teeth. _____ teeth are contacted by the drinking water as it passes into the mouth.

ANTERIOR POSTERIOR ANTERIOR

The incidence of root caries is approximately __% less for lifelong residents of a fluoridated community

With fluoridation from birth, the caries incidence is reduced up to __% in the primary teeth.

Foods cooked in fluoridated water ____ fluoride from the cooking water.

RETAIN

Examples of foods that contain flouride

meat, eggs, veggies, cereals, fruit

Breast milk may contain ___ ppm fluoride, and all types of infant formula themselves contain a low amount of fluoride (0.11–0.57 ppm).

0.02ppm

when are flouride lozenges and tablets best taken

bedtime after teeth are brushed. avoid drinking,eating or rinsing before bed

liquid concentrate flouride is primary used for :

- Child aged 6 months - 3 years | - Patient of any age unable to use other forms that require chewing and swallowing

No more than ___ mg NaF (120 mg fluoride ion) to be dispensed per household at one time.

264

Administration of prenatal dietary fluoride supplements is recommended. true or false

false

The use of fluoride supplements in children over 6 years of age shows a ___% decrease in DMF tooth surfaces in permanent teeth compared to no fluoride supplements.

24%

Consider the child’s ___, _____ , and all sources of fluoride exposure before recommending the use of fluoride supplements.33

age | caries risk

5% NaF varnish at least every __-__ months (for all ages and adult root caries)

3-6 months

1.23% APF gel 4-minute trays at least every __-__, months (for 6 years and older and adult root caries)

3-6

may etch porcelain and composite restorative materials, so it is not indicated for patients with porcelain, composite restorations, and sealants.50

APF

is effective in reversing active pit and fissure enamel lesions in the primary dentition and remineralizing enamel lesions, regardless of whether it is applied over or around the demineralizing lesion.

varnish

how does applying professional topical flouride help our teeth?

1. prevention of dental caries 2. remineralization 3. desensitization (flouride aids in blocking dentinal tubules)

No more than _ mL of gel is placed in each tray for children, and no more than _ mL is placed in each tray for adults

2 | 5

only professional fluoride recommended for children under 6 y of age

Varnish Application (5% NaF)

after tray application patient instructions :

Instruct patients not to rinse, eat, drink, brush, or floss until at least 30 minutes after gel or foam applications.

after varnish application patient instructions:

avoid hot drinks and alcoholic beverages; eating hard, sticky, or crunchy foods; and brushing or flossing the teeth for 4–6 hours after application or until the next morning to allow fluoride uptake to continue undisturbed.

indications for using SDF (Silver diamine flouride)

- Extreme caries risk - Treatment challeneged by behavioural medical management - Diffucult to treat dental carious lesions - Patients with no access to dental care

Contraindications/relative contraindications to SDF

Allergy to silver | Pregnancy/breastfeeding

Concentrations of ____ ppm fluoride or less can be sold OTC. Some products containing less than ____ ppm of fluoride are available only by Rx.

1500

The three methods for self-application are by

tray rinsing toothbrushing

tray technique indications for use

Rampant enamel or root caries in persons of any age to prevent additional new carious lesions and promote remineralization around existing lesions.

refers to rapid intake of an excess dose over a short time.

acute toxicity

applies to long-term ingestion of fluoride in amounts that exceed the approved therapeutic levels.

chronic toxicity

isolated instances of osteosclerosis, an elevation in bone density, can result from chronic toxicity after long-term (10 years or more) ingestion of water with ___ ppm fluoride

8-10ppm

also called “neutral sodium fluoride” due to its neutral pH of __, contains 9,050 ppm fluoride ion.

NaF | 7.0

contains Low pH of 3.5 enhances fluoride uptake, which is greatest during the first 4 minutes.

1.23% APF gel

has a higher concentration of fluoride than gel or foam (__,___ ppm fluoride ion), but an overall less amount of fluoride is used per application

varnish | 22,600

Varnish is effective in reversing active pit and fissure enamel lesions in the ____ dentition and remineralizing enamel lesions, regardless of whether the varnish is applied over or around the demineralizing lesion.

primary

Varnish received approval from the U.S Food and Drug Administration (FDA) for use as a ___ _____ and for treatment of dentin hypersensitivity.

cavity liner

ph level of SDF

8-10