Flouride and Prevention Flashcards
Fluoride in nature
pale, yellow paste, widely distributed in nature and in our bodies
Sources of fluoride
Seafood (fish, clams, lobster, crab), tea, dry intact cereal,chicken products, artesian or deep wells, fresh surface water, seawater
Fluorine
chemical element
Where F is absorbed
80-95% in upper GIT and transported in plasma
**HE said he doesn’t like questions on numbers!!!
% absorbed in first 30 min
40%-95%
**HE said he doesn’t like questions on numbers!!!
F ingested on an empty stomach F produces a peak _____ level within ____ min/hours?
plasma in 30 min
F binds with ____ and other ______ and _____ _____
Calcium, divalent and trivalent cations
5mg F is cleared in ______
8-9 hours
F is deposited in ____
calcified tissues such as bone, teeth
F poisoning
accidental or intentional ingestion of F containing products
Elevated levels of F –>
chronic F toxicity
F handling is regulated by _____ and in the marketplace by the _____
Occupational Safety Health Legislation and FDA
Probable toxic dose (PTD)
defined as the minimum does that could cause toxic signs and symptoms, including death
Emergency Rx for F toxicity (immediate and non)
milk or milk and egg
vomitting
oral calcium of aluminum
maintenance of blood calcium with intravenous calcium
Emergency F overdose (less than 5mg)
give calcium orally (milk) and observe for a few hours
induced vomitting is not necessary
more than 5mg F overdose
ER room-pump stomach- not with downs or mental retardation tho
give oral calcium
F more than 15mg overdose
hospital immediately-induce vomitting
Cardiac monitoring; observe peak T waves and watch for shock
F therapies
F gel, foam, and varnish
F supplements
Salt F
Milk F
Post eruptive mechanism of action of F
promotes remineralization of enamel, inhibits demin of early carious lesion, inhibits glycolysis in which sugar is converted to acid by cariogenic bacteria
Pre eruptive mechanism of action of F
improves enamel crystallinity, reduces enamel solubility in acid, improves tooth morphology
Topical F
applied directly to and absorbed by the surface of the teeth
-can be home gel, dentrifice, mouth rinse, professional, or water
Systemic F
taken into the body by consuming products containing F
-water, dietary, dentrifice,dietary supplement
% of toothpastes which are F
79-90% in US
**HE said he doesn’t like questions on numbers!!!
how F in toothpaste is taken up
by dental plaque directly and demineralized tissue
brushing with F toothpaste increases the F concentration in salvia _______ fold and return to baseline in ______
100-1,000 fold and returns to baseline in 1-2 hours
**HE said he doesn’t like questions on numbers!!!
F toothpaste reduces caries in children by _____ in a 2-3 yr study
15-30%
**HE said he doesn’t like questions on numbers!!!
most common therapeutic agent in dentrifice
F
two forms of F toothpaste
prescription and nonprescription
Greater benefit of F TP when used with ____
F water
use of F TP 3 times a day?
unclear, use at least 2x
FT with 1500ppm of F is contraindicated for
children less than 6 yrs
F mouthrinse was developed for
daily or weekly use for children
____ is most commonly used b/c it lowers cost and better taste
NaF
daily use mouthrinse concentration
- 05% (230ppm) available as OTC for >6yrs
* KNOW THIS
weekly use mouthrinse concentration
.20% (920ppm), weekly use school based program
*KNOW THIS
____% caries reduction in children over 2-3 yrs
20-35%
F uptake in acidic environment
increases
F gel is ___ in pH
low (acidic)
Prevents decalcification beneath orthodontic bands
F varnish
can bill medicaid for F varnish?
yeah- and covered on insurances
a single app of F varnish increases enamel F by __%
77
F does what to thermal and tactile pain
reduces
varnish will set on contact with
saliva
Can kids eat after F varnish?
yeah
Do you brush a kids teeth after F varnish?
not that night, the next day
halo effect
consider all sources of F of a patient
F supplementation ______ recommended for prenatal use
NOT recommended-NO evidence!
KNOW THIS
F supplements benefit in elderly
not proven but probably
Prescribe F for prenatal?
NO
age 6-16 consuming water with ____ F in water
> 0.6
recommend F for 3-6, and 6-16 if water is below ___ F
0.3-0.6 or <0.3
3-6yr old with <0.3 water F give how much F in mg/day
.5mg
F salt not recommended for persons at risk of
hypertension
when F salt is taken in F is released from ____ all day
plasma
evidence of F salt??
not RCT or clinical trials
Milk F?
Not common or very supported
Cost effectiveness of F modalities (high and low risk)
not well supported but cost effective for persons at high caries risk
target mouthrinsing to persons at ____
high risk
Apply ____ concentration F to persons at _____ risk for caries
high
Supervise use of F among children for children around and under what age
~6
Use an alternative source of water for children aged _____ years whose primary drinking water contains >__ ppm F
<8 yrs and contains >2ppm
