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BDS3 OSCE > Fluoride > Flashcards

Fluoride Flashcards

1
Q

What are the different concentrations for fluoride toothpaste

A

1000ppm

1450ppm

2800ppm

5000ppm

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2
Q

What is the concentration of fluoride varnish

A

22600pmp

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3
Q

What is the concentration of fluoride mouthwash

A

225 ppm

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4
Q

What is the concentrations of fluoride tablets

A

1mg

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5
Q

What is the concentration of SDF

A

44,800ppm

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6
Q

What are the functions of fluoride

A
  • Fluoride is incorporated into enamel crystal to form fluorapitite which is more caries resistant than hydroxyapatite
  • Has bacteriocidal properties
  • Interferes with the adhesion forces of bacteria reducing their ability to stick to the surface of teeth
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7
Q

Who is 1000ppm fluoride toothpaste suitable for

A

<3 years

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8
Q

How much toothpaste should <3 YO use

A

smear

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9
Q

Who should be using 1450ppm toothpaste

A
  • standard risk adults
  • 4-16 year olds who are standard risk
  • high risk <10s
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10
Q

Who can be prescribed 2800ppm toothpaste

A

high risk >10 YO

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11
Q

Who can be prescribed 5000ppm toothpaste

A

high risk >16 year olds

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12
Q

Who can be prescribed 5000ppm toothpaste

A

high risk >16 year olds

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13
Q

How often and to who should fluoride varnish be given

A
  • Topical fluoride should be applied to dentition at least twice yearly for pre-school children deemed at being high risk of caries
  • Fluoride varnish can be administered for high risk adult
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14
Q

Who shouldn’t be given fluoride mouthwash

A
  • Not recommended for children under the age of 6
  • Always assess child’s ability to properly exporate
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15
Q

What dose of toothpaste would give a probable toxic dose

A
  • 5mg/kg bodyweight
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16
Q

What is intervention for fluoride overdose dependant on

A

how much toothpaste was ingested

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17
Q

If less than 5mg/kg was ingested, what should the intervention be

A
  • give calcium orally (milk) and observe for a few hours
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18
Q

If 5-15mg/kg was ingested, what should the intervention be?

A
  • If 5-15 mg/kg ingested → give calcium orally (milk, calcium gluconate, calcium lactate) and admit to hospital
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19
Q

If >15mg/kg is ingested, what should the intervention be

A
  • admit to hospital immediately, cardiac monitoring and life support, intravenous calcium gluconate
20
Q

What should you not do to someone with suspected fluoride overdose

A

induce vomiting

risk of aspiration

21
Q

What does SDF stand for

A

Silver diamine fluoride

22
Q

What is SDF

A
  • liquid substance used to help prevent tooth cavities (or caries) from forming, growing, or spreading to other teeth.
23
Q

What is SDF

A

liquid substance used to prevent tooth cavities or caries from forming/growing/spreading to other teeth

24
Q

Who is the manufacturer of SDF in the UK

A

riva star

25
Q

What is the function of potassium iodide in SDF

A

reduces staining

26
Q

What is SDF made of

A
  • silver
  • water
  • fluoride
  • ammonia
27
Q

What is the function of the silver in SDF

A
  • helps kill bacteria
28
Q

What is the function of water in SDF

A
  • Provides a liquid base for the mixture
29
Q

What is the function of fluoride in SDF

A
  • Helps your teeth rebuild the materials they’re made of (known as remineralisation)
30
Q

What is the function of ammonia in SDF

A

Helps the solution remain concentrated so that it is maximally effective against cavity resonance

31
Q

What colour does SDF turn caries

A

black

may temporarily stain soft tissues brown for 1-3 weeks

32
Q

What is a rare side effect of SDF to the gingiva

A
  • Rarely, it can cause a chemical burn to the gingivae
33
Q

What are indications for SDF

A
  • Asymptomatic cavitated dentine carious lesions in primary teeth
  • Lesions that can be made cleansable
  • Dentinal lesions that are non-restorable
  • Root surface caries
  • Promoting the arrest and remineralisation of active carious lesions
  • Active dentinal lesions
  • Pre-cooperative children
  • Permanent teeth with MIH (blocking dentinal tubules may reduce sensitivity)
34
Q

What are contraindications of SDF

A
  • Signs/symptoms of irreversible pulpitis, or dental abscess or sinus
  • Radiographic peri-radicular radiolucency or signs of pulpal involvement
  • Infection/pain from pulpal origin or food packing
  • Allergy to any ingredient inclusive of silver and other heavy metals
  • Active ulceration, mucositis or stomatitis
  • Pregnant or breastfeeding
  • Patients undergoing thyroid gland therapy or on thyroid medication (if potassium iodide used)
35
Q

What is the clinical procedure for SDF

A

Apply petroleum jelly to the soft tissues including the lips if possible

Protect the gingiva using petroleum jelly and cotton wool rolls or Riva Star gingival barrier

  • Ensure teeth are clean and free of debris
  • Dry teeth using a cotton wool roll or gauze
  • Use the silver brush or another micro-brush to pierce the silver capsule
  • Carefully apply the solution from the silver capsule (silver diamine fluoride) to the treatment site with the silver brush, a micro brush or other single use applicator. This should be left to dry for at least 1 minute, ideally 3 minutes.
  • If a decision has been made with the family to use potassium iodide then follow 7
  • 7a) pierce the foil of the green capsule
  • 7b) apply solution from green capsule (potassium iodide) to treatment site, with the green brush, a micro brush or other single use applicator. Continue application until the creamy white solution present on the lesion turns clean
  • Blot teeth dry using a cotton wool roll, gauze or fresh single use micro-brush
  • Remove gingival barrier if used
36
Q

When would a patient be followed up after application of SDF

A

2-4 weeks after first application

37
Q

How do you know if the SDF has arrested caries

A
  • hard, darkened lesion.
38
Q

What is the function of fluoride varnish

A
  • Slows down the development of decay by stopping demineralization
  • Makes enamel more resistance to acid attack and speeds up remineralization – bonds with calcium and phosphate to create fluorapatite
  • Can stop bacterial metabolism at high concentrations to produce less acid
39
Q

How would you describe fluoride varnish to parents

A
  • Provides extra protection against tooth decay when used in addition to brushing
  • Pale yellow gel that sets quickly when applied to childrens teeth using a soft brush
40
Q

What is the max amounts of applications for fluoride varnish

A

4 times a year

41
Q

What are contraindications for fluoride varnish

A
  • Allergy to colophony
  • Hospitalized with severe asthma in past 12 months
  • Ulcerative gingivitis
  • Residual varnish is visible
  • Child has had varnish applied in the past 24 hours
42
Q

What ml of fluoride varnish should be used for children that are in < P1

A

0.25

43
Q

What ml of fluoride varnish should be used for children >P2

A

0.4ml

44
Q

What is the aftercare for fluoride varnish

A
  • Eat soft foods for rest of the day to reduce chewing
  • Children should not brush their teeth that evening but should continue to brush twice a day with fluoride toothpaste from the following morning (this is debatable - clinicians would probably disagree but this is whats on childsmile)
45
Q

What is resin fissure sealant made from

A
  • bis-GMA with dimethacrylaet monomer to make the sealant easy to flow

BDS3 OSCE (65 decks)

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