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PATIENT CARE III EXAM 2 > fluoride > Flashcards

fluoride Flashcards

1
Q
  1. Hardest and most mineralized tissue in the body
  2. Outer covering of enamel is made up of calcium and phosphate
A

enamel

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2
Q
  1. Layer of tooth structure that is directly underneath the enamel
    and is positioned around the pulp
  2. Less mineralized than enamel, but more mineralized than bone or
    cementum
A

dentin

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3
Q

soft layer of a tooth that contains nerves, blood vessels, and
connective tissue

A

pulp

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4
Q

Acids diffuse into tooth and dissolve calcium & phosphate minerals

A

demineralization

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5
Q

If acid attacks are infrequent/short duration, saliva aids in repair of
damage by neutralizing acid and replacing minerals and fluoride
lost from tooth

A

remineralization

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6
Q

If flow of saliva is low and bacterial level is high, tooth mineral lost by
acid attacks are too great for repair by remineralization, thus
resulting in carie

A

resulting in caries

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7
Q

pathologic factors associated with caries

A
  1. Acid-producing bacteria (S. mutans)
  2. Low salivary flow (due to salivary gland
    dysfunction, mouth-breathing, medications,
    etc.)
  3. Carbohydrates in diet (i.e., Pasta,
    cereal, bread, crackers, sugar)
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8
Q

protective factors associated with caries

A
  1. Minerals in saliva (calcium, phosphate,
    fluoride, proteins)
  2. Normal salivary flow
  3. Antibacterial agents (if needed)
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9
Q
  1. Untreated caries present in more than ___ adults
  2. Disproportionately distributed among those of lower socioeconomic
    status1
A

1 in 5 adults

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10
Q

_____% of pediatric population has caries present in primary dentition2
___% of pediatric population has caries present in permanent dentition2
Caries is most prevalent in ethnic minority groups from lower income families

A

10%

<3%

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11
Q
  1. a natural inorganic occurring mineral
  2. Naturally present at low concentrations in most fresh and
    saltwater sources
  3. Either the fluorine ion (F-) or a compound containing fluoride
    (NaF)
  4. In the correct concentrations can decrease the likelihood of
    dental caries
A

fluoride

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12
Q

fluoride aids in _____and decreases the risk of carious lesions by up to 25%

A

remineralization

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13
Q

fluoride is _____to caries prevention- NOT solution

A

supplement

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14
Q

ingested agents delivered to the oral cavity via the bloodstream:
1
2
3

A

systemic application

  1. water
  2. supplements
  3. food/beverage
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15
Q

strengthen teeth already in the mouth making them more resistant to caries:
1
2
3

A

topical application
1. water
2. homecare products (toothpaste, mouth rinses, etc)
3. in-office products

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16
Q

Fluoride inhibits _______ when present in solution (mouth
rinse, toothpaste, etc.)

A

demineralization

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17
Q

Fluoride present on tooth surfaces and in plaque fluid inhibits acid
demineralization by:
(interferes with acid-production of bacteria)

A

reducing the solubility of the tooth mineral

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18
Q

Fluoride enhances _____ and accelerates remin
process by absorbing into tooth surfaces and attracting calcium
ions

A

remineralization

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19
Q

Fluoride ions incorporate into remin tooth structures that result in
the development of _______ which are less soluble
than original enamel and make remin lesions less susceptible to
future demin

A

fluorapatite crystals

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20
Q

-Community water fluoridation
-School water fluoridation
-Fluoride supplements
-Foods containing fluoride
-Salt

A

systemic fluoride

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21
Q

Fluoride is incorporated into the mineralizing structure during

A

tooth development

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22
Q

Fluoride present in ____ enhances mineralization of enamel
during enamel maturation phase

A

saliva

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23
Q

An increase of the natural fluoride level in a community’s
water supply to a

A

level optimal for dental health

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24
Q

considered one of the most cost-effective
preventive dental program by public health

A

water fluoridation is

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25
Q

benefits of water fluoridation

____% decrease in caries in primary dentition
___% decrease in children permanent dentition
about ___% decrease in coronal caries and ____% decrease in root caries in adult population

A

30-39%
35%
20-30%
20-40%

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26
Q

levels of water fluoridation
optimal =
optimal range=

A

minimal caries with minimal fluorisis

range= 0.6-1.2ppm

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27
Q

.7ppm decreases caries with _____% of population with fluorsis

A

<10%

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28
Q

how does topical fluoride work?

A

Fluoride deposited in enamel during enamel
maturation phase results in a concentration
of fluoride in the enamel

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29
Q

highest concentration of fluoride occurs on the

A

outermost portion and decreases as you move toward the dentin

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30
Q

Fluoride ions are substituted into the
_______ and form a stable,
more compact bond making the tooth
resistant to demineralization

A

hydroxyapatite crystal

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31
Q

fluoride (does/does not)

A

does not

32
Q

fluoride/enamel reaction to fluoride is influenced by

A

concentration of fluoride, pH, and fluoride, and length of exposure

33
Q

acidic fluorides typically form

A

calcium fluoride

34
Q

higher concentrations of fluoride form

A

calcium fluoride

35
Q

3 benefits of topical fluoride

A
  1. remineralization
  2. interferes with bacterial metabolism
  3. prevention
36
Q

3 types of topical fluoride applications

A
  1. 2% neutral sodium fluoride (9000ppm)
  2. 1.23% acidulated phosphate fluoride (APF) (12,300ppm)
  3. 5.0% NaF (22,600 ppm)
37
Q

available as a varnish application
commonly used in dental practices
what fluoride

A

5.0% NaF

38
Q

Available as a foam or
gel application
(rarely used in practice)

A

1.23% acidulated phosphate fluoride

39
Q

Available as a foam or gel
application
(rarely used in practice)

A

2% neutral sodium fluoride

40
Q

are initial deposits of fluoride permanent?

A

no
rapid loss after 24 hours
loss continues for several weeks

41
Q

after every application of topical fluoride, there is an ____in the amount of permanently bound fluoride in the outermost layer of enamel

A

increase
=decrease in caries susceptibility

42
Q

two types of fluoride

A
  1. fluorohydroxyaptite
  2. calcium fluoride
43
Q

most desired form of fluoride for enamel in caries prevention

A

fluorihydroxyaptite

44
Q

From prolonged exposure of
enamel to low concentrations of
fluoride

A

Fluorohydroxyapatite

45
Q

source of fluoride for
remineralization of enamel

A

calcium fluoride

46
Q

Deposits of calcium fluoride are
dissolved by plaque acids and are
available as a source to facilitate
remineralization

A

calcium fluoride

47
Q

benefits of topical fluoride treatments is directly related to

A

the amount of topical fluoride treatments provided

48
Q

does the type of topical fluoride system used affect the benefit?

A

no
does not benefit sound enamel
greater uptake with higher concen of fluoride

49
Q

when should topical fluoride be used

A
  1. High caries risk individuals
  2. Sensitive teeth/exposed root surfaces
  3. Around margins of older restorations
  4. Overdentures (with natural teeth)
  5. Xerostomia
  6. Newly erupted teeth
50
Q

probable toxic dose PTD based on:

A

body weight

considered to be 5mg F/kg of body weight

<5mg/kg: office use
>5mg: hospital observation
>15mg: ER

51
Q

concentrated fluoride salts can cause chemical burn when in contact with:

A

oral mucosa

-inhibits enzyme systems
-binds calcium
-cardiotoxic due to hyperkalemia

52
Q

signs and symptoms of too much fluoride

A

nausea
vomiting
diarrhea
abdominal cramping
increased salivation/dehydration

53
Q

pros of fluoride varnish 5% NaF

A
  1. proven efficacious in decreasing caries, especially in early childhood
  2. easy to apply following oral exam and prophylaxis
  3. easy to follow post-op instructions
54
Q

cons of fluoride varnish 5% NAF

A
  1. leaves a thin-visible film on teeth that some patients do not like
  2. possible allergies linked to specific brands of fluoride varnish
55
Q

application of fluoride varnish

A
  1. Applied to clean tooth surfaces (following a
    prophylaxis or toothbrushing)
  2. varnish is retained on teeth from 24-48 hours after application, during which time fluoride is released for reaction with the underlying enamel
  3. application should occur every 3-6 months (dependent upon caries risk)
56
Q

silver diamine fluoride

A

clear liquid composed on 24-29% silver and 5-6% fluoride

57
Q

silver diamine fluoride is considered alkaline at a pH level of

A

10

58
Q

silver contributes to antimicrobial effect and

A

fluoride remineralizes tooth structure

59
Q

silver diamine fluoride derives its effectiveness from

A

silver nitrate and fluoride

60
Q

silver diamine fluoride antibacterial action on cariogenic bacteria is by:

A

silver

61
Q

silver diamine fluoride Remineralization and inhibition of demineralization of
enamel and dentin
and
Inhibition of dentin collagen type 1 degradation
by

A

fluoride

62
Q

found to be most superior at arresting caries compared to
lower concentrations

A

38% SDF
(multiple applications found to be more successful at arresting than one-time placement

63
Q

SDF: Fluoride and silver are made soluble in water
by the addition of

A

ammonia

64
Q

in SDF, these damage and degrade bacterial cell walls,
disrupt bacterial DNA synthesis and
replication and disrupt intracellular
metabolic activity, eventually leading to cell
death

A

silver ions which act as tiny silver bullets

65
Q

The killed bacteria further act as a carrier for silver ions and can kill living bacteria nearby in a process known as the

A

“zombie effect”

66
Q

once SDF is applied, a physical barrier precipitates out of the clear solution onto the carious lesion.
2 products then form:

A
  1. silver phosphate (acts as a reservoir of phosphate ions
  2. calcium fluoride, which is a pH regulated fluoride supply available during cariogenic challenge
67
Q

once SDF is applied, free silver ions in the lesion are reduced by environmental oxygen and turn the lesion ____ which is the major nonmedical side effect of SDF

A

black

68
Q

5% SDF solution contains ____ppm fluoride which is almost twice as much as 5% NaF

A

44,800

69
Q

SDF reacts with calcium and phosphate ions to produce:
which are less susceptible to solubility and crucial to tooth remineralization

A

fluorohydroxyaptite crystals

70
Q

one application of SDF is not sufficient so

A

may need to place few time

71
Q

when to use SDF

A

dentin hypersensitivity
and
uncooperative patients, root surface caries on elderly pts with existing restorations

72
Q

placement of SDF

A
  1. dry tooth
  2. micro brush
  3. allow area to dry 1-3 mins then rinse
  4. caries will be arrested over time and turn black
  5. SDF has an unpleasant metallic taste
    DO NOT USE WITH SILVER ALLERGY OR PULPAL INVOLVEMENT
73
Q

this is not considered a therapeutic/preventive agent for caries

polishing alone removes .1-1.0 microns of fluoride-rich enamel, therefore at best this will replace the fluoride lost by abrasive paste

A

fluoridate prophy paste

74
Q

what fluoride rinse does

A
  1. remineralizes tooth structure
  2. strengthens enamel to prevent caries
  3. kills bad breath
75
Q

mi paste alone uses this to relieve tooth sens not to prevent decay

A

recaldent (milk derived)

76
Q

changes in appearance of enamel caused by too much systemic fluoride

A

fluorosis

77
Q

fluorosis will feel

A

smooth

PATIENT CARE III EXAM 2 (10 decks)

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