Fluoride Flashcards
what are the main sources of fluoride ?
salts, all natural water, human body, fish, tea
what is the concentration of fluoride in sea water ?
1.3 ppm
what concentration of fluoride in water offers caries protection but does not cause dental fluorosis ?
1.0 ppm / 1Mg/L
what is the mechanism of action of fluoride ?
fluoride incorporated into hydroxyapetite in replace of OH- ions
what are the pre-eruptive effects of fluoride ?
enamel less susceptible to acid effects
what are the post-eruptive effects of fluoride ?
interferes with mechanism of plaque forming bacteria,
enhanced mineralisation of enamel
what methods of fluoride delivery are given at an individual level ?
toothpaste, gels, tablets/drops, mouth rinses, varnish
what methods of fluoride delivery are given at population level ?
milk, slat, water
what are the advantages of population interventions ?
more cost effective, don’t require personnel, reduce inequalities, more universal coverage
what is the simplest method of fluoride delivery ?
toothpastes
what are the pros and cons of toothpastes as a method of fluoride delivery ?
pros -
easy, effective, freedom of choice
cons -
expense, risk of overdose
what initiative has been proven to reduce caries in the population ?
toothpaste distribution schemes
what are the pros and cons of fluoride gels as a method of fluoride delivery ?
pros -
effective, freedom of choice, useful in children at high risk
cons - compliance needed, access
what are the pros and cons of tablets/drops as a method of fluoride delivery ?
pros -
40-50% reduction in caries experience, freedom of choice
cons -
compliance needed, risk of overdose, fluorosis
what are the pros and cons of mouth rinses as a method of fluoride delivery ?
pros -
effective even in combination with toothpaste and water,
freedom of choice
cons -
compliance, risk of overdose, young children cannot rinse
what are the pros and cons of fluoride varnish as a method of fluoride delivery ?
pros -
effective, freedom of choice
cons -
compliance, access
what are the advantages of fluoridated milk as a method of fluoride delivery ?
evidence insufficient to confirm effectiveness,
school based intervention not consistent,
relies on positive consent,
untested in community settings
what is the advantage of fluoridated milk ?
safe
what are the pros and cons of fluoridated salt ?
pros -
caries protective effect as good as water fluoridation, freedom of choice
cons -
conflicts with general health message to consume less salt
what is the definition of water fluoridation ?
the controlled addition of a fluoride compound to a public water supply in order to bring the fluoride concentration up to a level that effectively prevents dental decay
what are the findings of systematic reviews of the effects of water fluoridation ?
increases proportion of children without tooth decay by 15%,
children in fluoridated areas have 2.25 fewer teeth affected by decay
fluorosis of aesthetic concern 12.5 %
no association with bone fracture or cancer incidence
what percentage of the adult population can be protected from caries in the adult population ?
27%
what is dental fluorosis ?
mottling of enamel caused by uptake of excessive fluoride during tooth development 18-36 months of age i.e. duration of development of permanent incisors
what is the prevalence of fluorosis ?
3 % in fluoridated areas, 0.5 % in non fluoridated areas
what can be done to remedy the increase in prevalence of fluorosis in fluoridated areas ?
use low concentration fluoride toothpaste
which areas of the UK are fluoridated ?
west midlands and north east england,
10% of population - 60 million people
what does the UK law state about water fluoridation ?
water fluoridation act 1985, replaced by 1991 water industry act - clause 58 stated no obligation of water companies to fluoridate
amendment of water fluoridation act clause 58 in 2003 stated companied must fluoridate if requested to do so by relevant authorities
what is the public opinion of water fluoridation ?
omnibus survey 2003 - 43 % adults think they have fluoridated water already, 63 % think it should be added if it prevents tooth decay
Way are the details of the amendment made to the water industry act clause 58 in 2003?
Local public consultation to be organised by SHA
Indemnity of water companies arranged by Secretary of State for health
Relevant authorities to meet capital and operating costs
Review of dental health every 4 years
What are the issues with water fluoridation ?
Adverse health effects
Environmental effects
Civil liberties
