Fluoride

Question 1

what are the main sources of fluoride ?

Answer 1

salts, all natural water, human body, fish, tea

Question 2

what is the concentration of fluoride in sea water ?

Answer 2

1.3 ppm

Question 3

what concentration of fluoride in water offers caries protection but does not cause dental fluorosis ?

Answer 3

1.0 ppm / 1Mg/L

Question 4

what is the mechanism of action of fluoride ?

Answer 4

fluoride incorporated into hydroxyapetite in replace of OH- ions

Question 5

what are the pre-eruptive effects of fluoride ?

Answer 5

enamel less susceptible to acid effects

Question 6

what are the post-eruptive effects of fluoride ?

Answer 6

interferes with mechanism of plaque forming bacteria,

enhanced mineralisation of enamel

Question 7

what methods of fluoride delivery are given at an individual level ?

Answer 7

toothpaste, gels, tablets/drops, mouth rinses, varnish

Question 8

what methods of fluoride delivery are given at population level ?

Answer 8

milk, slat, water

Question 9

what are the advantages of population interventions ?

Answer 9

more cost effective, don’t require personnel, reduce inequalities, more universal coverage

Question 10

what is the simplest method of fluoride delivery ?

Answer 10

toothpastes

Question 11

what are the pros and cons of toothpastes as a method of fluoride delivery ?

Answer 11

pros -
easy, effective, freedom of choice
cons -
expense, risk of overdose

Question 12

what initiative has been proven to reduce caries in the population ?

Answer 12

toothpaste distribution schemes

Question 13

what are the pros and cons of fluoride gels as a method of fluoride delivery ?

Answer 13

pros -
effective, freedom of choice, useful in children at high risk
cons - compliance needed, access

Question 14

what are the pros and cons of tablets/drops as a method of fluoride delivery ?

Answer 14

pros -
40-50% reduction in caries experience, freedom of choice
cons -
compliance needed, risk of overdose, fluorosis

Question 15

what are the pros and cons of mouth rinses as a method of fluoride delivery ?

Answer 15

pros -
effective even in combination with toothpaste and water,
freedom of choice
cons -
compliance, risk of overdose, young children cannot rinse

Question 16

what are the pros and cons of fluoride varnish as a method of fluoride delivery ?

Answer 16

pros -
effective, freedom of choice
cons -
compliance, access

Question 17

what are the advantages of fluoridated milk as a method of fluoride delivery ?

Answer 17

evidence insufficient to confirm effectiveness,
school based intervention not consistent,
relies on positive consent,
untested in community settings

Question 18

what is the advantage of fluoridated milk ?

Answer 18

safe

Question 19

what are the pros and cons of fluoridated salt ?

Answer 19

pros -
caries protective effect as good as water fluoridation, freedom of choice
cons -
conflicts with general health message to consume less salt

Question 20

what is the definition of water fluoridation ?

Answer 20

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

Question 21

what are the findings of systematic reviews of the effects of water fluoridation ?

Answer 21

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

Question 22

what percentage of the adult population can be protected from caries in the adult population ?

Answer 22

27%

Question 23

what is dental fluorosis ?

Answer 23

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

Question 24

what is the prevalence of fluorosis ?

Answer 24

3 % in fluoridated areas, 0.5 % in non fluoridated areas

Question 25

what can be done to remedy the increase in prevalence of fluorosis in fluoridated areas ?

Answer 25

use low concentration fluoride toothpaste

Question 26

which areas of the UK are fluoridated ?

Answer 26

west midlands and north east england, | 10% of population - 60 million people

Question 27

what does the UK law state about water fluoridation ?

Answer 27

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

Question 28

what is the public opinion of water fluoridation ?

Answer 28

omnibus survey 2003 - 43 % adults think they have fluoridated water already, 63 % think it should be added if it prevents tooth decay

Question 29

Way are the details of the amendment made to the water industry act clause 58 in 2003?

Answer 29

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

Question 30

What are the issues with water fluoridation ?

Answer 30

Adverse health effects Environmental effects Civil liberties