fluoride

Question 1

how does fluoride make the enamel apatite less soluble?

Answer 1

becomes incorporated as fluoroapatie = less sol

displaces carbon and magnesium ions = improves crystalline structure and reduces solubility

Question 2

how does F have an effect on enamel remineralisation after acid attack?

Answer 2

reduced the more soluble carbonate of enamel = less sol
releases F ions after acid attack from enamel into saliva = favours remineralisation
accumulates in early carious lesions at concs high enough to reduce solubility

Question 3

how does fluoride affect the morphology of teeth when ingested during tooth development?

Answer 3

wider fissures
more rounded cusps
enamel and dentine thinner

Question 4

F is an enzyme inhibitor and has an effect on plaque metabolism how?

Answer 4

binding to plaque bacteria at high concentrations

inhibiting metabolic pathways so demineralising acids are not formed

Question 5

F absorbed where?
stored where?
excreted from where?
what is a partial barrier to F?

Answer 5

stomach
skeletal tissue
via kidneys/sweat/faeces
placenta

Question 6

dosage of F tablets/drops?

Answer 6

0,25 mg - 6m-3yrs
0.5mg - 3-6yrs
1mg - over 6 yrs

Question 7

what effects can F have on skeletal tissue? over 8 ppm regular intake

Answer 7

skeletal fluorosis - increase in bone density and increased thickness of long bones
calcification of ligaments

Question 8

what is fluorosis?

Answer 8

excess fluoride causing distrurbance of enamel matrix and calcification and impaired ameloblastic function

Question 9

child under 3 years what ppmF toothpaste?

Answer 9

no less than 1000

Question 10

at what ages should parental supervision whilst brushing cease?

Answer 10

7

Question 11

what did Dr Frederick McKay find in 1901?

Answer 11

colorado mottling stain - fluoridated water

Question 12

what is the issue with carbonated portions of HA?

Answer 12

weak struture

suscpetible to acid erosion

Question 13

what is the conc of daily F mw?

Answer 13

0.05%

Question 14

what is the conc of weekly F mw?

Answer 14

0.2%

Question 15

what is the critical pH of Fluoroapatite?

Answer 15

4.5 = larger drop in pH needed to cause disolution

Question 16

what did Dr Trendley Dean do in 1934?

Answer 16

21 cities

high f in water = less caries

Question 17

what is the Strathclyde case?

Answer 17

1978 - catherine mccoll - lord jauncey

claims fluoridated water was against informed consent

Question 18

on what 4 grounds was F in water banned?

Answer 18

beyond powers
nuisance
breach of water act
medicinal product with no lisence

Question 19

what did the 1980 Knox report conclude?

Answer 19

Fluoride at 1ppm not mutagenic but theraputic

Question 20

for what age is duraphat 2800 recommended for?

Answer 20

10 and over

Question 21

for what age is duraphat 5000 recommended for?

Answer 21

over 16’s

Question 22

what happened in oregan state hospital?

Answer 22

fluoride given instead of powdered milk
236 died
47 injured

Question 23

how should F tablets be given?

Answer 23

sucked in sulcus to give topical and systemic effects

Question 24

how much does 1g of 1500ppmF toothpaste have of fluoride?

Answer 24

1.5mg

Question 25

what is the adult toxic fluoride dose?

Answer 25

5-10g

Question 26

what is the child toxic fluoride dose?

Answer 26

over 5g

Question 27

what bulk sweetner has synergistic effects with fluoride?

Answer 27

xylitol

Question 28

how to work out if child at risk of F toxicity?

Answer 28

body weight x 5g = x

how much toothpaste have they consumed?

Question 29

from birth to 6 months how should a child look after their teeth?

Answer 29

soft tb
smear of tp
1000ppmF

Question 30

how should a toddler brush their teeth?

Answer 30

smear and soft tb

1000-1500ppmF

Question 31

what is the conc of duraphat varnish?

Answer 31

22600ppmF

Question 32

children (under 7) giving concern - high risk/disabled - should be given what advice e.g cleaning/F?

Answer 32

pea size 1350-1500ppmF, fluoride varnish applied 3-4 times a year, tablets and drops