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Pediatrics Oral Micro > Fluoride and caries > Flashcards

Fluoride and caries Flashcards

1
Q

in 1930 fluoride levels in drinking water was noted for what

A

fluorosis was related to F in drinking water and F was associated with reduced caries rates

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2
Q

what is the ideal concentration of F to maximize caries benefits and minimize fluorosis

A

F at 1 ppm! reduced caries by 50%!

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3
Q

what lays down enamel

A

ameloblasts

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4
Q

what happens during secretory stage of ameloblasts

A

ameloblasts lay down protein matrix and rods begin to form

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5
Q

what happens during pre eruptive stage (maturation stage) of ameloblasts

A

maturation stage= ameloblasts fill in crystal structure with mineral

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6
Q

during the secretory stage high levels of F can do what

A

high levels of F during secretory stage causes pitting and disturbances in form

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7
Q

what happens during the maturation stage when moderately high levels of F are present

A

maturation stage + high levels of F = chalky whiteness and weakness of enamel causing possible fracture and stain after eruption

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8
Q

how much F is incorporated into the enamel during the pre eruptive stage

A

very little F put into enamel during maturation stage

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9
Q

before tooth eruption does F water provide a benefit?

A

NO benefit of F water before tooth eruption

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10
Q

in order for benefits to continue what must happen

A

fluoridation must continue throughout life

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11
Q

will people benefit from fluoridation after teeth have erupted?

A

YES

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12
Q

What has impacted reduced caries rate in addition to F water?

A

topical products like toothpaste!

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13
Q

what are the effects of water fluoridation?

A

water fluoridation = topical effects

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14
Q

what increases fluorosis

A

INGESTION of F

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15
Q

topical products or systemic supplements which one provides a lower risk

A

TOPICAL products = lower risks

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16
Q

who do we systemically supplement with F

A

HIGH risk children, but policies are not in line with evidence

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17
Q

Enamel composition

A

87% HA
11% water
2% organic

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18
Q

what do newly formed crystals in a young tooth usually have?

A

Impurities such as carbonate, sodium, other ions

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19
Q

what is post eruptive enamel maturation

A

the replacement of carbonate with phosphate, replacement of sodium w calcium, and replacement of hydroxyl with F through the bathing of saliva that has been exposed to F

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20
Q

what does post eruptive maturation do to enamel

A

makes HA less soluble and this enamel stronger

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21
Q

what teeth are more susceptible to caries?

A

young teeth, post eruptive maturation strengthens teeth over time

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22
Q

when does HA crystals dissolve?

A

when pH drops below 5.5

the lower the pH the more demineralization occurs

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23
Q

What does F ions do?

A

F prevents dissolving of Ca ions, under acidic conditions HA dissolves and reprecipitates as F-HA

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24
Q

what is less soluble thus stronger? HA or F-HA

A

F-HA is stronger and less soluble

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25
Q

what does the pH needs to remain above for F-HA to form when HA dissolves from subsurface

A

F-HA needs pH above 4.5!! and F must be available

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26
Q

when pH rises above 5.5 what happens

A

F ions enhance remineralization of enamel and dentin

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27
Q

presence of F at ____ levels in solution is more ____ than ____ concentrations incorporated into enamel

A

presence of F at low levels in solution is more beneficial than high concentrations incorporated into enamel

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28
Q

outer enamel (surface) has more what and less what?

A

surface enamel has more F-HA and less carbonate

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29
Q

does F diffuse well into the body of a lesion?

A

NO F will react with outer layers first to form F-HA

30
Q

what happens during demineralization?

A

subsurface HA is dissolved while surface F-HA is formed leaving a demineralized subsurface and a thin enamel shell

31
Q

white spot lesions usually have what compared to surrounding enamel areas?

A

white spot lesions have very HIGH F concentrations

32
Q

areas covered by plaque have what

A

plaque covered enamel has HIGH F levels

33
Q

worn areas from abrasion and erosion have what levels of F

A

worn areas= low levels of F

34
Q

when does F-Ha form on the surfaces of enamel

A

when topical F concentrations are 50 ppm or lower

35
Q

what happens when topical F concentrations are 100 ppm or higher?

A

CaF2 precipitates, acid helps with deposition of CaF bc Ca ions are available

36
Q

what happens on the surface, in crevices, and in plaque to F

A

spherical globules precipitate

37
Q

what 3 factors increase CaF2 deposition

A

INC concentration of F
INC exposure time
low pH

38
Q

what protects from CaF2 deposition

A

limit rinsing or covering with varnish

39
Q

what prevents teeth from dissolving

A

supersaturation of saliva with Ca and P

40
Q

why don’t HA crystal continue to grow?

A

Bc salivary pellicle proteins coat the enamel such as Tyrosine proteins, statherin, and proline proteins

41
Q

what prevents spontaneous precipitation in salivary ducts?

A

salivary pellicle proteins

42
Q

what does plaque do

A

Prevents access of saliva to enamel surface

43
Q

what leads to calculus formation

A

high concentrations of Ca and P

44
Q

when can fluorosis occur

A

During TEETH DEVELOPMENT

45
Q

F concentration on teeth highest where

A

F highest on tooth surface decent on topical exposure

46
Q

is exposure during tooth development a major determinant of F levels in enamel?

A

NO!!

47
Q

what is fluorosis

A

Fluorosis is an increase in enamel porosity that appears chalky white

48
Q

when does brown discoloration occur to teeth

A

post eruptively due to staining and browning of exposed proteins

49
Q

Fluorosis severity and incidence is correlated with what

A

amount of F exposure

50
Q

is there a threshold which will cause now fluorosis below that threshold?

A

NO low levels of F a certain level of fluorosis occurs

51
Q

what is seen as attractive by most?

A

mild fluorosis

52
Q

what teeth have the greatest risk of fluorosis and when?

A

Upper central incisors from 15-30 months

53
Q

How does F play a role in antimicrobial effects?

A

F binds to sites that would normally bind to OH and inhibits enzymes and regulatory proteins

54
Q

Do bacteria develop resistance to F?

A

NOO bacterial resistance to F

55
Q

What does F do to enolase to prevent acid production?

A

F inhibits enolase

56
Q

when is F most effective against glycolysis

A

at low pH

57
Q

how does F affect the ecology of biofilms?

A

reduces enrichment of acid tolerant species

58
Q

does F have affect bacteria at normal pH?

A

No! F has no inhibitory effects at higher pH

59
Q

what is the most productive way to distribute F?

A

Community based water Fluoridation

60
Q

Self applied F

A

topical, high freq low concentration and systemic supplements

61
Q

professionally applied

A

low freq, high concentration topical

62
Q

when is optimum benefit of F observed?

A

during acid challenge

63
Q

Toothpaste F concentration

A

1000 ppm F (.1 or .15%)

64
Q

NaF2 and SnF2 have equal or different effectiveness and concentrations of F

A

both are equally effective and equally concentrated with F

65
Q

what is not compatible with chalk based formulas?

A

NaF2 need silica based for NaF2

66
Q

what is compatible with chalk based formulas?

A

MFP

67
Q

Rx toothpaste has what concentration of F

A

5000 ppm

68
Q

is there a relationship between amount of toothpaste and caries

A

NO. amount doesn’t matter concentration is the important

69
Q

what is important with toothpaste and brushing?

A

Frequency! twice a day best!

70
Q

rinse or no rinse better?

A

NO RINSE best!

71
Q

safe amounts for preschool children?

A

pea sized dab

72
Q

OTC F rinse concentration and effectiveness

A

.02% F (200 ppm)

25% reduction in caries

Pediatrics Oral Micro (9 decks)

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