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DEN2025 - Dental Public Health and Behavioural Science > Fluorides and Fissure Sealants > Flashcards

Fluorides and Fissure Sealants Flashcards

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1
Q

What is the most common childhood disease worldwide?

A

Dental caries

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2
Q

What does prevention of dental caries depend on?

A

Control of dietary sugar

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3
Q

What 2 things can improve ease of prevention of dental caries?

A
  1. Optimal levels of fluoride is orally available

2. Good salivary function

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4
Q

How does fluoride facilitate the easier prevention of caries?

A

Fluoride promotes remineralisation and prevents demineralisation of tooth surface by exerting a topical effect at tooth surface promoting uptake of calcium and phosphate ions

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5
Q

What can occur if excess fluoride is consumed during period of tooth formation?

A
  • White spots to severe defects of enamel can occur
  • Excess fluoride interferes with secretion and maturation of dental enamel of the crown
  • Can cause fluorosis
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6
Q

Describe the fluoridation of toothpaste

A
  • Added largely in 1970s
  • Widespread introduction
  • Use of fluoride toothpastes led to significant improvements in child dental health
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7
Q

What studies were carried out by Cochrane in 2003 with regards to fluoride?

A

International evidence synthesis of clinical benefit of fluoride toothpastes

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8
Q

What was the main outcome of the Cochrane studies in 2003?

A

The effect of fluoride toothpaste increased with higher baseline DMFS values and supervised brushing

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9
Q

What studies were carried out by Cochrane in 2019 with regards to fluoride?

A

International evidence synthesis on benefits of different strengths of fluoride toothpaste

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10
Q

Describe the 3 main outcomes of the Cochrane studies in 2019

A
  • In permanent teeth of children and adolescents, less new decay was found as strength of fluoride increased
  • In permanent teeth of adults 1000 ppm toothpaste reduced decay
  • PHE recommended children use fluoridated toothpaste containing no less than 1000 ppm fluoride
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11
Q

Name 4 advantages of fluoridating toothpastes for community prevention of caries

A
  1. Accepted as routine part of personal hygiene
  2. Relatively low cost
  3. No need for specialists
  4. Higher strength fluoride can be prescribed for high risk adults
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12
Q

Name 2 disadvantages of fluoridating toothpastes for community prevention of caries

A
  1. Cost barrier

2. Needs to be used twice daily every day for maximum benefit

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13
Q

Describe Colorado Brown Stain

A
  • 1915
  • Local dentist in USA reported defects on teeth and low caries
  • Excess fluoride in drinking water
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14
Q

Describe Trendly Dean’s discovery in 1933

A

When fluoride was at 1 ppm, prevalence of caries was low and fluorosis was mild

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15
Q

Describe the fluoride related experiment in Grand Rapids, Michigan

A
  • 1945
  • First town to have level of fluoride in water artificially adjusted to 1ppm
  • Nearby city of Muskegon acted as control
  • In 6 years, caries reduced by 50% in Grand Rapids
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16
Q

From 2000, how has the attitude to water fluoridation changes in Europe?

A
  • Many reviews on safety and effectiveness
  • No new schemes in Europe with some reversals
  • Cochrane Review (2015) raised doubts on quality and age of studies supporting water fluoridation
17
Q

What are 4 advantages of water fluoridation for community prevention of caries?

A
  1. Reaches all communities
  2. Passive prevention
  3. Low cost per person
  4. Potential to reduce health inequalities
18
Q

What are 3 disadvantages of water fluoridation for community prevention of caries?

A
  1. Environmental opposition on a matter of personal freedom
  2. Based on systemic need than topical mechanism of fluoride
  3. As fluoride toothpastes are now widely used, potential for over-consumption
19
Q

How may fluoride be administered other than in toothpastes and water?

A

Fluoride varnishes

20
Q

Describe the application and effectiveness of fluoride varnishes

A
  • Application 2-4 times per year
  • Caries preventive effect
  • 2.2% NaF used
21
Q

Name 2 programmes which are made up partly of fluoride varnishes

A
  1. Childsmile (Scotland)

2. Designed to Smile (Wales)

22
Q

What is NICE guidance and PHE recommendation on fluoride varnish?

A

Used in children aged 3 years and older at high caries risk

23
Q

What are 3 advantages of fluoride varnish use for community prevention of caries?

A
  1. Easy to apply
  2. Well accepted
  3. Relatively low cost for use in community programmes
24
Q

What are 2 disadvantages of fluoride varnish use for community prevention of caries?

A
  1. High risk individual or population strategy needs professional application twice a year
  2. Does not address underlying causes of caries
25
Q

What is the recommendation for fluoride mouth rinses?

A

High caries risk individuals on a personal basis at home

26
Q

What is important in the use of fluoride mouth rinses to ensure optimal benefit?

A

The mouth rinse should be used at a different time of the day from toothbrushing

27
Q

What is used as the active ingredient in fluoride mouth rinses?

A

0.2% NaF solution

28
Q

Describe the fluoridation of milk

A
  • Large schemes in Russia, China, Chile and Thailand
  • No clinical trials have been conducted
  • Little data is available to reliably measure efficacy
29
Q

What are fissure sealants?

A

Provide a physical barrier across fissures of teeth to prevent accumulation of cariogenic plaque biofilm

30
Q

When should fissure sealants be applied to be most effective?

A

Applied soon after eruption of first permanent molars

31
Q

What 2 types of patients are fissure sealants recommended for?

A
  1. Individual prevention

2. Used in community caries prevention programmes for children in UK

32
Q

What are 2 advantages of fissure sealant use for community prevention of caries?

A
  1. Fluoride methods are most effective on smooth surfaces

2. Cost-effective in community programmes when applied by trained dental nurses

33
Q

What are 3 disadvantages of fissure sealant use for community prevention of caries?

A
  1. Needs careful application with good moisture control
  2. Professional is needed to apply
  3. Needs good co-operation from a child
34
Q

Name 2 influences in choosing community strategies for caries prevention

A
  1. Best clinical evidence

2. Budgets available (practical considerations)

DEN2025 - Dental Public Health and Behavioural Science (25 decks)

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