Fluroides In Caries Prevention

Question 1

What are anti caries action of fluoride?

Answer 1

1. Topical effect
   - promotes remineralisation
   - inhibits demineralisation
   - inhibits bacterial metabolism when concentrated
2. Little systemic benefits

Question 2

How is fluoride metabolised?

Answer 2

It’s absorbed quickly in the stomach, when there is food the absorption is slower
E.g. milk and calcium product bind to fluoride and reduce absorption

90% absorbed 10% excreted

Question 3

What organs removes Fluoride?

Answer 3

Excreted via kidneys

Question 4

What are risks of fluoride usage?

Answer 4

1. Actuate toxicity
2. Chronic toxicity (fluorosis)
   Risk are associated with children shallowing fluoride

Question 5

What is acute toxicity?

Answer 5

Very rare but can be lethal
- only effects very young (1 year - 3)
Causes:
1. Nausea
2. Vomiting
3. Respiratory and cardiac depression l
4. Sometimes coma

Question 6

How to manage acute toxicity?

Answer 6

Need to be admitted to emergency hospital
Giving milk can slow down the absorption of fluoride into the body

Question 7

How to prevent acute toxicity

Answer 7

• Ensure you use correct dosage of fluoride toothpaste for children
• keep toothpaste away from childrens reach

Question 8

What is chronic toxicity?

Answer 8

• Dental fluorosis
• At risk at age 6-7
  This is when the child is exposed to excess ingested fluoride during tooth formation

Question 9

What are the symptoms of chronic toxicity?

Answer 9

• Change in tooth appearance
  but this is only relevant at 6 or younger

Question 10

How to prevent fluorosis ?

Answer 10

Keep fluoride products out of reach from small children
Adults should supervise children brushing
Encourage spitting not swallowing
Brush after meals this slows down absorption of fluoride

Question 11

When is sodium fluoride 2800 ppm fluoride toothpaste used?

Answer 11

When there is high dental caries risk for patient over 10
Patient with dental caries
When patient have a highly cariogenic diet or medication

Question 12

When is 5000ppm sodium fluoride toothpaste used?

Answer 12

• High dental caries risk patient ages 16+
• patient with root or coronal caries
• when this are medical risk factors e.g. dry mouth
• Pateint who are receiving head and neck radiotherapy or chemotherapy

Question 13

When is fluoride varnish used?

Answer 13

Applied twice a year by dentist to reduce dental caries
Applied before removing gross plaque

Question 14

What should fluoride mouthwash be used?

Answer 14

Used for patients aged 8 or over
- has 230ppm of Fluoride
Should be used at a different time to toothbrushing to increases topical effect

Question 15

What ppm fluoride toothpaste should be Prescribed for a 10+ patient?

Answer 15

2800ppm sodium fluoride toothpaste

Question 16

What ppm fluoride toothpaste should be prescribed for 16+ patients?

Answer 16

5000ppm sodium fluoride toothpaste
Used for dry mouth …

Question 17

When can patients use fluoride mouthwash?

Answer 17

8+, has a 230ppm fluoride concentration

Question 18

What ppm fluoride toothpaste should a 2+ old use?

Answer 18

1000ppm fluoride but only a small pea sized amount

Question 19

What ppm fluoride toothpaste should a 6+ child use?

Answer 19

1450ppm, a pea sized amount

Question 20

When should fluoride varnish be applied?

Answer 20

Easiest to do after surgery, done 2 times a year ideally