High-concentration Fluoride Toothpastes

Question 1

Do requests for high-concentration fluoride toothpastes require a counselling room?

Answer 1

No

Question 2

What is 1 red flags for referral with requests for high-concentration fluoride toothpastes require a counselling room?

Answer 2

1. Clinical need for high-concentration fluoride toothpaste not confirmed by a registered dental practitioner or medical practitioner

Question 3

Does high-concentration fluoride toothpaste have a PSA self-care card?

Answer 3

No

Question 4

What are the directions for high-concentration fluoride toothpaste?

Answer 4

Used in the same way as other commercially available toothpastes: Apply a pea-sized amount of toothpaste to the head of a soft toothbrush. Brush teeth for approximately 2 minutes. Spit out excess toothpaste. Avoid eating, drinking or rinsing out the mouth for 30 minutes (children may be advised to rinse their mouth). Brushing should be repeated twice a day, unless otherwise directed by a dental or medical practitioner. Continue using until dental or medical practitioner decides patient is no longer at high risk of dental caries, then they can resume using a lower-concentration fluoride toothpaste.

Question 5

How should high concentration fluoride toothpastes be used in children under 10?

Answer 5

Younger children often cannot brush their teeth without significant swallowing. If used in a child <10 years, a small, pea-sized amount should be used. Brushing should be done under parental supervision, emphasizing the expectoration of the paste slurry.

Question 6

Is high concentration fluoride toothpaste safe in pregnancy?

Answer 6

Yes (provided toothpaste is not ingested)

Question 7

Is high concentration fluoride toothpaste safe in breastfeeding?

Answer 7

Yes (provided toothpaste is not ingested)

Question 8

What is the age range for high concentration fluoride toothpaste?

Answer 8

Safe in children over 10 years (can be used in younger children on the advice of a dental or medical practitioner)

Question 9

What are 7 pieces of non-pharmacological advice for high concentration fluoride toothpastes?

Answer 9

1. Fluoride mouth rinses should be used at a time of day when toothpaste is not used, and must not be used as a substitute for brushing with fluoride-containing toothpaste. After rinsing, the mouth rinse should be spat out, not swallowed.
2. The preventive plan may also include:
3. dietary changes (e.g. reducing sugar consumption and frequency of snacking)
4. addressing poor salivary flow (e.g. using saliva substitutes, reviewing medicines that may be contributing to hyposalivation)
5. People at high risk of dental caries should be encouraged to visit their dental practitioner:
6. for review every 3 to 6 months, or as advised by the dental practitioner
7. at the first sign of decay (e.g. ‘white spots’—an early decay lesion that can be healed if risk factors are addressed)

Question 10

What is High-concentration fluoride toothpaste indicated for?

Answer 10

Use in people at high risk of dental caries as part of a caries preventive regimen.

Question 11

What are 8 risk factors for dental caries?

Answer 11

1. inadequate salivary flow or quality
2. having a high number of cariogenic oral bacteria
3. receding gums
4. poor oral hygiene
5. frequent consumption of sugar-containing foods and drinks
6. insufficient fluoride exposure due to a non-fluoridated water supply
7. taking medicines that reduce saliva production (e.g. antidepressants, antipsychotics, antihypertensives, antihistamines, anticholinergics)
8. using a dental appliance (e.g. braces, orthodontic plate, partial dentures).