Module 6 Flashcards
What is necessary for optimum oral health at all ages?
fluoride
By what 2 means is fluoride made available at the tooth surface?
systemically and topically
how is the tooth surface exposed to fluoride systemically?
by way of the circulation to developing teeth
what is preeruptive exposure?
systemic exposure
how is the tooth surface exposed to fluoride topically?
directly to the exposed surfaces of erupted teeth
what is the posteruptive exposure?
Topical exposure
What can be swallowed during toothe development to provide both preeruptive exposure and posteruptive exposure to teeth currently erupted?
topically applied fluoride
Epidemiologic evidence shows maximum caries inhibiting effect what there is what?
- systemic exposure before tooth eruption
- frequent topical exposure throughout life
What is fluoride and how do we get it?
systemic nutrient taken into the body by way of water, dietary supplements, foods
How is fluoride adsorbed?
rapidly, by passive diffusionin the stomach as hydrogen fluoride
What does the rate of adsorbtion of fluoride depend on?
the solubility of the fluoride compound and its gastric acidity
How long does it take fluoride to be adsorbed?
60 minutes
What happens to the fluoride that isnt adsorbed in the stomach?
it will be adsorbed by the small intestine
When is there less adsorbtion of fluoride?
when it is taken with mik and other food
WHat carries the fluoride in the blood stream?
plasma
What does the plasma carry the fluoride for?
distribution and elimination throughout the body
When are maximum blood levels of fluoride reached in the body?
within 30 minutes of intake
What is fluoride distributed by and where to?
plasma, all tissues and organs
What does fluoride have a strong affinity for?
calcified tissues
Where are concentrations of fluorides the highest?
at the surfaces next to the tisse fulid supplying the fluoride
fluoride is stored as an integral part of what
the crystal lattice of teeth and bones
When can fully matured fluoride depositied during development be altered?
by cavitated dental caries, erosion, or mechanical abrasion
Where is most fluoride excreted?
kidneys
where is the smaller amount of fluoride excreted?
sweat of glands and in the feces
Is there transfer of fluoride from plasma to breast milk?
it is very limited
When and where is fluoride depositied during formation of the enamel
it starts at the DEJ, after the enamel matrix is laid down by the ameloblasts
Fluoride is incorporated directly in the the what?
hydroxyapetite crystalline structure
What does preeruptive fluoride result in?
shallower occlusal grooves
When do first permanent molars begin to mineralize?
at birth
how is fluoride available to developing teeth?
by way of the blood plasma to the tissues surrounding tooth buds
What is dental fluorosis?
form of hypomineralization that results from systeminc ingestion of an excess amount of fluoride during tooth development
When is the enamel highly receptive to free fl2 ions?
mineralization
Is dental fluorosis a result of a cumulative or threshold amount of fl2
cumulative
What does the excess fluoride cause the ameloblasts do?
inhibits the ameloblasts, results in discontinuty of crystal growth
after mineralization is complete and before eruption what coninues in the surface of the enamel
fluoride deposition
where is fluoride taken up in the preeruptive/maturation stage?
it is taken up from the nutrient tissue fluids surrounding the tooth crown
during what period is more fluoride aquired by the outer surface of enamel than the underlying layers of enamel druing mineralization
preeruptive: maturation stage
children who are exposed to fluoride for ____________ before eruption have the greatest amt of fl2 during the preeruptive stage
first 2 years
What is the posteruptive stage?
after eruption and throughout the lifespan of the teeth
What is the outermost surface of the enamel most dependent on?
topical fluoride
What are examples of topical fl2?
water, dentifrices, mouth rinse
Fl2 on the outermost surface of the enamel available for
inhibiting demineralizaton and enhancing remineralization
What can the continuous presence of fluoride ihibit?
initiation and and progression of dental caries
When is uptake most rapid on the enamel surfacw
during the first years after eruption
What does the uptake of fluoride depend on?
the level of fl2 in the oral environment
what adsorbes fluoride in greater quantities?
hypomineralized enamel
What has a greater concentration of fl2 than sound enamel?
demineralized enamel that has been remineralized
The fluoride in exposed dentin is _______ than in enamel
greater
Where is the higher concentration of fluoride in dentin?
pulpal or inner surface wher e exhange takes place
newly formed dentin adsorbs fluoride_____
rapidly
The level of fluoride in cementum is
________
the level of fluoride in cementum _______ with age
increases
When is fluoride available to cementum?
when the root surface is exposed
What are resivors for fluoride?
biofilm and saliva
How does fluoride ehance remineralizatoin?
adsorbing to the crystal surface and attrating calcium and phosphate ions
how much fluoride is in dental biofilm?
5 to 50 ppm
what does fluoride interfere with?
growth and metabolism of bacteria
what is enolase?
an enzyme neded by bacteria to metabolize carbohydrates
how does fluoride inhibit bacterial activity?
inhibits enolase
What is fluoridation?
adjustment of the natural fl2 ion content of water supply to the optiumum physiologic concentration that will maximize caries prevention and limit enamel fluorosis
What is the most efficent means of effective reliable and inexpensive means for improving and maintaining oral health
fluoridation
What has fluoridation been named as?
one of the 10 most significant pubilc health measures of the 20th century
What is the annual const per person per year of fluoridation?
$.54-3.44
What did Dr. frederick S. Mckay do?
did studies to find the cause of brown stains that he observed in the people of colorado springs
what is the other name for the brown stain?
mottled enamel and now dental fluorosis
What did dr. HV Churchill do??
pinpointed fluorin as the spoecivic element Dr. Mckay had been observing clinically
What did Dr. H Trendly Dean do?
concluded that the level of fluoride in the water optimum for dental caries prevention averages 1ppm in moderate climiates and fluorosis is over 2ppm
what is associated with over 2ppm of fl2 in the water?
dental fluorosis
When were the first communities fluoridated?
1945
What was the first city to be fluoridated?
Grand Rapid Michigan
What city where they had natrual fluoide was used to compare the benefits of natural with citys with fluoridation
Aurora, Illinois
What are some of the frist fluoridated cities?
grand rapids, michigan
newburgh, new york
brantford, ontario
evanston, illinois
What were some of the control cities?
Muskegon, Michigan
Kingston, NY
Sarnia, Ontario
Oak Park, Illinois
What is the optiumum concentration of Fl2 in warmer climates?
.7ppm
what is the optimum fl2 concentration in colder climates?
1.2 ppm
WHat is the number that is used for all communities?
.7 ppm
What are the sources of fl2?
naturally occuring, and from mining
what are examples of fl2
fluorspar, cryolite, apetite
What are the criteria for acceptance of a fluoride compound for fluoridation?
solubility, inexpensive, readily available
What compounds are used in fluoridation
Dry- sodium fluoride, sodium silicon fluoride
Liquid- hydrofluoricsilicic acid
What do teeth exposed to an optiumum or slighly higher level of fluoride appear as?
white, shining, opaque and without blemishes
When the fl2 level is slightly more than optiumum exposed developing teeth may exhibit ____
mile enamel fluorosis seen as white areas in bands or flecks
The majority of fluorosis that we see is _____
mild
the reduction in caries due to water fluoridation alone among adults is____
27%
what teeth recieve most protection from fluoride?
anterior maxillary teeth because it is contacted by drinking water
Is root caries prevalence less in lifelong residence of a fluoridated community?
Yes, by 50%
How much does fluoridation from birth reduce caries by?
40% in primary teeth
Tooth loss due to dental caries is much______ in both primary and permanent teeth without fluoride
greater
What are the good effects of fluoride on perio health?
- improved bone density, no carious leisons to harbor bacteria for perio, fewer teeth are lost to perio
What is partial defluoridation?
communites have excess fluoride in their water
what do the teeth look like in partial defluoridation?
very hard and brittle
What is school fluoridation?
benefits children in communities that cant have community fluoridation and they add fluoride to the schools water system
What is discontinued fluoridation?
fl2 is removed from a community water supply that had dental caries conrol
Where did they remove fl2 because of anti-fluoridationists and the community voted it back in
antigo wisconsin in 1966 was reinstated
