Non-water community fluoride delivery Flashcards
What is the primary mode of action of fluoride in reducing caries?
A topical effect after eruption.
Name vehicles for fluoride delivery?
Water, salt, milk, varnish/gels, rinses, supplements and tooth paste.
What are the disadvantages of fluoridated salt?
- Risk of CVD in increased salt intake
- Different levels of fluoride in different salts depending on manufacturer.
What is the advantage of using fluoridated salt?
- Requires little conscious action by the individual
- Provides element of choice.
What are the advantages of fluoridated milk?
- Natural healthy drink for children
- Rich in nutrients
- Enables fluoride to be targeted to those who would benefit most.
What are the disadvantages of fluoridated milk?
- Distribution delayed until nursery/school age
- Not all children drink milk
- Shelf life/Cost issues
- Evidence of lack of long term benefit.
What are APF gels?
ACIDULATE PHOSPHATE FLUORIDE GELS.
They are professionally applied with a fluoride concentration of 12,300ppm. Takes 30 minutes up to 3 times a year. Custom made trays are needed and there is an acute toxicity risk if ingested.
Not recommended for young children.
What is the evidence for fluoridated gels?
There is only evidence for the permanent dentition and adverse effects were not addressed.
What is the evidence for fluoride mouth rinses?
Early studies show evidence in caries reduction and since then there are doubts about marginal benefit and cost effectiveness. Reasonable to use these mouthwashes in high risk caries patients but there is doubtful evidence in low risk caries groups. One in two children with high levels of tooth decay (and one in 16 with the lowest levels) would have less decay. Limited attention to adverse affects and acceptability of mouth rinses.
What are the recommended levels of fluoride supplements for up to 6 years?
0-6 months= 0
6 months- 3 years= 0.25
3-6 years= 0.5
6 years += 1 (mg F per day with under 0.3ppm fluoridated water supply).
What is the evidence for fluoride supplements?
Population levels there tends to be poor compliance and not suitable for a public health measure. Should be directed towards “at risk” children only. Careful assessment of risks and benefits for children under 7 years old ie. risk of fluorosis.
What are the key elements of fluoride tooth paste and brushing?
- Conc of fluoride
- Frequency of brushing
- Age at commencement of brushing
- Post brushing rinsing.
What concentration of fluoride in toothpaste must be reached in order to prevent caries?
1000 ppm.
Reminder to revise fluoride in toothpaste concentrations for high and low risk.
.
List some advice for toothbrushing instructions for children.
- Brush teeth and gums morning and last thing before bedtime.
- Use a dry toothbrush.
- Wipe the child’s mouth or encourage spitting out.
- Only rinse the brush after brushing teeth.
- Help child with brushing until at least 7 years old.
