Pedo Fluoride and Sealants Flashcards
What is the most common chronic disease of childhood?
Caries
What percentage of children are affected by caries?
58%
What ist he most prevalent unmet dental need in US Children?
Dental care
What is the disparity among children for caries?
25% suffer 80% of all tooth decay
Dental disease disproportionately affects children younger than what age and from what backgrounds?
Younger than 6, lower socioeconomics
What is the new model for primary prevention?
Examine early, access risk, give age appropriate instruction
What are 3 things fluoride does ?
- Inhibits demineralization
- Promotes remineralization
- Form fluorohydroxyapatite
What are 4 methods of administration for fluoride therapy?
- Systemic fluoride
- Professionally applied
- Home and school rinses
- Dentrifices
When should one start giving a child fluoride?
At first tooth eruption
If the patient’s water source has less than 0.3 ppm fluoride in water, how many milligrams does the patient need at 0-6mo, 6mo-3yrs, 3yrs-6yrs, 6yrs-16 yrs?
0months to 6 months = 0mg
6months to 3 years = 0.25mg
3 years to 6 years = 0.5mg
6 years to 16 years = 1.00mg
If the patient’s water source has between 0.3-0.6ppm fluoridel in water, how many milligrams does the patient need: 0-6mo, 6mo-3yrs, 3yrs-6yrs, 6yrs-16 yrs?
0months to 6 months = 0mg
6months to 3 years = 0mg
3 years to 6 years = 0.25mg
6 years to 16 years = 0.50mg
If the patient’s water source has more than 0.6ppm Fl in water, are any more milligrams needed for any age group?
No
Professional Fl application based on what?
Caries risk assessment
Do you have to do prophylaxis prior to fluoride application?
No
What must be done if rubber cup prophylaxis is performed?
Fluoride application
Acidulated Phosphate Fluoride thixotropic gel should be in tray for how long and in what age child?
4 min, +4-5 yrs
Over-the-counter fluoride rinse has what percentage of fluoride ions?
0.05%NaF = 0.022%F ion
MI paste contains what?
Casein (milk protein)
Stannous fluoride can do what to teeth?
Stain
What is the recommended toothpaste for children less than 2 years of age?
Smear
What is the recommended amount of toothpaste for children 2-5 yrs?
Pea size
Why supervise children brushing when younger?
To prevent excess ingestion of fluoride
What is the most important characteristic of fluoride varnish?
Gradual fluoride release
Is contamination of fluoride varnish a problem?
No
Can you eat and drink after fluoride varnish application?
You can eat and drink soft foods immediately
What is the most important clinical feature of fluoride varnish?
Ingestion is minimal and exposure occurs over many hours
How is fluoride varnish applied?
Apply a thin layer to dry teeth
What are 3 instructions for fluoride varnish?
- Eat soft non-abrasive diet for rest of day
- Do not floss or brush until following morning
- Resume regular diet and routing oral hygiene next day
How often apply fluoride varnish?
Every 6 months or more often for high risk
The success of fluoride varnish is directly related to what?
Continuity of placement
Fluoride is classified as what by FDA?
A medical device
What presents minimal risk and is subject to the lowest level of regulation?
A medical device
Fluoride varnish is approved as what?
Cavity liner and desensitizing agent
Once something is approved as a device that means it can be used how?
Off label
What is a lethal dose of fluoride?
15-64 mg/Kg
What is a probable toxic dose of fluoride?
5-8 mg/Kg
How do you treat a fluoride overdose?
Drink milk (bind the Fl) and refer to emergency dept
What is a clear or opaque filling material applied to pits and fissures of teeth?
Sealants
What is the most at-risk tooth surface?
Pits and fissures
What is the material in dental sealants?
BIS-GMA, bisphenol A, and glycidyl methacrylate
What percent of caries are found on the occlusal surface? What percent of the tooth is the occlusal surface?
Occlusal surface is 50% of caries and only 12.5% of tooth surface
What teeth are most susceptible to occlusal decay?
Permanent molars
When is the highest rate of sealant loss?
1st year following placement
Where are sealants lost quicker, mandible or maxilla?
Mandible
What are some factors affecting sealant retention?
- Position of teeth in mouth
- Skill of operator
- Age of patientt
- Eruption level or soft tissue proximity to pits and fissures
What is critical to sealant retention?
Isolation
The acid etch for the sealant consists of what percentage of phosphoric acid and for how long is it applied?
30-50% Phosphoric acid for 60 sec
What is the cure time for sealants?
20 seconds
Can you touch up sealants at recalls?
Yes
What is the critical pH for dissolution of enamel?
5.5
Remineralization of incipient subsurface lesion my occur as long as what?
The surface layer enamel remains
What demographic is usually susceptible to rampant caries?
Young teenagers
