Professional F Application

Question 1

Contraindications of F

laundry list of stuff you know

Answer 1

Treatment of cavitated lesions

Low risk/no risk/ caries free patients living in fluoridated
communities

Situations where post fluoride treatment esthetics is a concern

Patients w/ Ulcerative gingivitis or stomatitis

Patient w/ possible sensitivity or allergy
– Casein

Phosphopeptides come from milk casein and
should not be used with a proven Milk Protein allergy

Dyspnea has occurred in Asthmatic patients (extremely
rare)

Nausea has occurred with extremely sensitive digestive
systems after extensive applications

Question 2

Topical Fluoride Concentrations: High Concentrations- ‘In Office’

Know ppm F

Answer 2

– 9,040 to 22,5000 ppm fluoride

– Promotes remineralization via CaF

**KNOW THIS

Question 3

Low Concentrations- @ Home F Concentration

Answer 3

225-5,000 ppm fluoride

*KNOW THIS

Promotes remin via frequent use

Question 4

How High [c] promotes remin

Answer 4

via CaF

Question 5

How low [c] promotes remin

Answer 5

frequent use

Question 6

Types of Fluoride

Answer 6

Acidulated
Phosphate
Fluoride (APF)

■ 2% Neutral
Sodium Fluoride
(NaF)

■ Stannous Fluoride
(SnF2)

■ Silver Diamine
Fluoride (SDF)

Question 7

Concentration of NaF Varnish

Answer 7

Concentration (highest available)
– 5.0% Neutral Sodium Fluoride
– 22,600 ppm Fl available

Question 8

How we use NaF based on what FDA says

Answer 8

Off label for caries prevention

Question 9

Is NaF etching and why or why not

Answer 9

No b/c neutral pH

Question 10

NaF varnish solifies on contact with

Answer 10

saliva

Question 11

The varnish of choice for kids under age 4

Answer 11

Neutral NaF Varnish

Question 12

Knee to Knee technique

Answer 12

how varnish is applied to very young

Question 13

After perio therapy, what might help reduce sensitivity

Answer 13

Neutral NaF Varnish

Question 14

Avoid alcohol post NaF varnish application why?

Answer 14

Like dissolves like

Question 15

apply NaF into proximals?

Answer 15

Yes, especially if you see changes in the radiograph

Question 16

APF Topical- Gel or Foam Concentration

and for how long?

Answer 16

– 1.23% Acidulated Phosphate Fluoride
– 12,300 ppm available
– 3.5 pH **

4 minute application time

Question 17

Contraindications for who for APF topical gel or foam

Answer 17

for individuals with extensive porcelain
veneers, porcelain crowns or extensive composite resins

**(pH too > ; possible micro-etching of surface)

Question 18

How long can one not rinse/brush/eat etc for after APF gel/foam tray?

Answer 18

30 minutes

Question 19

Should APF foam be filled over the top of the tray?

Answer 19

No-they will swallow it

Question 20

Neutral NaF topical Foam concentration

and how long is the application and slow uptake?

Is there a caution time out period?

Answer 20

– 2.0% Neutral Sodium Fluoride
– 9040 ppm Fl available
– 7.0 pH

slow uptake-4 min application

still 30 min wait-no brush/eat/rinse etc

Question 21

If not using varnish… agent of choice for patients with porcelian or composite restorations or those with reduced salivary flow caused by radiation, chemo, medication

Answer 21

Neutral NaF topical foam

Question 22

Worried about someone swallowing, use APF gel or foam?

Answer 22

Use foam because the dose is lower

Question 23

****Both ____ and _____ are contraindicated for children under 3! Use what instead???

Answer 23

NaF and APF foams and gels

Use Varnish instead!

*KNOW THIS

Question 24

Stannous Fluoride-SnF2 Concentration

OTC, rinse, and office

Answer 24

Concentration
– 0.4 % gel (OTC or RX) ; 1,000ppm
– 0.63 % rinse; 3000 ppm (Mix ratio 1:8)
– (8% in-office………)

Question 25

Mechanism of stannous F and instructions on food and liquid intake

Answer 25

Tin (stannous) component can retard
bacterial metabolism – Forms non- water-soluble stannous layer

No restrictions on food or liquid intake?

Question 26

Why stannous F is good for perio and plaque reduction

Answer 26

it has antimicrobial properties

Question 27

Cons of Stannous F

Answer 27

(especially w/ 8%)
– Metallic taste *
– Staining of pellicle *
– Staining of the tooth (?) *