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AU '18 - Peds III exam III > Systemic Fluorides > Flashcards

Systemic Fluorides Flashcards

1
Q

routes of fluoride administration

A
  1. systemic

2. topical

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2
Q

systemic fluoride is for pre- or post-eruptive maturation?

A

pre-eruptive maturation

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3
Q

topical fluoride is for pre- or post-eruptive maturation?

A

post-eruptive maturation

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4
Q

is there benefit to fluoridation before tooth eruption?

A

no

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5
Q

T/F: little fluoride is incorporated during development

A

true

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6
Q

where is fluoride deposited during development instead of being incorporated into the tooth?

A

deposited on surfaces

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7
Q

why is ingested fluoride effective during oral transit?

A

because the ingested fluoride is secreted in saliva thus provides topical benefit

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8
Q

fluoride is especially beneficial for what type of teeth?

A

young teeth

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9
Q

why is fluoride especially beneficial for young teeth?

A

because the fluoride replaces hydroxyl to strengthen crystal structure and is incorporated into enamel

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10
Q

fluoride is incorporated into enamel as what?

A

fluorapatite

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11
Q

fluorapatite is more resistant to what?

A

demineralization

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12
Q

when does fluoride get incorporated into enamel as fluorapatite?

A

occurs with low concentration fluoride ion

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13
Q

what causes precipitation on surface, crevices and micropores of lesions

A

CaF2 from HIGH concentration topical products

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14
Q

T/F: CaF2 is incorporated into enamel

A

false, is NOT

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15
Q

CaF2 from HIGH concentration topical products serves as what?

A

reservoir of F- ion

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16
Q

what does the CaF2 reservoir promote during an acid attack?

A

remineralization

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17
Q

summary of mechanisms of CaF2 reservoirs

A
  1. remineralizes demineralized enamel
  2. lowers enamel solubility
  3. inhibits bacterial acid production
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18
Q

what causes fluorosis?

A

excess ingestion of fluoride during development

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19
Q

fluorosis may lead to what?

A
  1. white mottling
  2. pits and hypoplasia
  3. brown staining
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20
Q

T/F: topical applications of fluoride products can cause fluorosis

A

false

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21
Q

how much fluorinated water would someone have to drink to have flurosis?

A

water > 2 ppm

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22
Q

T/F: there is no homeostatic mechanism to control fluoride concentration

A

true

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23
Q

what happens when there is excess ingestion of fluoride during enamel secretory stage (protein scaffold)?

A

produces pitting and hypoplasia

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24
Q

what happens when there is excess ingestion of fluoride during maturation stage (mineralization)?

A

causes chalky whiteness and weak enamel

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25
Q

T/F: mild fluorosis does not bother most people and is usually considered attractive

A

true

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26
Q

when does fluorosis occur?

A

during tooth development

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27
Q

what is the most critical age for fluorosis?

A

22-26 months

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28
Q

T/F: although fluoride is a naturally occurring trace element, it can be toxic in excessive quantities

A

true

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29
Q

there is no evidence for concern at what level of fluoride in water?

A

1 ppm

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30
Q

EPA’s Reference Dose

A

RfD = 0.06 mg/kg-da

31
Q

acute high-dose toxicity

A

PTD = 5 mg/kg

32
Q

symptoms of fluoride overdose

A
  1. nausea
  2. vomiting
  3. abdominal pain
  4. diarrhea
  5. hyper-salivation/drooling
  6. numbness, tingling
  7. muscle cramps
  8. seizures
  9. death with large overdoses
33
Q

initial local effect on GI tract due to acute fluoride toxicity

A

HF formed in stomach –> GI irritation results in nausea, vomiting, diarrhea

34
Q

systemic effect due to acute fluoride toxicity

A
  1. binds to calcium ions (hypocalcemia)
  2. direct cytotoxic effects
  3. interference w/ multiple enzyme systems
35
Q

systemic effect due to acute fluoride toxicity will result in what?

A
  1. respiratory paralysis
  2. dysrhythmia
  3. cardiac failure
36
Q

tx for fluoride toxicity

A
  1. give Ca2+ or Mg2+ to bind fluoride
    …antacids and milk
  2. hospitalization if over PTD
37
Q

sources of systemic fluoride

A
  1. water fluoridation
  2. dietary supplements
  3. ingestion of topical products
38
Q

water fluoridation reduced what percent of PRIMARY caries?

A

30-60%

39
Q

water fluoridation reduced what percent of MIXED caries?

A

20-40%

40
Q

water fluoridation reduced what percent of PERMANENT caries?

A

15-35%

41
Q

annual cost of water fluoridation is how much per person?

A

50 cents

42
Q

what is the lifetime cost per person less than with water fluoridation?

A

less than cost of a single filling ($140)

43
Q

T/F: water fluoridation benefits the entire community and has no personal effort

A

true

44
Q

what’s the historic fluoride levels?

A

0.7-1.2 mg/liter

45
Q

when was the historic water fluoride levels set?

A

1962

46
Q

the historic water fluoride levels were set based on what?

A

climate

47
Q

what is the new fluoride water level recommendation changed to?

A

0.7 mg/liter

48
Q

why was there a new fluoride water level?

A
  1. increases sources of fluoride

2. increases mild fluorosis consumption no longer dependent on climate

49
Q

why is the new fluoride water level no longer dependent on climate?

A
  1. air conditioning

2. less outdoor activity

50
Q

what percent of Ohioans drink fluoridated water?

A

82%

51
Q

who doesn’t have fluoridated water?

A
  1. private wells
  2. bottled water
  3. breast-fed infants
  4. formula-fed infants
  5. some communities
52
Q

when was water fluoridation in ohio?

A

since 1969

53
Q

what size communities in ohio get water fluoridation?

A

communities >5000

54
Q

how many counties in ohio does not have water fluoridation?

A

23

55
Q

how is the the water fluoride analyzed?

A
  1. published

2. mail-in testing service

56
Q

fluoride halo effect

A

diffusion of fluoride in food

57
Q

ADA guidelines recommend dietary supplementation recommended for what type of pts?

A

high risk pts when water levels less than optimum

58
Q

dietary supplements of fluoride

A
  1. tablets
  2. drops
  3. swish & swallow rinse
59
Q

2.2 mg sodium fluoride contains how much fluoride ion?

A

1 mg

60
Q

T/F: fluoride benefits are topical and is not completely safe for ingestion

A

true

61
Q

there is a greater risk of fluorosis from what than dentifrice use (pea-sized amount) in young children?

A

supplements

62
Q

fluorides are primarily effective against what?

A

smooth surface decay

63
Q

fluoride has a smaller effect on what?

A

fissure decay

64
Q

what percent of monofluorophosphate (MFP) is fluoride?

A

13%

65
Q

what percent of stannous fluoride (SnF2) is fluoride?

A

24%

66
Q

what percent of sodium fluoride (NaF) is fluoride?

A

45%

67
Q

what percent of acidulated phosphate fluoride (APF) is fluoride?

A

100%

68
Q

T/F: NaF tastes sweet

A

false, tasteless

69
Q

what does acidulated phosphate fluoride (APF) taste like?

A

has sour taste

70
Q

where can acidulated phosphate fluoride (APF) be found?

A
  1. foams
  2. gels
  3. rinses
71
Q

what does stannous fluoride (SnF2) taste like?

A

bitter, astringent taste

72
Q

what does stannous fluoride (SnF2) cause?

A

staining

73
Q

T/F: stannous fluoride (SnF2) is unstable in water

A

true

74
Q

where can stannous fluoride (SnF2) be found?

A
  1. rinses
  2. gels
  3. toothpaste

AU '18 - Peds III exam III (12 decks)

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