The clinical use of flouride

Question 1

List some groups of children who are being targeted for prevention of dental caries

Answer 1

1. Young caries prone children
2. Disabled children
3. Socially deprived/ low socio economic children
4. Immigrant groups

Question 2

What does prevention include

Answer 2

1. Diet control
2. tooth brushing
3. Fluoride
4. Fissure sealants
   5/ Regular check ups at the dentist

Question 3

State the critical pH

Answer 3

5.5

Question 4

What happens to enamel when the pH drops below 5

Answer 4

It demineralises

Question 5

What happens to enamel when the pH is above 7

Answer 5

It remineralises

Question 6

What happens to hydroxyapatite in the presence of fluoride

Answer 6

It forms fluorapatite

Question 7

Describe fluroapatite

Answer 7

Fluorapatite is resistant to acid attack until the pH drops to 3.5

Question 8

Where can flouride be found

Answer 8

1. Mouth wash
2. Supplements
3. Varnishes
4. Toothpastes
5. gels

Question 9

What is the optimum level of floruide in

Answer 9

1ppm

Question 10

If the water floruidaion level is above 1ppm what effect does this have on caries

Answer 10

Caries can be reduced by 50%

Question 11

What are the disadvantages of prescribing floruide tablets and drops

Answer 11

Poor compliance and overdosing can lead to fluorosis

Question 12

How much flouirde does toothpaste contain

Answer 12

1000 or 1450 ppm in adult toothpaste

Question 13

What advice should we give parents about their childs oral health

Answer 13

1. Brush twice a day
2. The child may need help with brushing
3. Half a pea six amount or small smear of toothpaste
4. Rinse dont spit

Question 14

List some factors involved in the balance between caries and fluorosis

Answer 14

1. Flouride concentration of tooth paste
2. Amount of toothpaste beign used
3. Water rinsing
4. Frequency of brushing

Question 15

What is more beneficial burshign before or after breakfast? why?

Answer 15

Before as
1. Removes plaque
2. Minimises acidogenic responses
3. Provides intra oral fluoride before acid challenge

Question 16

What are some problem associated with brushing after breakfast

Answer 16

1. Acidogenic response has occurred.
2. Teeth softened
3. Further mineral loss by abrasion of tooth brushing
4. No fluoride before acid attack (breakfast)

Question 17

When should we apply flouride varnish

Answer 17

2-3 times a year

Question 18

How effective are mouth rinses

Answer 18

20-50% caries reduction

Question 19

How effective are floruide varnishes

Answer 19

50-70% caries reduction

Question 20

What is flouride varnish

Answer 20

Duraphat 5% NaF 22,600ppm

Question 21

Where can we get flouride from in our diet

Answer 21

1. Salt
2. Milk
3. Orange juice
4. Mineral water

Question 22

List the early sympotms of fluoride toxicity

Answer 22

1. Nausea
2. Vomiting
3. Hypersalivation
4. Abnormal pain
5. Diarrhoae

Question 23

List some later symtpoms fo flouide toxicity

Answer 23

1. Convulsions
2. Cardiac failure
3. Respiratory failure
4. Death

Question 24

How do we treat floruide toxicity

Answer 24

1. Induce vomiting to remove fluoride
2. Give milk or 1% calcium gluconate orally to slow fluoride absorption
3. Advise hospital of acute fluoride poisoning

Question 25

How is the probably toxic dose of fluoride calculated

Answer 25

5mg/kg body weight

Question 26

How is the certainly lethal dose of fluoride calculated

Answer 26

32-64mgF/ Kg body weight

Question 27

Name the different dental types of chronic fluorosis

Answer 27

1. Demarcated
2. Diffuse
3. Hypoplastic
4. Combinations

Question 28

How do we treat dental fluorosis

Answer 28

1. Microabrasion
2. Composite veneers
3. Porcelain veneers
4. Crowns