The role of flouride in caries management

Question 1

How much water can legally be added to UK water

Answer 1

1ppm

Question 2

What can happen if there is too much flouride in water

Answer 2

Can increase risk of mottling

Question 3

What does fluoride do to enamel

Answer 3

1. Decreases demineralisation of enamel
2. Increases remineralisation of enamel
3. Can be incorporated in developing enamel

Question 4

What doe we need for dental decay to form

Answer 4

1. Tooth enamel
2. Bacteria in a biofilm
3. Fermentable carbohydrates
4. Time

Question 5

When does enamel dissolve

Answer 5

Below critical pH (5.5)

Question 6

Describe the first sign of decay

Answer 6

white spot lesion showing demineralisation

Question 7

What does enamel need to remineralise

Answer 7

Calcium

Question 8

What can we use to arrest early enamel lesion

Answer 8

Flouride varnish

Question 9

How is florid in corporate into develop gin enamel

Answer 9

As fluoridated hydroxyapatite

Question 10

How much florid is prescribed in duraphat

Answer 10

5000ppm

Question 11

What happens below the critical pH

Answer 11

Enamel dissolves

Question 12

What is the concentration of fluoride in fluoride varnishes?

Answer 12

7000-22600ppm

Question 13

Give some examples of topical fluoride

Answer 13

1. Toothpaste
2. Varnishes
3. Rinses
4. Silver diamine fluoride
5. Glass ionomer cements
6. Compomers
7. Some fissure sealants
8. Some resin composites

Question 14

What is silver diamine fluoride

Answer 14

Form of topical fluoride
60,000ppm fluoride

Question 15

What is a negative associated with diamine flouride

Answer 15

results in black stained lesions

Question 16

What are the guidelines surrounding fluoride and under three yr olds

Answer 16

1. Toothpaste with 1000ppm fluoride
2. Smear of toothpaste
3. Parents to brush child’s teeth

Question 17

What are the guidelines surrounding fluoride and 3-6 year olds

Answer 17

1. Toothpaste with 1350-1500 ppm fluoride
2. Pea size toothpaste
3. Parents to help with brushing

Question 18

When prescribing florid mouthwash what should you do

Answer 18

1. Consider the age of the patent
2. Give appropriate instructions to the patient
3. Check if mouthwash has alcohol

Question 19

When are children at greatest risk of fluorosis and why

Answer 19

18 months to 3 years as children don’t learn how to spit until they are 3-4 so they swallow more toothpaste

Question 20

Describe the enamel of a patient with dental fluorosis

Answer 20

The enamel has a higher protein content giving It a chalky looking appearance

Question 21

How can we prevent dental fluorosis?

Answer 21

1, Additional systemic fluorides should beavoided before 3 yrs of age
2. Parents should make sure there is only a smear of toothpaste on the brush for an infant
3. Parents shouldn’t share their mouth wash
4. All fluoride products should have child-safety tops