The Role Of Fluoride In Caries Management Flashcards

1
Q

When were stained teeth first reported

A

Pre 1900s

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2
Q

When was Colorado brown stain described

A

1901

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3
Q

Who was Colorado brown stain described by

A

McKay

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4
Q

Who described enamel histology

A

Black

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5
Q

When was enamel histology described

A

1909

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6
Q

When was mottling seen in enamel in England

A

1925- by Ainsworth

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7
Q

When was mottling related to fluoride levels

A

In 1928

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8
Q

Who is ALCOA

A

Aluminium company of America

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9
Q

When was mottling in different communities studied

A

1931-1939

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10
Q

Who was mottling in different communities studied by

A

Trendley dean

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11
Q

When did dream show minimal mottling effects

A

1942

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12
Q

What concentration of fluoride has low mottling

A

1ppm of fluoride

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13
Q

if water is fluoridated what conc of fluoride is in the water

A

0.7PPM

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14
Q

what does DMFT mean

A

decayed missing filled teeth

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15
Q

what does the graph of fluorosis and DMFT show

A

that with the ppm of fluoride increasing there is only a slight decrease in DMFT
but the severity of fluorosis greatly increases

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16
Q

where is fluoride absorbed in the body

A

mainly in the stomach

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17
Q

what type of absorption is fluoride absorbed by

A

systemic absorption

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18
Q

where does excretion of fluoride happen

A

in the kidneys

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19
Q

how is fluoride absorbed into the blood

A

as HF

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20
Q

where is fluoride incorporated

A

in calcified tissues such as bones and teeth

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21
Q

where does fluoride also enter

A

saliva

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22
Q

how does fluoride work

A

decreases demineralisation of enamel
increases remineralisation of enamel
incorporated in developing enamel
interferes with metabolism of some plaque bacteria

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23
Q

what are some examples of bacteria ghat cause caries

A

strep mutans

lactobacillus

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24
Q

what is the critical ph of enamel

A

5.5

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25
Q

how long does it take to get the ph of the mouth back up to normal after an acid attack

A

around an hour( some notes say 20-40 mins)

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26
Q

what does acid demineralisation cause in the enamel crystals

A

porosities

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27
Q

why does the lesion appear chalky

A

due to the fact that light is refracted differently of those enamel porous crystals leaving a chalky appearance

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28
Q

what ions are important for remineralisation

A

calcium
phosphorus
fluoride

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29
Q

will demineralised enamel take fluoride up

A

yes

30
Q

where can we get calcium and phosphate from

A

saliva
dairy food
CPP-ACP mousse

31
Q

what is tooth mousse

A

made from casein
it is milk product to paste on teeth
very common

32
Q

what does CPP-ACP stand for

A

Casein phosphopeptide–amorphous calcium phosphate

33
Q

where do we lose most of the enamel

A

at the sub surface

34
Q

what is the conc of fluoride varnish used in clinic

A

22600 ppm

35
Q

what do we apply at the surface enamel

A

high fluoride varnish

36
Q

what do we apply at the whole enamel lesion

A

water or simple toothpaste will remineralise the whole area

37
Q

what can high conc fluorides form

A

calcium fluoride

38
Q

what does fluoride do to bacteria

A

changes the bacterial pH- more acidic

also interferes with the glycolytic pathway

39
Q

how is fluoride incorporated in enamel

A

are fluoridated hydroxyapatite or as fluorapatite

40
Q

is this enough fluoride if it is only incorporated with crystals

A

no it needs to be used daily in the form of toothpaste twice a day

41
Q

which animal has the highest amount of fluorapatite in its enamel

A

sharks

42
Q

what is the ppm of silver diamine fluoride

A

40000 ppm

43
Q

what is the issue with silver diamine fluoride

A

THE TEETH WILL GO BLACK DUE TO THE FLUORIDE

44
Q

in 2018 how many children had teeth extracted under GA

A

40000

45
Q

how much fluoride per ppm is in tea

A

4-8ppm

46
Q

what is the fluoride conc in ppm of fish

A

greater than 2 and higher in bony fish

47
Q

what is the reduction in caries % in water

A

50-60%

48
Q

what are the sources of systemic fluoride

A
swallowed toothpaste
water
foods-fish,tea
tablets/drops
milk
salt
49
Q

at age 5 what is the ratio of kids needing GA for dental care in fluoridated Dunedin

A

1:88

50
Q

at age 5 what is the ratio of kids in low fluoride mosgiel (NZ)

A

1:24

51
Q

what are conc of toothpastes in supermarkets

A

1450ppm

52
Q

what is the conc of prescribed toothpaste

A

2800-5000ppm

53
Q

what is the conc of fluoride varnish in clinics

A

7000-22000 ppm

54
Q

what is the conc of fluoride rinses

A

226-910 ppm

55
Q

what is the percentage of silver diamine fluoride

A

37%

56
Q

what is the conc of ppm of silver diamine fluoride

A

60000ppm

57
Q

what do we recommend about toothpaste for children( 3 years)

A

upto 3 years old
1000ppm fluoride
smear of toothpaste
parents brush

58
Q

what do we recommend about toothpaste for children 3-6 years

A

toothpaste 1350-1500ppmF
pea sized amount
parents help with brushing

59
Q

what should be the conc of daily fluoride mouthwash

A

0.05%

60
Q

what should be the conc of weekly fluoride mouthwash

A

0.2%

61
Q

what do we consider when prescribing fluoride mouthwash

A

age
alcohol or not?
appropriate instructions

62
Q

what fluoride varnish should be apply if the patient has asthma

A

colophony free

63
Q

what are other courses of fluoride

A

GIC
composite
resin
some fissure sealants

64
Q

what is dental fluorosis

A

occurs when more than trace amounts are ingested during tooth development stage

65
Q

when is the highest risk of fluorosis in permanent anterior teeth

A

18 months- 3 years

66
Q

when do children learn how to spit

A

3-4 years

67
Q

how do we prevent fluorosis

A

stopping additional systemic fluoride before the age of three
make sure kids have the correct amount of toothpaste
all fluoride should have child safety tops

68
Q

what is the lethal amount of 0.05% NaF daily mouthwash for a 12kg 12 year old

A

199ml

69
Q

what is the lethal amount of fluoride varnish for a 12kg 12 year old

A

8ml

70
Q

what is the lethal amount of toothpaste 1000ppm for a 12kg 12 year old

A

150g

71
Q

what is the lethal amount of NaF 1.1mg for a 12kg 12 year old

A

300 tablets

72
Q

what makes toothpaste beneficial if a child was to ingest too much

A

it has foaming agents so will just cause vomiting