Fluoride and Dental Caries Prevention
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Questions and Answers

How does fluoride contribute to the prevention of caries?

  • By promoting enamel glossiness
  • By enhancing saliva production
  • By increasing tooth sensitivity
  • By making teeth more resistant to demineralization (correct)

    • What is the primary mechanism by which fluoride is absorbed during the pre-eruptive stage?

  • Via direct application on the teeth
  • By being swallowed (correct)
  • Through foods high in calcium
  • Through the saliva

    • Which component does fluoride replace in the enamel during tooth formation?

  • Calcium phosphate
  • Fluorapatite
  • Dentin
  • Hydroxyapatite (correct)

    • What may occur due to excess fluoride during enamel development?

    <p>Discoloration known as fluorosis</p> Signup and view all the answers

    During which stage does fluoride deposition primarily occur after calcification but prior to tooth eruption?

    <p>Maturation stage</p> Signup and view all the answers

    Who documented the 'stain' on teeth in Colorado Springs in 1916?

    <p>Dr Frederik McKay</p> Signup and view all the answers

    What investigation did Churchill conduct in 1931?

    <p>He tested water samples for fluoride content.</p> Signup and view all the answers

    What was suggested by McKay in 1932 regarding fluoride?

    <p>Fluoride may reduce the chance of caries.</p> Signup and view all the answers

    What was Dr H Trendley-Dean assigned to research?

    <p>The relationship between fluoride, mottling, and decay.</p> Signup and view all the answers

    What was identified as a possible cause of mottling according to Churchill's findings?

    <p>High fluoride content in water.</p> Signup and view all the answers

    How did the teeth with mottling differ in terms of decay compared to normally calcified teeth according to McKay?

    <p>They showed no greater chance of decay.</p> Signup and view all the answers

    What role did GV Black play in relation to the Colorado stain?

    <p>He collaborated with McKay to investigate the stain.</p> Signup and view all the answers

    What innovation followed McKay's investigation regarding fluorosis?

    <p>Addition of fluoride to public water supplies.</p> Signup and view all the answers

    What is the consequence of frequent acid attacks on dental health?

    <p>Increased risk of caries</p> Signup and view all the answers

    What is the atomic number of fluorine?

    <p>9</p> Signup and view all the answers

    Which of the following is NOT a natural source of fluorine?

    <p>Artificial sweeteners</p> Signup and view all the answers

    What is a significant historical study related to fluoride and caries reduction?

    <p>Ainsworth UK water fluoride comparison studies</p> Signup and view all the answers

    What reaction occurs between fluorine and metals?

    <p>Forms salts or halides</p> Signup and view all the answers

    Which year marked the first experiment of artificial water fluoridation?

    <p>1945</p> Signup and view all the answers

    In which year did the Royal College of Physicians conduct an enquiry into water fluoridation?

    <p>1976</p> Signup and view all the answers

    What term is often used to refer to fluoride when it bonds with other elements?

    <p>Halides</p> Signup and view all the answers

    Who was involved in the investigation of Colorado Stain related to fluoride?

    <p>Frederick McKay</p> Signup and view all the answers

    What is the classification of fluorine on the periodic table?

    <p>Halogen</p> Signup and view all the answers

    What effect does fluoride have on the wettability of enamel?

    <p>Decreases wettability</p> Signup and view all the answers

    How does reduced pellicle formation impact plaque accumulation?

    <p>Decreases plaque accumulation</p> Signup and view all the answers

    Which of the following structural changes may result from systemic fluoride during tooth development?

    <p>Shallower pits</p> Signup and view all the answers

    What is root caries primarily associated with?

    <p>Exposure of dentine and cementum</p> Signup and view all the answers

    Which group is more susceptible to root caries?

    <p>Patients with xerostomia</p> Signup and view all the answers

    Which mechanism does fluoride use to reduce the likelihood of root caries?

    <p>Providing antibacterial effects</p> Signup and view all the answers

    What is one of the main benefits of fluoride during the remineralization process?

    <p>Incorporating into tooth surfaces</p> Signup and view all the answers

    What happens to bacteria adherence due to fluoride's effectiveness?

    <p>Reduces as enamel wettability decreases</p> Signup and view all the answers

    What causes the drop in pH during the post-eruptive stage?

    <p>Bacterial acid production</p> Signup and view all the answers

    Which mineral is primarily lost from the tooth surface during demineralization?

    <p>Calcium</p> Signup and view all the answers

    What is the primary function of fluoride during the post-eruptive stage?

    <p>To reduce the progression of caries</p> Signup and view all the answers

    Why is the uptake of fluoride greater in the first few years post-eruption?

    <p>The teeth are more porous</p> Signup and view all the answers

    What composes fully reformed hydroxyapatite after remineralization?

    <p>Calcium and phosphate</p> Signup and view all the answers

    What role does demineralized enamel play concerning fluoride absorption?

    <p>It facilitates fluoride absorption</p> Signup and view all the answers

    What happens when fluoride is applied topically to teeth?

    <p>It does not penetrate deeply</p> Signup and view all the answers

    Which statement regarding fluoride replacement is accurate?

    <p>Fluoride can be replaced as the tooth surface is abraded</p> Signup and view all the answers

    What is the significance of fluoroapetite in dental health?

    <p>It enhances the hardness and stability of tooth enamel.</p> Signup and view all the answers

    How does fluoroapetite contribute to reducing caries incidence?

    <p>By promoting remineralisation and inhibiting demineralisation.</p> Signup and view all the answers

    What is the critical pH of fluoroapetite, and why is it important?

    <p>4.5; it makes the tooth more resistant to acid attacks.</p> Signup and view all the answers

    What is one way fluoride contributes to tooth remineralisation?

    <p>Through bonding with calcium to form calcium fluoride.</p> Signup and view all the answers

    Which of the following topical fluoride sources generally does not require a prescription?

    <p>Water Fluoridation</p> Signup and view all the answers

    Why is a regular supply of low-level fluoride important for dental health?

    <p>It prevents the loss of fluoride ions during acid attacks.</p> Signup and view all the answers

    What fluoride level is typically found in fluoride mouth rinses?

    <p>225ppm</p> Signup and view all the answers

    What happens to fluoride when an acid attack occurs on teeth?

    <p>Fluoride is released from calcium fluoride in saliva.</p> Signup and view all the answers

    Study Notes

    Fluoride and the Tooth Surface

    • Topic: Fluoride and its role in dental caries prevention.
    • Learning Outcomes:
      • Describe the properties of relevant medicines and therapeutic agents related to patient management, and discuss their application.
      • Provide patients with accurate preventative education and instructions to encourage self-care and motivation.
      • Underpin all patient care with a preventative approach contributing to long-term oral and general health.
      • Prescribing and applying a range of preventative materials and treatments.
      • Describe and evaluate the role of health promotion in changing environments, community, and individual behaviours to deliver health gains.
      • Explain evidence-based prevention and apply it appropriately
    • Pre-reading:
      • Aetiology of Dental Caries (time, susceptible tooth surface, plaque bacteria, fermentable carbohydrates)
      • Histology of enamel and dentine
    • Intended Learning Outcomes:
      • List key milestones in fluoride history and its use in caries prevention.
      • Outline the stages in fluoride deposition.
      • Describe the modes of fluoride action.
      • Explain how fluorosis occurs.
      • Identify and assess fluorosis severity.
    • Refresher session:
      • Enamel is mainly hydroxyapatite(96%), which has a lattice structure and is made of phosphate and calcium ions (Ca10(PO4)6(OH)2).
      • Low pH (below 5.5) leads to demineralisation.
      • Frequent acid attacks increase demineralisation risk, while infrequent ones reduce it.
    • How is fluoride relevant to dental professionals?: Relevance to dental practice.
    • Fluorine: Detailed description.
    • Fluoride History: Key events in fluoride history, including the identification of Colorado stain (1916), water sampling studies (1931), identification of fluoride reduction of caries (1932), shoe leather studies (1930-1940).
    • Cochrane Review 2015:
      • Fluoridated water reduces caries in children's permanent teeth by 26%.
      • Fluoridation increases the percentage of children with no decay in deciduous teeth by 15%.
      • 73% of the studies focused on areas with natural fluoridation.
    • Modern Day: Controversy, prevalence of fluoridated water in the UK (approximately 10%).
    • How does fluoride prevent caries?: Fluoride uptake into the tooth surface, making it more resistant to demineralization, occurring through multiple stages (pre-eruptive and post-eruptive stages (systemic and topical fluoride), matrix secretion, maturation).
    • How is it absorbed?: Matrix secretion and maturation stage.
    • Post-eruption stage: Crucial role of frequent fluoride supply to replace lost ions.
    • Key points on Post-eruptive stage: acquisition of fluoride during the 2-3 years post-eruption, porous enamel that facilitates uptake due to demineralized enamel, fluoride reacts strongly with calcium, maximum uptake, efficacy for caries.
    • Why is fluoroapatite important?: Critical role in preventing future acid attacks, reduces demineralisation, formed by replacing hydroxyl ions during remineralisation (more stable due to improved hydrogen bonds, fewer imperfections, and larger crystals). Lower critical pH makes the tooth less soluble preventing demineralisation.
    • Where does the fluoride come from?: Topical applications create a fluoride reservoir in saliva; fluoride bonds to calcium forming CaF2; when acid attacks occur and pH drops, fluoride is released; this fluoride enters the tooth during remineralisation.
    • Ways to ensure a regular fluoride supply: Topical fluoride sources (toothpaste, mouth rinse, restorative materials, fluoride varnishes).
    • Fluoridation:
      • Water fluoridation: A key public health measure, potentially reducing caries. No association with bone fractures or cancer.
    • Important Indices:
      • Details of Indices for recording fluorosis (Dean Index, Thylstrup and Fejerskov Index)
    • Root Caries Recap:
      • Gingival recession exposes dentine and cementum; they are less mineralized, and decay progresses faster
      • Xerostomia patients and those undergoing radiotherapy are more susceptible
    • How does fluoride prevent root caries?:
      • Incorporating into surface during remineralisation
      • Reducing surface wettability
      • Antibacterial effects
    • What does research say about topical fluoride?:
      • Professionally applied fluoride (e.g., silver diamine fluoride, fluoride varnish) reduces risk of root caries.
      • Self-applied fluoride (e.g., various sodium fluoride concentrations, fluoride toothpaste) reduces risk of root caries at 1 year.
    • Fluorosis: Definition of fluorosis—associated with excess ingestion and its variations, from white opacities and lines/flecks to brown-yellow mottling.
    • Mechanism of fluorosis: excess fluoride inhibits ameloblast activity; hypomineralization, more porous enamel that readily takes up stain.
    • Aetiological agents for fluorosis: Dietary fluoride supplements, drinking water, toothpaste, and topical applications.
    • How to identify fluorosis?: Based on physical characteristics, indices (Dean Index, Thylstrup and Fejerskov Index-score from 0 to 9), and clinical presentation.
    • Fluoride action on bacteria: High fluoride concentrations are antibacterial, reducing bacterial plaque growth.
    • Action on enamel surface and tooth morphology: Fluoride reduces enamel surface energy, reducing bacteria adhesion.
    • Action on bacterial enzymes: Fluoride inhibits glycolysis. Also, fluoride inhibits enzyme systems.
    • Summary (in various formats): Diagrams showing stages of fluoride deposition, mode of action of fluoride, and summaries of different aspects of the topic.

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    Fluoride and the Tooth Surface PDF

    Description

    This quiz covers the essential role of fluoride in preventing dental caries. It explores the properties of therapeutic agents, patient management, and the importance of preventative education to enhance oral health. Participants will understand the evidence-based approaches to promoting health within communities and individual behaviors.

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