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Questions and Answers
What is the minimum fluoride concentration children under 3 should use in toothpaste?
What is the minimum fluoride concentration children under 3 should use in toothpaste?
Which toothpaste option is recommended for high risk children under 3 who can spit out the paste?
Which toothpaste option is recommended for high risk children under 3 who can spit out the paste?
At what age can children be prescribed duraphat 2800ppm sodium fluoride toothpaste?
At what age can children be prescribed duraphat 2800ppm sodium fluoride toothpaste?
Why is supervision recommended for children under 7 using fluoride toothpaste?
Why is supervision recommended for children under 7 using fluoride toothpaste?
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What concentration of fluoride toothpaste is most commonly found in regular fluoride toothpastes?
What concentration of fluoride toothpaste is most commonly found in regular fluoride toothpastes?
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What percentage increase in children with no decay in deciduous teeth was achieved through fluoridation?
What percentage increase in children with no decay in deciduous teeth was achieved through fluoridation?
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What is the fluoridation level that gives a 12% chance of developing fluorosis?
What is the fluoridation level that gives a 12% chance of developing fluorosis?
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Which of the following is NOT a source of fluoride without a prescription?
Which of the following is NOT a source of fluoride without a prescription?
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What type of fluoride is categorized as 'topical'?
What type of fluoride is categorized as 'topical'?
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According to the 2015 Cochrane Review, what percentage reduction in caries in children's permanent teeth was noted?
According to the 2015 Cochrane Review, what percentage reduction in caries in children's permanent teeth was noted?
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Which of the following is a professionally applied fluoride treatment?
Which of the following is a professionally applied fluoride treatment?
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What is the effect of systemic fluorides compared to topical fluorides?
What is the effect of systemic fluorides compared to topical fluorides?
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Which source of fluoride mentioned is not intended for children?
Which source of fluoride mentioned is not intended for children?
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What is the minimum amount of fluoride that may be fatal for some children?
What is the minimum amount of fluoride that may be fatal for some children?
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Which symptom is NOT associated with sub-lethal fluorine toxicity?
Which symptom is NOT associated with sub-lethal fluorine toxicity?
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How soon do symptoms typically appear after ingestion of fluoride?
How soon do symptoms typically appear after ingestion of fluoride?
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Which fluoride preparation has the highest potentially lethal poisoning dose for a 5-year-old child weighing 20kg?
Which fluoride preparation has the highest potentially lethal poisoning dose for a 5-year-old child weighing 20kg?
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What should parents do regarding children's use of dental products?
What should parents do regarding children's use of dental products?
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Which product type is indicated as the topical agent of choice for high-risk patients?
Which product type is indicated as the topical agent of choice for high-risk patients?
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What should be kept out of reach of young children?
What should be kept out of reach of young children?
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What action should be taken if there is doubt about the quantity of fluoride ingested by a child?
What action should be taken if there is doubt about the quantity of fluoride ingested by a child?
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What is a primary benefit of using Silver Diamine Fluoride in dental practice?
What is a primary benefit of using Silver Diamine Fluoride in dental practice?
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What is the highest concentration of fluoride found in Silver Diamine Fluoride?
What is the highest concentration of fluoride found in Silver Diamine Fluoride?
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Which of the following is a noted side effect of Silver Diamine Fluoride?
Which of the following is a noted side effect of Silver Diamine Fluoride?
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What can be a consequence of using prophylaxis paste containing fluoride?
What can be a consequence of using prophylaxis paste containing fluoride?
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How long can fluoride be released from glass ionomer cements according to studies?
How long can fluoride be released from glass ionomer cements according to studies?
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What is a potential limitation of silver ion release from glass ionomer materials?
What is a potential limitation of silver ion release from glass ionomer materials?
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Which patient group is not typically recommended to use Silver Diamine Fluoride?
Which patient group is not typically recommended to use Silver Diamine Fluoride?
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Which characteristic of Silver Diamine Fluoride makes it palatable for some patients?
Which characteristic of Silver Diamine Fluoride makes it palatable for some patients?
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What is a common compliance issue associated with the use of Silver Diamine Fluoride?
What is a common compliance issue associated with the use of Silver Diamine Fluoride?
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What happens when Silver Diamine Fluoride is applied to teeth?
What happens when Silver Diamine Fluoride is applied to teeth?
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What is the maximum fluoride amount recommended for children aged 3-6 years?
What is the maximum fluoride amount recommended for children aged 3-6 years?
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What does the recommendation for adults with active coronal or root caries specify?
What does the recommendation for adults with active coronal or root caries specify?
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What is recommended for young adults aged 7 and older who may have active caries?
What is recommended for young adults aged 7 and older who may have active caries?
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What precaution should be taken when using fluoride toothpaste for young children?
What precaution should be taken when using fluoride toothpaste for young children?
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What happens if patients rinse with mouthwash after using fluoride toothpaste?
What happens if patients rinse with mouthwash after using fluoride toothpaste?
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What is a downside of using fluoride toothpaste mentioned in the recommendations?
What is a downside of using fluoride toothpaste mentioned in the recommendations?
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Why is it advised against rinsing after using fluoride toothpaste?
Why is it advised against rinsing after using fluoride toothpaste?
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What is the recommended fluoride level for adults?
What is the recommended fluoride level for adults?
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What is the primary concern related to pre-natal administration of fluoride for caries prevention?
What is the primary concern related to pre-natal administration of fluoride for caries prevention?
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What is a major downside of fluoridated salt?
What is a major downside of fluoridated salt?
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Which of the following is true concerning fluoridated milk programs?
Which of the following is true concerning fluoridated milk programs?
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What is a significant benefit of using fluoridated milk?
What is a significant benefit of using fluoridated milk?
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What is the risk associated with the acute lethal dose of fluoride?
What is the risk associated with the acute lethal dose of fluoride?
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What is a notable issue regarding the compliance of fluoride treatments?
What is a notable issue regarding the compliance of fluoride treatments?
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What is a potential consequence of excessive fluoride use?
What is a potential consequence of excessive fluoride use?
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What does the variable intake of salt fluoridation imply?
What does the variable intake of salt fluoridation imply?
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How does fluoridated salt affect consumer choice?
How does fluoridated salt affect consumer choice?
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Why is it complicated for families with more than one child to use fluoridated milk?
Why is it complicated for families with more than one child to use fluoridated milk?
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Flashcards
Caries Prevention
Caries Prevention
Fluoride helps in preventing tooth decay (caries) by strengthening teeth.
Fluoridated Water
Fluoridated Water
Water with added fluoride to reduce caries in children's permanent teeth by 26%.
Fluorosis Risk
Fluorosis Risk
Fluoridation at 0.7ppm offers a 12% chance of aesthetic concerns like mottling.
Cochrane Review
Cochrane Review
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Decay Reduction in Children
Decay Reduction in Children
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Systemic vs. Topical Fluoride
Systemic vs. Topical Fluoride
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Sources of Fluoride
Sources of Fluoride
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Professionally Applied Fluoride
Professionally Applied Fluoride
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Fluoride Toothpaste ppm
Fluoride Toothpaste ppm
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Children's Toothpaste under 3
Children's Toothpaste under 3
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High-Risk Children
High-Risk Children
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Duraphat Prescription
Duraphat Prescription
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Manual Dexterity in Children
Manual Dexterity in Children
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Toxic dose for children
Toxic dose for children
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Sub lethal effects
Sub lethal effects
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Neutralization method
Neutralization method
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Symptoms onset
Symptoms onset
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Fluoride varnish dosage
Fluoride varnish dosage
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Lethal dose for children
Lethal dose for children
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Supervision During Use
Supervision During Use
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Dietary advice
Dietary advice
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Silver Diamine Fluoride (SDF)
Silver Diamine Fluoride (SDF)
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Fluoride concentration in SDF
Fluoride concentration in SDF
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Uses of SDF
Uses of SDF
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Side effect of SDF
Side effect of SDF
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Glass Ionomer Cement
Glass Ionomer Cement
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Fluoride release duration
Fluoride release duration
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Prophylaxis Paste
Prophylaxis Paste
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Fluoride recharge in ionomers
Fluoride recharge in ionomers
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Patient compliance with SDF
Patient compliance with SDF
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Limitations of prophylaxis pastes
Limitations of prophylaxis pastes
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Fluoride recommendation for 0-3 years
Fluoride recommendation for 0-3 years
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Fluoride recommendation for 3-6 years
Fluoride recommendation for 3-6 years
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Fluoride level for young adults
Fluoride level for young adults
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Fluoride danger for children
Fluoride danger for children
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Fluoride in adults
Fluoride in adults
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Spit don’t rinse concept
Spit don’t rinse concept
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Fluoride paste awareness
Fluoride paste awareness
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OraHealth: Fluoride dosage control
OraHealth: Fluoride dosage control
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Fluoride Supplementation
Fluoride Supplementation
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Fluoridated Salt
Fluoridated Salt
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Fluoridated Milk
Fluoridated Milk
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Milk Dosage for Fluoride
Milk Dosage for Fluoride
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Toxic Dose of Fluoride
Toxic Dose of Fluoride
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Pros of Fluoridated Salt
Pros of Fluoridated Salt
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Discontinuation of Fluoride
Discontinuation of Fluoride
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Fluoride Challenges
Fluoride Challenges
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Study Notes
Fluoride Delivery Methods
- Fluoride is delivered through various methods to prevent dental caries.
- Over-the-counter fluoride sources include toothpaste, mouthwash, fluoridated water, fluoridated salt, and fluoridated milk.
- Prescription-only fluoride sources include higher concentration toothpastes, mouthwashes, fluoride tablets, and fluoride drops.
- Professionally applied fluoride sources include fluoride varnish, glass ionomer cement, and silver diamine fluoride.
GDC Learning Outcomes
- Dentists should describe relevant medicines and therapeutic agents and their application.
- Dental practitioners should provide thorough preventive education, promoting self-care and motivation in patients.
- All patient care should involve a preventative approach for long-term oral and general health.
- Provide appropriate preventative materials and treatment plans.
- Describe and evaluate health promotion within evolving environments, communities, and individual behaviors to improve health.
- Explain and apply evidence-based prevention strategies effectively.
Aetiology of Dental Caries Lecture
- Dental caries results from the interaction of susceptible tooth surface, time, and fermentable carbohydrates.
- Plaque bacteria play a critical part in this process.
Histology of Enamel and Dentine Lecture
- This lecture explores the microscopic structure of enamel and dentine and their impact on dental health.
Fluoride and the Tooth Surface Lecture
- This lecture focuses on the relationship between fluoride and the tooth surface.
Learning Objectives
- List over-the-counter fluoride supplementation options.
- List prescription-only fluoride supplementation options.
- Detail professionally applied fluoride interventions.
- Explain concerning fluoride levels in various age groups.
Recap - What do we know so far?
- The presentation intends to summarize current knowledge on fluoride.
How is Fluoride Absorbed? - Post-Eruptive Stage
- Tooth surface health is impacted by pH change due to bacterial acid production.
- The loss of calcium and phosphate from hydroxyapatite weakens the tooth structure.
- Calcium, phosphate and fluoride from saliva remineralize the demineralized tooth surface, forming fluoroapatite.
How Does Fluoride Work? - Uptake into the Tooth
- Fluoride is absorbed into the tooth surface during tooth formation and throughout the demineralization process.
- Pre-eruptive fluoride (systemic) is ingested and incorporated into teeth during development.
- Post-eruptive fluoride (topical) strengthens existing teeth.
- Fluoride uptake into the teeth occurs in multiple stages, specifically during matrix secretion and maturation.
How is Fluoride Absorbed? - Post-Eruptive Stage - Key Points
- Fluoride application creates a reservoir in saliva.
- Fluoride uptake is more efficient in the demineralized areas of the teeth.
- Demineralized enamel absorbs fluoride easily.
Essential Fluoride Supply
- To prevent dental caries, a regular supply of low-level fluoride is essential to replace lost ions.
Recap
- Insufficient evidence exists on fluoride's effect on adults.
- Studies based on older research reveal that fluoridated water reduces caries in children's permanent teeth by 26% and in deciduous teeth by 35%.
- Fluoridated water shows a 15% decrease in deciduous teeth decay incidence, and a 14% decrease in permanent teeth decay incidence.
How Can This Fluoride Be Supplied?
- The presentation is structured to highlight available fluoride sources.
Delivering Better Oral Health - Toolkit for Prevention
- This document is an evidence-based toolkit to support dental teams in improving their patients' oral and general health.
Sources Without Prescription
- Common fluoride sources accessible without a prescription include fluoride toothpaste, mouthwash, fluoridated water, fluoridated salt, and fluoridated milk.
Sources With Prescription
- These include higher concentrations of fluoride toothpaste, mouthwashes, fluoride tablets, and fluoride drops — all requiring a prescription.
Professionally Applied Sources
- Professional applications include fluoride varnish, glass ionomer cement, and silver diamine fluoride.
Systemic vs Topical Fluoride
- Systemic fluorides are ingested and incorporated into developing teeth, while topical fluorides strengthen existing teeth.
Fluoride Levels
- A full list of fluoride levels is available in the Delivering Better Oral Health document.
Toothpaste
- Fluoride toothpaste with less than 1450ppm provides limited effectiveness in controlling dental caries.
- 1450ppm concentration is common in various toothpastes.
- Fluoride toothpaste concentration varies with age groups.
Toothpaste - Recommendations
- Children under 3 years require a 1000 ppm fluoride toothpaste.
- Children aged 3 and above should use toothpaste with 1350-1500 ppm fluoride concentration.
- Supervision and ability to spit are paramount in controlling intake.
Recommendations - Age Considerations for Fluoride in Toothpaste
- Age-appropriate fluoride levels in toothpastes are specified for different age groups.
Pros and Cons of Using Fluoride Toothpaste
- Fluoride toothpaste is commonly available, cost-effective and easy to use, allowing for tailored use and application.
- However, factors like risk of ingestion concern for young children, and potential patient awareness of fluoride levels are important to consider.
Recommendations Regarding Fluoride Rinses
- Recommend daily fluoride rinsing (0.05% NaF) for individuals above 7 years of age.
- This method is best suited for individuals at higher risk of dental caries.
Recommendation for Patients who may indicate high caries risk
- Individuals with obvious active caries, orthodontic appliances, reduced salivary flow or additional needs, are those likely to benefit from extra attention.
Fluoride Varnish
- A sticky substance applied directly to the teeth for treatment and prevention of carious lesions.
- Varnish application requires patient/guardian post-operative instruction.
Fluoride Varnish - Procedure
- No eating, drinking, or rinsing for 30 minutes after treatment.
- Brushing can be resumed before bedtime, the next day.
Pros and Cons of Fluoride Varnish
- Can target specific groups, is applicable as needed and available in various flavors.
- Disadvantage is the complexity in dose control, potential need for dental appointments for application.
Silver Diamine Fluoride
- A clear, odorless liquid used for arresting caries lesions, particularly in high-risk individuals, and in those challenging for other procedures.
- Its application results in permanent black staining.
Silver Diamine Fluoride - Action Mechanism
- Applied fluoride initiates a sequence of chemical reactions that block dentinal tubules, eliminate bacteria, and limit collagen breakdown.
Silver Diamine Fluoride - Advantages and Disadvantages
- Advantages: Maintaining space for growing teeth, treating anxious adults, successful compliance in some patients.
- Disadvantages: Permanent staining, potential inability to monitor effectiveness, and potential pulp damage if treatment is not rapid enough.
Glass Ionomer Cements
- Glass ionomer cement-based materials containing fluoride leach fluoride into the demineralized tooth surface.
- Low fluoride levels are released for prolonged periods.
Prophylaxis Paste
- Prophylaxis paste, even if fluoride-containing, may not be suitable for prevention.
- These contain abrasives that can lead to more enamel loss.
Systemic Fluoride Methods - Fluoride Tablets/Lozenges/Drops
- Administer these to be sucked or dissolved in mouth, usually in the evening.
- These products are typically prescribed by dentists.
- The concentration of fluoride needs careful consideration to avoid increasing patient risk of fluorosis.
Recommendations for Systemic Fluoride
- Fluoride supplements are a consideration but not a first-line treatment for deciduous teeth—further research is needed in this area.
- Focus on diet and oral hygiene practices to avoid intake of fluoride from other sources.
Recommendations for Fluoride Intake
- Varying fluoride levels are recommended for different age brackets.
Pre-natal Fluoride Administration
- Recommendations about pre-natal fluoride administration are cited in the document, highlighting the current evidence.
Fluoridated Salt
- Some countries mandate salt fluoridation.
- Salt fluoridation bypasses any issues of individuals not consistently consuming fluoridated water.
Pros and Cons of Fluoridated Salt
- Salt is inexpensive, readily available and widely consumed, but variability in intakes across populations could pose an issue.
Fluoridated Milk
- Fluoridated milk programs exist for school children in some areas.
- Fluoride supplements may cause problems in combination with milk.
Pros and Cons of Fluoridated Milk
- Fluoridated milk is palatable, helps to target specific populations, can be stopped/started easily, but may be expensive and the dose may be not accurate/consistent.
Fluoride Toxicity
- Acute lethal levels can exist due to ingestion of fluoride.
Fluoride Toxicity - Symptoms and Management
- Symptoms such as salivation, nausea, and vomiting may suggest harmful fluoride ingestion.
- Immediate action should be taken by contacting emergency services or a medical professional, providing the necessary details about ingested amount and type.
Fluoride Toxicity - Dose Calculations (5 year old)
- Sub-lethal and potentially lethal doses of fluoride products for a 5-year-old child are presented for various methods.
Summary
- Fluoride varnish is a top choice for topical delivery, particularly for high-risk patients.
- Regular use/prescription of other fluoride products requires professional supervision, particularly for young children.
- Dietary advice and oral hygiene are essential in managing dental health.
References
- Include studies, publications, and reports on fluoride's effect on teeth and associated risks.
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Description
This quiz covers various fluoride delivery methods essential for preventing dental caries. It discusses over-the-counter and prescription fluoride sources, as well as professional applications used by dental practitioners. Understanding these methods is crucial for effective patient education and preventive care.