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Questions and Answers
What is a recommended technique for children under the age of 5 when using fluoride toothpaste?
What is NOT an indication for the use of high potency fluoride rinses?
Which fluoride preparation can be applied by brush or tray?
Which of the following is an advantage of a supervised mouth rinse program?
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What is the primary function of fluoride toothpaste in preventing dental caries?
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What should be avoided for at least 30 minutes after using a fluoride rinse?
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What is the fluoride concentration in children strength toothpaste?
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Which of the following is true about the use of fluoride rinses in patients undergoing radiotherapy?
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What is the principal mode of application for varnishes?
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Which indication is NOT a reason for applying varnish?
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What is a special property of varnishes?
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What enhances the effectiveness of Titanium Tetra-fluoride treatment?
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Which of the following is a method for slow-released fluoride delivery?
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Which fluoride rinse concentration is recommended for daily use?
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What benefit does Titanium Tetra-fluoride provide to teeth with hypersensitivity?
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What is the primary purpose of fluoride releasing fissure sealants?
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What is a characteristic advantage of sodium fluoride solution?
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Which of the following is a disadvantage of using stannous fluoride solution?
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The Knutson Technique for applying fluoride involves what frequency of application at the age of 3?
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Which preparation combines both fluoride and vitamins to aid motivation for regular ingestion?
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What is one of the major advantages of thixotropic gel as a fluoride application method?
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Which type of fluoride delivery is typically not recommended for dilution in liquids?
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In which form is slow-released fluoride typically delivered?
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What is a primary benefit of using fluoride varnish?
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Which fluoride application method is specifically noted for its effectiveness in adults?
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Study Notes
Fluoride Preparations and Applications Overview
- High potency and low frequency fluoride applications are recommended for specific patient groups and situations.
- Low potency and high frequency applications are recommended for daily use and long-term preventive measures.
Indications for High potency and low frequency Fluoride Applications
- School-based programs in communities with low fluoride levels and moderate to high caries activity.
- Patients with increased caries risk.
- Patients undergoing orthodontic treatment.
- Patients undergoing radiotherapy.
Contraindications
- Children below the age of 6 years.
Fluoride Rinses
- The most commonly recommended concentration for a daily rinsing program is 0.05% neutral sodium fluoride (Low potency, high frequency).
- Weekly rinses with 0.2% sodium fluoride have also been shown to be effective.
Self-Applied Fluoride Gel
- Commonly available in 0.4% stannous fluoride gel and 0.05% APF gel formats.
- Can be applied using a brush or tray.
Fluoride Toothpastes
- Fluoride toothpastes are effective in reducing dental caries.
- Widespread use of fluoridated toothpaste is attributed to the decline in dental caries prevalence in industrialized countries.
- When introduced into the mouth, fluoride in toothpaste is taken directly by dental plaque and demineralized enamel.
- It also increases the fluoride concentration in saliva.
- Toothpaste may be the most important source of fluoride globally.
- Fluoride toothpastes contain various fluoride compounds:
- Sodium fluoride.
- Acidulated phosphate fluoride.
- Sodium monofluorophosphate.
- Adult strength: 1000-1500 ppm.
- Extra strength: 2500 ppm.
- Children's strength: 500-550 ppm.
Fluoride Toothpaste Safety and Usage for Children
- Fluoride toothpastes carry advice that for children under the age of 6 years, brushing should be supervised and only a very small amount (less than 5mm) should be placed on the brush.
- Children under the age of 5 years may ingest more than 0.5 mg fluoride daily from 2 brushings of toothpaste containing 1000-1500 ppm.
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Recommendations for young children:
- Use low fluoride toothpaste (500-550 ppm).
- Apply a small pea-sized amount of paste to a child-sized toothbrush.
- Parents should brush their children's teeth until the child can do it properly.
- Children should be encouraged to spit the paste out after brushing.
Fluoride Varnishes
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Properties:
- High fluoride content.
- Long contact time with the enamel surface.
-
Mode of application:
- Twice a year.
- 3 consecutive applications within a 10-day period/year for 3 years (high risk).
-
Indications:
- Nervous children.
- Failed fissure sealant.
- Children with medical and physical problems.
- Arresting rampant caries.
- Reduction of secondary caries activity.
- Preventive program against root caries.
- In orthodontic patients.
Fluoride Prophylactic Paste
- Applied using a small brush.
- Leaves a yellow film on the teeth after application.
Titanium Tetra-Fluoride (Ti F4)
- When dental enamel is exposed to an aqueous solution of Ti F4, a glaze layer forms on the tooth surface.
- This glaze layer is a product of the interaction between Ti F4 and proteins on the enamel surface.
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Properties:
- Hard.
- Hydrophobic.
- Reflecting a spectrum of colors.
- 4% Ti F4 treatment is more suitable than 1% because the glaze appears to be more tenacious and thicker after this treatment.
- Titanium Tetra-fluoride has gained recognition in various dental fields:
- Application on the surface of hypersensitive teeth.
- Reduced caries formation around fixed orthodontic appliances.
- Used as a fissure sealant in primary teeth.
- Protects teeth against erosions caused by strong acids.
- Effective in preventing dental erosion caused by hydrochloric acid in patients with frequent vomiting or gastro-esophageal reflux.
Slow-Release Fluoride
- Intra-oral devices in the form of copolymer devices or glass devices can elevate salivary fluoride levels for up to 2 years.
Other Vehicles for Applying Topical Fluoride
- Fluoride-releasing fissure sealants.
- Amalgam containing fluoride.
- Composite resin restorations containing fluoride.
- Glass ionomer cement.
- Cavity liners with fluoride.
Fluoride Tablets
- Common tablets include neutral sodium fluoride and acidulated phosphate fluoride.
- Used as lozenges or crushed and chewed for one minute before swallowing.
- Chewing provides topical protection of teeth and systemic benefits.
Fluoride Drops
- Neutral sodium fluoride solutions are used as fluoride drops for infants.
- Dispensed using a dropper.
- Each drop contains about 0.1 mg of fluoride.
- The number of drops is adjusted according to the recommended dosage.
- Drops are placed directly on the tongue or inside the cheeks.
- Dilution in milk, juice, or water is no longer recommended.
Fluoride-Vitamin Preparations
- Recommended when a patient requires both fluoride and vitamins.
- The combined preparation may aid in motivation for continued and regular fluoride ingestion.
- The addition of vitamins has no observable effect on the decay-prevention properties of fluoride.
Dietary Fluoride Preparations
- Salt Fluoridation.
- Milk Fluoridation.
- Flour Fluoridation.
Professionally Applied Fluoride
- Different forms of fluoride are used for professional application, including:
- Fluoride solutions.
- Fluoride gels.
- Thixotropic gels.
- Fluoride foams.
- Fluoride varnishes.
- Fluoride-containing prophylaxis Paste.
- Slow-released fluoride.
Fluoride Solutions
-
Sodium Fluoride Solution (2.0%):
- 45.0 mg in 5 ml → 9,050 ppm
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Stannous Fluoride Solution (8.0%):
- 97.0 mg in 5 ml → 19,363 ppm
- Acidulated Fluoride Solution (1.23%):
Advantages of Sodium Fluoride Solution
- Stable in plastic containers.
- Acceptable taste.
- Non-irritating to the gingiva.
- Doesn't discolor or stain teeth.
Knutson Technique
- 4 applications at the ages of 3, 7, and 10 years, with four applications one week apart for each age group.
Advantages of Stannous Fluoride Solution
- More effective in adults than sodium fluoride.
- Can be applied at regular recall appointments of 6-12 months without additional appointments.
Disadvantages of Stannous Fluoride Solutions
- Unstable in aqueous solution and must be prepared daily or weekly.
- Metallic, astringent taste poorly acceptable by children.
- Can cause yellowish-brown pigmentation around carious lesions and composite restorations.
- Can cause gingival irritation and occasional sloughing of diseased gingiva.
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Description
This quiz covers the various fluoride preparations and their applications in dental care. It highlights the differences between high potency and low frequency fluoride applications versus low potency and high frequency ones. Additionally, it addresses indications, contraindications, and common fluoride rinses used for preventive measures.
