Fluoride and Toothpaste Quiz (ODS Learning Outcomes)
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Questions and Answers

What year did Frederick McKay identify the potential caries-reducing effect of fluoride despite its association with tooth staining?

  • 1916
  • 1931
  • 1932 (correct)
  • 1940
  • Which report published in 2000 found no evidence linking fluoride with cancer or bone fractures?

  • York report (correct)
  • Cochrane review
  • CDC report
  • Knox report
  • At what concentration (ppm) of fluoride is it suggested to optimally reduce caries while preventing mottling?

  • 1.5 ppm
  • 0.5 ppm
  • 1.0 ppm (correct)
  • 2.0 ppm
  • During which developmental stage does the majority of fluoride absorption occur after tooth eruption?

    <p>Post eruptive stage (B)</p> Signup and view all the answers

    In the context of fluoride effects, what is indicated by the term 'fluorosis'?

    <p>Aesthetic tooth staining (A)</p> Signup and view all the answers

    What is the process through which fluoride replaces hydroxyapatite in teeth?

    <p>Deposition (C)</p> Signup and view all the answers

    What was one conclusion from the Cochrane review conducted in 2015 regarding fluoride use in children?

    <p>Fluoride reduces caries incidence by 14%. (A)</p> Signup and view all the answers

    Which factor primarily influences the uptake of fluoride during the post-eruptive stage?

    <p>Porosity of enamel (A)</p> Signup and view all the answers

    What potential effect can excessive fluoride have during the pre-eruptive stage?

    <p>Inhibition of ameloblast activity (A)</p> Signup and view all the answers

    What is the main source of fluoride during the matrix secretion stage of tooth development?

    <p>Systemic sources (A)</p> Signup and view all the answers

    What is one of the main antibacterial effects of fluoride on bacteria such as Strep mutans?

    <p>It prevents the formation of biofilm. (D)</p> Signup and view all the answers

    Which fluoride delivery method is considered a prescription-only option?

    <p>Fluoride drops (C)</p> Signup and view all the answers

    How does fluoride influence tooth morphology?

    <p>Causes shallower pits and reduced fissure depth. (D)</p> Signup and view all the answers

    Which score indicates the presence of normal translucency in the enamel when assessing fluorosis severity?

    <p>Score 0 (C)</p> Signup and view all the answers

    What can result from excess fluoride during the ameloblast activity?

    <p>Formation of hypomineralized enamel. (C)</p> Signup and view all the answers

    At what fluoride level is it considered dangerous for children under 3 years old?

    <p>1000ppm smear (B)</p> Signup and view all the answers

    What is the fluoride concentration in Duraphat fluoride varnish?

    <p>22,600ppm (B)</p> Signup and view all the answers

    What level of fluoride is associated with toxicity in children?

    <p>15mg/kg body weight (A)</p> Signup and view all the answers

    Which system is affected by fluoride's antibacterial action, inhibiting bacterial uptake of glucose?

    <p>Glycolysis system. (D)</p> Signup and view all the answers

    Which fluoride delivery method is used for systemic effects?

    <p>Fluoridated water (B)</p> Signup and view all the answers

    Flashcards

    Dental Fluorosis

    A condition in which teeth have white or brown discoloration due to excessive fluoride exposure during tooth development.

    Water Fluoridation

    The process of adding fluoride to public water supplies to prevent tooth decay.

    Fluoroapatite

    A mineral found in teeth that is more resistant to acid attacks than the usual hydroxyapatite.

    Pre-Eruptive Stage

    The stage of tooth development where fluoride is absorbed from food and water.

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    Maturation Stage

    The stage of tooth development after calcification but before eruption, where fluoride continues to deposit.

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    Post-Eruptive Stage

    The stage after teeth erupt, where fluoride is applied topically.

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    Systemic Fluoride Deposition

    The process where fluoride is absorbed into the developing tooth from systemic sources like food and water.

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    Topical Fluoride Deposition

    The process where fluoride is applied directly to the teeth after they erupt, like with toothpaste or mouthwash.

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    1 ppm Fluoride

    The optimal level of fluoride in drinking water to reduce tooth decay.

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    Colorado Stain

    A study that showed a correlation between high fluoride levels in water & discoloration of teeth.

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    How does fluoride help prevent cavities?

    Fluoride can increase resistance to tooth decay by enhancing enamel's mineral content, making it more resistant to acid attacks, and inhibiting bacterial growth.

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    Explain fluoride's mechanism of action against bacteria.

    Fluoride directly inhibits bacterial enzymes involved in sugar metabolism. These enzymes are crucial for bacteria to break down sugars for energy. By disrupting these enzymes, fluoride effectively cuts off the bacteria's food supply.

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    Describe how fluoride helps remineralize enamel.

    Fluoride strengthens tooth enamel by incorporating into the enamel structure, making it more resistant to acid attacks. This process, known as remineralization, helps repair initial enamel damage.

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    How is fluorosis assessed?

    The severity of fluorosis is categorized based on the appearance of the enamel. Scores range from 0 (normal) to 9 (severe), with higher scores indicating greater enamel damage and discoloration.

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    Explain how fluorosis develops.

    Fluoride can cause fluorosis when consumed in excessive amounts during tooth development. This occurs because excessive fluoride interferes with ameloblast activity, leading to enamel hypomineralization and discoloration.

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    What is fluoride varnish?

    Fluoride varnish is a professional application that delivers a high concentration of fluoride directly to the tooth surface, promoting remineralization and reducing the risk of cavities. It is typically applied every 3 to 6 months.

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    What is silver diamine fluoride (SDF)?

    Silver diamine fluoride (SDF) is a topical solution that contains a high concentration of fluoride and silver ions. It has been shown to be effective in arresting cavities and reducing pain sensitivity. However, it can cause black staining on treated areas.

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    What is the recommended fluoride toothpaste usage for children?

    Fluoride toothpaste contains a specific concentration of fluoride, typically between 1000ppm and 1500ppm. The recommended amount for adults is a pea-sized amount, while children under 3 should use a smear amount.

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    What are the risks associated with fluoride toxicity?

    Fluoride toxicity occurs when excessive amounts of fluoride are ingested. Symptoms can range from mild nausea and vomiting to more severe effects like seizures and cardiac arrhythmias.

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    Why is fluoride supplementation important?

    Fluoride supplementation is crucial for individuals who lack adequate fluoride exposure through other sources. It can be achieved through fluoride toothpaste, mouth rinses, tablets, or even by drinking fluoridated water.

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    Study Notes

    Key Milestones in Fluoride Caries Prevention

    • 1916: Colorado Stain – Frederick McKay observed patients with stained teeth in Colorado Springs, initiating investigation into the cause.
    • 1931: Water Sampling – Churchill McKay discovered children near a mine water source had tooth staining, linked to the water.
    • 1932: Caries Reduction – Frederick McKay suggested that fluoride, although causing staining, could reduce tooth decay.
    • 1930-1940: Shoe Leather/21 Cities Studies – H. Trendley Dean's studies demonstrated a correlation between increasing fluoride in water and mottling, but also a decrease in tooth decay. Optimal level identified as 1 ppm. Led to artificial water fluoridation.
    • 1985: Knox Report – No significant link between fluoride in water and increased cancer risk found.
    • 2000: York Report – Further research confirmed no link between fluoride and cancer or bone fractures.
    • 2015: Cochrane Review – Studies showed a 14% reduction in tooth decay in children from fluoridated water. A 0.7 ppm level in water could result in a 12% chance of fluorosis.

    Fluoride Deposition Stages

    Pre-Eruptive Stage (Systemic Fluoride)

    • Matrix Secretion: Fluoride absorbed through the system (swallowed), travels to developing teeth. Deposited as fluoroapatite, replacing hydroxyapetite. Excess fluoride can hinder enamel formation, causing possible mottling (fluorosis).

    Maturation Stage

    • Fluoride Absorption: Fluoride continues to be absorbed after calcification but before eruption. Fluoride deposited further into the enamel.

    Post-Eruptive Stage (Topical Fluoride)

    • Maximum Uptake Period: Most fluoride uptake occurs post-eruption (2-3 years). Demineralized enamel and high porosity enable increased absorption. Fluoride does not penetrate deeply when applied topically.

    Modes of Action of Fluoride

    • Hydroxyapatite Replacement: Fluoride combines with calcium to form fluoroapatite, making enamel and dentin more resistant to acid attack.
    • Bacterial Inhibition: Fluoride is toxic to bacteria (like Streptococcus mutans). It impacts bacterial enzyme functions, specifically sugar metabolism, reducing their ability to cause decay.
    • Reduced Surface Energy: Fluoride reduces enamel surface energy, decreasing bacterial attachment and pellicle formation. This makes teeth less susceptible to initial decay. Affects root caries in a similar manner.

    Fluorosis: Cause and Assessment

    • Excess Fluoride: Excessive fluoride intake during tooth development inhibits ameloblast activity, leading to hypomineralized hypolasic enamel formation. This makes the enamel more porous, increasing the risk for staining.
    • Fluorosis Severity: Fluorosis scores range from 0 (normal) to 9 (severe). Scores 1-4 are characterized by increasing levels of staining without visible enamel loss, whereas scores 5-9 indicate a progressively higher loss of the enamel outer layer. Other factors such as trauma, genetic or disease can also cause this.

    Fluoride Delivery Methods and Supplementation

    Over-the-Counter Options

    • Toothpaste (1000-1450 ppm fluoride)
    • Mouth Rinse (0.05%)
    • Fluoridated Water (systemic effect)
    • Fluoridated Salt/Milk (systemic effect)

    Prescription Options

    • Toothpaste (2800, 5000 ppm)
    • Mouth Rinse (0.2%)
    • Fluoride Tablets (0.25/0.5%)
    • Fluoride Drops

    Professionally Applied Fluoride

    • Fluoride Varnish (Duraphat/Profloride - 22,600 ppm) to be applied every 3-6 months (avoid in ulcerative colitis or asthma)
    • Glass Ionomer Cement
    • Silver Diamine Fluoride (44,800 ppm)

    Dangerous Fluoride Levels for Children and High Risk

    • Supervision: Children under 7 need supervision with topical fluoride due to dexterity limitations.
    • Children under 3: Recommended 1000 ppm smear fluoride amount.
    • Children over 3: 1350-1500 ppm pea-sized applications.
    • High-Risk Children (any age): Higher fluoride concentrations (1350-1500 ppm for under 3s), up to prescription products (2800 ppm, 5000 ppm), are considered based on risk.
    • Toxicity: >15 mg/kg body weight is toxic.

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    Description

    This quiz explores significant historical milestones in fluoride caries prevention, detailing key findings and reports from the early 20th century to recent studies. Test your knowledge about the pivotal events and research that shaped public health policy regarding fluoride use in dental care.

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