Oral Health Promotion Chapter 16

Study Notes

Fluoride intake occurs through food, liquids, and dental products like dentifrices and mouth rinses.
Absorption starts with passive diffusion in the stomach as hydrofluoric acid (HF) and occurs within 60 minutes; excess fluoride is absorbed in the small intestine.
Fluoride reaches the bloodstream within 30 minutes, with plasma distributing fluoride to all tissues, primarily stored in teeth and bones.
99% of fluoride is integrally bound in the mineral structure, with the highest concentrations found on tooth surfaces.
Excretion primarily happens through kidneys, with small amounts found in sweat, feces, and breast milk.

Fluoride enhances remineralization and inhibits demineralization of tooth enamel.
It accumulates in biofilm and saliva, and high concentrations can reduce bacterial activity, helping to prevent dental caries.

Recommended fluoride levels in drinking water range from 0.7 to 1.2 parts per million (ppm).
Acceptable fluoride compounds for water adjustment include sodium fluoride, sodium silicofluoride, and hydrofluorosilicic acid, chosen for solubility and cost-effectiveness.

Effective in reducing dental caries in primary teeth and minimizing tooth loss among adults.
Contributes to the prevention of periodontal diseases.

Dietary sources include certain foods, salt, and bottled water, with a halo effect spreading fluoride from fluoridated water supplies.

Assess water fluoride levels to determine the need for supplements.
Available in forms like tablets, lozenges, rinses, and drops; dosage guidelines are essential.

Common professional fluoride treatments include 2.0% sodium fluoride (gel or foam), 1.23% acidulated phosphate fluoride (APF), and 5% neutral sodium varnish.
Objectives of topical treatments focus on caries prevention, remineralization, and desensitization.

During fluoride application, plaque and calculus should be removed, and patient counseling provided regarding caries risk and post-treatment instructions.
Common application techniques include tray application for gels or foam and paint-on varnish methods.

Self-applied fluoride methods include tray applications, rinsing, and toothbrushing.
Gels must be used with caution, with specific concentrations and precautions detailed in patient instructions.

Available as low potency/high frequency or high potency/low frequency preparations, beneficial for caries prevention but with certain limitations.

Brush-on gels contain varying concentrations of fluoride for effective dental caries protection.
Fluoride-containing dentifrices are recommended for all patients, serving as the first line of preventive care.

Fluoride safety and a combined program of fluoride use should be emphasized in patient education.
Age-specific recommendations for fluoride toothpaste use exist, tailoring for toddlers, children, and adults.

Fluoride toxicity can be acute or chronic, with accidental ingestion posing risks.
Certain lethal doses include 0.5 to 1.0 grams of sodium fluoride for children and 5 to 10 grams for adults, highlighting the need for careful storage and monitoring.