2024 Introduction To Fluorides PDF

INTRODUCTION TO FLUORIDES DEPARTMENT OF ORAL MEDICINE AND PERIODONTOLOGY S SIMONS 2024 GOOD MORNING ALL Today’s lecture will cover an introductory lecture on FLUORIDES. Fluorides will be covered more in depth in your 2nd year. FLUORIDES Fluorides was first thought to be beneficial only during tooth...

INTRODUCTION TO FLUORIDES DEPARTMENT OF ORAL MEDICINE AND PERIODONTOLOGY S SIMONS 2024 GOOD MORNING ALL Today’s lecture will cover an introductory lecture on FLUORIDES. Fluorides will be covered more in depth in your 2nd year. FLUORIDES Fluorides was first thought to be beneficial only during tooth development years Through research it was discovered that fluoride had additional benefits Decline in caries is attributed to increased use of fluoride Fluoride is an ionic compound derived from fluorine, which is the single most reactive element on the periodic table It is found throughout the earths crust e.g. rocks of volcanic origen,all natural waters, soil,cryolite Regardless of the challenging and occasional volatile properties of fluorine, it is a important element for humans and animals FLUORINE FLUORIDES It is commonly found in drinking water and toothpaste. Fluoride is added to public water supplies at an average concentration of about 1 part per million (1 ppm) or 1 milligram per liter, or slightly below It is without a doubt toxic at certain concentrations It has significant benefits during and after tooth development It is essential for formation of bones and teeth ( much like calcium and phosphorous is) FLOURIDE CONTENT Bone: Enamel: 0.01 – 0.3 % 0.01 – 0.02 % Carious teeth: 0.0069% HISTORY  Early 1900’s GV Black and Dr F McKay (almost 30 yrs) found people with ‘mottled enamel’  They discovered that people with mottled enamel had less dental decay  Only in 1930 did they discover the relationship between fluorides and mottled enamel  Through research an Optimum level of fluoride was found  At 1part per million (ppm): reduced Dental Caries with no mottling  Level needed be adjusted according to different climates  In Hot/warmer climates the level must be reduced due to intake of more water SOURCES OF FLUORIDE FLUOROSIS FLUOROSIS DEFINITION Is an enamel defect caused by ingestion of excessive fluoride during enamel formation Usually the first 8 years of life Damage is permanent but can be cosmetically treated SOURCES – EXCESSIVE FLOURIDE EXPOSURE  Public water fluoridation (particularly during infancy)  Soda cool drinks – usually made with fluoridated water  Abnormally high concentrations – natural fresh water  Dentifrice/fluoridated mouthrinse – young children Consider using unfluoridated toothpaste  Untested bottled water  Inappropriate use – fluoride supplements  Some foods –fluoride used as a preservative  Overheating Teflon pans while cooking, as some of the Teflon (a fluorine compound) may be released into the air. EFFECTS OF FLUOROSIS  White spots  Chalky appearance due to lack of minerals  Mottling light /dark brown ( ameloblasts – enamel forming cells)  Severe fluorosis cracks, pitting ,overall corroded appearance WATER FLUORIDATION  Water fluoridation is the controlled adjustment of fluoride to a public water supply to reduce tooth decay.  Fluoridated water contains fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride  Water fluoridation usually is accomplished by adding sodium fluoride (NaF), fluorosilicic acid (H2SiF6), or sodium fluorosilicate (Na2SiF6) to drinking water.  Benefits 1st tested in Grand Rapids, Michigan  1945 fluoride was added to water supply  Proven that dental caries was reduced by approximately 60% ADVANTAGES / DISADVANTAGES OF WATER FLUORIDATION ADVANTAGES Effective, efficient, reliable and inexpensive means – improving oral health Equitable public method Cost of dental care reduced DISADVANTAGE No choice for the individual DIFFERENT TYPES OF FLUORIDES IN DENTISTRY Sodium fluoride Most commonly used Stannous fluoride Acidulated Phosphate Fluoride Another fairly commonly used fluoride Amine Fluoride HOW DOES FLOURIDE WORK MECHANISM OF ACTION  Fluoride will always be present in our lives as it is a part of the natural environment  Fluoride enters the body with food, through respiration and products which contains fluoride.  About 90% of fluoride is absorbed in the gastrointestinal tract after consumption  After absorption, fluoride is transported into the bloodstream and is distributed through the organism  The calcium and phosphate compound which makes up tooth enamel is a modified form of hydroxyapatite, which is susceptible to attack by acids  Fluoride binds to tooth enamel [which is primarily made up of hydroxylapatite, a crystal composed of calcium, phosphorus, hydrogen and oxygen]  It replaces the hydroxyl molecule on hydroxyl apatite, fluoride makes the tooth more resistant to acid attack from bacteria SYSTEMIC FLUORIDES SYSTEMIC FLUORIDES ARE FLUORIDES THAT ARE INGESTED AND BECOME INCORPORATED INTO FORMING TOOTH STRUCTURES. THE INGESTED FLUORIDES CIRCULATES THROUGH BLOOD STREAM IT IS THEN INCORPORATED INTO DEVELOPING TEETH AVAILABILITY OF SYSTEMIC FLOURIDES NATURALLY - EVERY FOOD GROUP MOST LIQUIDS COMMUNITY DRINKING WATER DIETARY SUPPLEMENTS SMALL AMOUNTS – SALT, MEAT, VEG, CITRUS FRUIT, MILK HIGHER CONCENTRATIONS - MILK SYSTEMIC VS TOPICAL TOPICAL FLUORIDES  Fluoride directly applied to exposed surfaces of an erupted dentition  Topical fluorides strengthen teeth already present in the mouth, making them more decay resistant  Remineralizes teeth externally EFFECTS OF TOPICAL FLUORIDES  Antibacterial  Disrupts enzymes systems  Remineralization of small defects  Improved quality of enamel  Inhibits demineralization PROFESSIONALLY APPLIED TOPICAL FLUORIDES GEL APPLICATION VARNISH POLISHING PASTE POLISHING PROCEDURE VARNISH APPLICATION INDICATIONS FOR PROFESSIONALLY APPLIED FLUORIDES WHEN WOULD WE AS CLINICIANS APPLY FLOURIDE FOR A PATIENT              Primary teeth Active caries Orthodontic appliance wearers Compromised salivary flow Lack of compliance Post eruptive period-esp. those that are not caries free Secondary caries Teeth supporting a denture Fixed dental prosthesis Exposed root surface Low or no fluoride in water Early carious lesion After periodontal surgery when roots are teeth are exposed HOME CARE (FLUORIDE) Available:  Toothpaste  Mouth rinses FLUORIDE TOXICITY Toxic in excessive amounts Lethal dose varies 2.5 – 10 gram( adults) 0.25gr ( infants) FLUORIDE TOXICITY  Acute fluoride poisoning – extremely rare FLUORIDE INGESTED OVER A SHORT PERIOD OF TIME  Chronic fluoride poisoning – ingestion of high fluoride levels in the water or combinations FLUORIDE INGESTED OVER A LONG PERIOD OF TIME  Teeth ‘mottled enamel’ or fluorosis or enamel hypoplasia FLUORIDE LEVEL 1.8 – 2ppm Suspected overdose – milk mucous membranes BENEFITS OF FLUORIDE BENEFITS Numerous studies show evidence of benefits tooth mineralization Enamel tooth demineralization Promotes dental enamel remineralization dentin sensitivity Primary benefit is the reduction of dental caries Less primary and permanent tooth loss due to dental caries Less malocclusion in permanent teeth Fewer bridges, partials, dentures Improved bone density – stronger bone/healthier periodontal tissues THANK YOU FOR YOUR ATTENTION !!!!!