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PATIENT CARE III EXAM 2 > fluoride > Flashcards

fluoride Flashcards

1
Q
  1. Hardest and most mineralized tissue in the body
  2. Outer covering of enamel is made up of calcium and phosphate
A

enamel

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2
Q
  1. Layer of tooth structure that is directly underneath the enamel
    and is positioned around the pulp
  2. Less mineralized than enamel, but more mineralized than bone or
    cementum
A

dentin

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3
Q

soft layer of a tooth that contains nerves, blood vessels, and
connective tissue

A

pulp

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4
Q

Acids diffuse into tooth and dissolve calcium & phosphate minerals

A

demineralization

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5
Q

If acid attacks are infrequent/short duration, saliva aids in repair of
damage by neutralizing acid and replacing minerals and fluoride
lost from tooth

A

remineralization

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6
Q

If flow of saliva is low and bacterial level is high, tooth mineral lost by
acid attacks are too great for repair by remineralization, thus
resulting in carie

A

resulting in caries

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7
Q

pathologic factors associated with caries

A
  1. Acid-producing bacteria (S. mutans)
  2. Low salivary flow (due to salivary gland
    dysfunction, mouth-breathing, medications,
    etc.)
  3. Carbohydrates in diet (i.e., Pasta,
    cereal, bread, crackers, sugar)
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8
Q

protective factors associated with caries

A
  1. Minerals in saliva (calcium, phosphate,
    fluoride, proteins)
  2. Normal salivary flow
  3. Antibacterial agents (if needed)
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9
Q
  1. Untreated caries present in more than ___ adults
  2. Disproportionately distributed among those of lower socioeconomic
    status1
A

1 in 5 adults

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10
Q

_____% of pediatric population has caries present in primary dentition2
___% of pediatric population has caries present in permanent dentition2
Caries is most prevalent in ethnic minority groups from lower income families

A

10%

<3%

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11
Q
  1. a natural inorganic occurring mineral
  2. Naturally present at low concentrations in most fresh and
    saltwater sources
  3. Either the fluorine ion (F-) or a compound containing fluoride
    (NaF)
  4. In the correct concentrations can decrease the likelihood of
    dental caries
A

fluoride

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12
Q

fluoride aids in _____and decreases the risk of carious lesions by up to 25%

A

remineralization

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13
Q

fluoride is _____to caries prevention- NOT solution

A

supplement

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14
Q

ingested agents delivered to the oral cavity via the bloodstream:
1
2
3

A

systemic application

  1. water
  2. supplements
  3. food/beverage
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15
Q

strengthen teeth already in the mouth making them more resistant to caries:
1
2
3

A

topical application
1. water
2. homecare products (toothpaste, mouth rinses, etc)
3. in-office products

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16
Q

Fluoride inhibits _______ when present in solution (mouth
rinse, toothpaste, etc.)

A

demineralization

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17
Q

Fluoride present on tooth surfaces and in plaque fluid inhibits acid
demineralization by:
(interferes with acid-production of bacteria)

A

reducing the solubility of the tooth mineral

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18
Q

Fluoride enhances _____ and accelerates remin
process by absorbing into tooth surfaces and attracting calcium
ions

A

remineralization

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19
Q

Fluoride ions incorporate into remin tooth structures that result in
the development of _______ which are less soluble
than original enamel and make remin lesions less susceptible to
future demin

A

fluorapatite crystals

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20
Q

-Community water fluoridation
-School water fluoridation
-Fluoride supplements
-Foods containing fluoride
-Salt

A

systemic fluoride

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21
Q

Fluoride is incorporated into the mineralizing structure during

A

tooth development

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22
Q

Fluoride present in ____ enhances mineralization of enamel
during enamel maturation phase

A

saliva

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23
Q

An increase of the natural fluoride level in a community’s
water supply to a

A

level optimal for dental health

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24
Q

considered one of the most cost-effective
preventive dental program by public health

A

water fluoridation is

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25
benefits of water fluoridation ____% decrease in caries in primary dentition ___% decrease in children permanent dentition about ___% decrease in coronal caries and ____% decrease in root caries in adult population
30-39% 35% 20-30% 20-40%
26
levels of water fluoridation optimal = optimal range=
minimal caries with minimal fluorisis range= 0.6-1.2ppm
27
.7ppm decreases caries with _____% of population with fluorsis
<10%
28
how does topical fluoride work?
Fluoride deposited in enamel during enamel maturation phase results in a concentration of fluoride in the enamel
29
highest concentration of fluoride occurs on the
outermost portion and decreases as you move toward the dentin
30
Fluoride ions are substituted into the _______ and form a stable, more compact bond making the tooth resistant to demineralization
hydroxyapatite crystal
31
fluoride (does/does not)
does not
32
fluoride/enamel reaction to fluoride is influenced by
concentration of fluoride, pH, and fluoride, and length of exposure
33
acidic fluorides typically form
calcium fluoride
34
higher concentrations of fluoride form
calcium fluoride
35
3 benefits of topical fluoride
1. remineralization 2. interferes with bacterial metabolism 3. prevention
36
3 types of topical fluoride applications
1. 2% neutral sodium fluoride (9000ppm) 2. 1.23% acidulated phosphate fluoride (APF) (12,300ppm) 3. 5.0% NaF (22,600 ppm)
37
available as a varnish application commonly used in dental practices what fluoride
5.0% NaF
38
Available as a foam or gel application (rarely used in practice)
1.23% acidulated phosphate fluoride
39
Available as a foam or gel application (rarely used in practice)
2% neutral sodium fluoride
40
are initial deposits of fluoride permanent?
no rapid loss after 24 hours loss continues for several weeks
41
after every application of topical fluoride, there is an ____in the amount of permanently bound fluoride in the outermost layer of enamel
increase =decrease in caries susceptibility
42
two types of fluoride
1. fluorohydroxyaptite 2. calcium fluoride
43
most desired form of fluoride for enamel in caries prevention
fluorihydroxyaptite
44
From prolonged exposure of enamel to low concentrations of fluoride
Fluorohydroxyapatite
45
source of fluoride for remineralization of enamel
calcium fluoride
46
Deposits of calcium fluoride are dissolved by plaque acids and are available as a source to facilitate remineralization
calcium fluoride
47
benefits of topical fluoride treatments is directly related to
the amount of topical fluoride treatments provided
48
does the type of topical fluoride system used affect the benefit?
no does not benefit sound enamel greater uptake with higher concen of fluoride
49
when should topical fluoride be used
1. High caries risk individuals 2. Sensitive teeth/exposed root surfaces 3. Around margins of older restorations 4. Overdentures (with natural teeth) 5. Xerostomia 6. Newly erupted teeth
50
probable toxic dose PTD based on:
body weight considered to be 5mg F/kg of body weight <5mg/kg: office use >5mg: hospital observation >15mg: ER
51
concentrated fluoride salts can cause chemical burn when in contact with:
oral mucosa -inhibits enzyme systems -binds calcium -cardiotoxic due to hyperkalemia
52
signs and symptoms of too much fluoride
nausea vomiting diarrhea abdominal cramping increased salivation/dehydration
53
pros of fluoride varnish 5% NaF
1. proven efficacious in decreasing caries, especially in early childhood 2. easy to apply following oral exam and prophylaxis 3. easy to follow post-op instructions
54
cons of fluoride varnish 5% NAF
1. leaves a thin-visible film on teeth that some patients do not like 2. possible allergies linked to specific brands of fluoride varnish
55
application of fluoride varnish
1. Applied to clean tooth surfaces (following a prophylaxis or toothbrushing) 2. varnish is retained on teeth from 24-48 hours after application, during which time fluoride is released for reaction with the underlying enamel 3. application should occur every 3-6 months (dependent upon caries risk)
56
silver diamine fluoride
clear liquid composed on 24-29% silver and 5-6% fluoride
57
silver diamine fluoride is considered alkaline at a pH level of
10
58
silver contributes to antimicrobial effect and
fluoride remineralizes tooth structure
59
silver diamine fluoride derives its effectiveness from
silver nitrate and fluoride
60
silver diamine fluoride antibacterial action on cariogenic bacteria is by:
silver
61
silver diamine fluoride Remineralization and inhibition of demineralization of enamel and dentin and Inhibition of dentin collagen type 1 degradation by
fluoride
62
found to be most superior at arresting caries compared to lower concentrations
38% SDF (multiple applications found to be more successful at arresting than one-time placement
63
SDF: Fluoride and silver are made soluble in water by the addition of
ammonia
64
in SDF, these damage and degrade bacterial cell walls, disrupt bacterial DNA synthesis and replication and disrupt intracellular metabolic activity, eventually leading to cell death
silver ions which act as tiny silver bullets
65
The killed bacteria further act as a carrier for silver ions and can kill living bacteria nearby in a process known as the
“zombie effect”
66
once SDF is applied, a physical barrier precipitates out of the clear solution onto the carious lesion. 2 products then form:
1. silver phosphate (acts as a reservoir of phosphate ions 2. calcium fluoride, which is a pH regulated fluoride supply available during cariogenic challenge
67
once SDF is applied, free silver ions in the lesion are reduced by environmental oxygen and turn the lesion ____ which is the major nonmedical side effect of SDF
black
68
5% SDF solution contains ____ppm fluoride which is almost twice as much as 5% NaF
44,800
69
SDF reacts with calcium and phosphate ions to produce: which are less susceptible to solubility and crucial to tooth remineralization
fluorohydroxyaptite crystals
70
one application of SDF is not sufficient so
may need to place few time
71
when to use SDF
dentin hypersensitivity and uncooperative patients, root surface caries on elderly pts with existing restorations
72
placement of SDF
1. dry tooth 2. micro brush 3. allow area to dry 1-3 mins then rinse 4. caries will be arrested over time and turn black 5. SDF has an unpleasant metallic taste DO NOT USE WITH SILVER ALLERGY OR PULPAL INVOLVEMENT
73
this is not considered a therapeutic/preventive agent for caries polishing alone removes .1-1.0 microns of fluoride-rich enamel, therefore at best this will replace the fluoride lost by abrasive paste
fluoridate prophy paste
74
what fluoride rinse does
1. remineralizes tooth structure 2. strengthens enamel to prevent caries 3. kills bad breath
75
mi paste alone uses this to relieve tooth sens not to prevent decay
recaldent (milk derived)
76
changes in appearance of enamel caused by too much systemic fluoride
fluorosis
77
fluorosis will feel
smooth

PATIENT CARE III EXAM 2 (10 decks)

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