fluoride Flashcards
(27 cards)
Mechanism of fluoride action
When sodium fluoride is applied on the tooth
surface it reacts with hydroxil apatite crystals
rapidly to form calcium fluoride.
a thick layer of calcium fluoride gets
formed it interferes with the further diffusion of fluoride from aqueous solution to react with hydroxil apatite.
The calcium fluoride reacts with hydroxil apatite to form
fluoridated hydroxil apatite.
Why professionally applied fluoride agents are recommended for public health programs ?
- For areas with relatively homogenous high-risk
prevalence, fluoride-deficient drinking water and lack of fluoride toothpaste - In special risk groups such as the mentally handicapped or elderly people with reduced salivary
flow, exposed root surfaces and heavily restored dentitions; and in people with senile dementia.
professionally applied fluoride indications
Patients who are at high risk for caries (smooth surface , root surfaces )
White spots
Active decay
• Special patient groups, such as:
-Orthodontic patients
-Patients with decreased salivary flow
( Xerostomia)
Children whose permanent molars should, but can not be sealed.
And areas whithout fluoridated water
Professionally Applied Fluorides
Types and materials
• Professional Topical fluoride therapy
– Sodium Fluoride
– Stannous Fluoride
– Acidulated Phosphate Fluoride
– Fluoride Varnish
• Self applied fluoride agents
– Fluoride Dentifrice
– Fluoride Mouth Wash
– Fluoride Impregnated Dental Floss
– Fluoride Chewing Gum
• Alternative fluoride agents
– Intraoral Controlled Release Device for Fluoride
– Fluoride Containing Alginates
– Fluoride Restorative Materials
forms of fluoride delivery
- Gels
- Foams
- Mouth rinse (mouthwash)
- Varnish
Sodium fluoride Method of Preparation
To prepare 2% NaF –20 gms of NaF is dissolved in 1 liter
distilled water in a plastic container
Sodium fluoride technique of application
Polishing
Isolation
2% NaF applied
Allowed to dry 3 – 4 min
Patient is advised to avoid rinsing, drinking and eating for
next half an hour
Sodium fluoride advantages and disadvantages
Advantages
Chemically stable
Acceptable taste
Non-irritant to gingiva
Does not discolor teeth
Inexpensive
Disadvantages
4 visits within a short time
30% Caries reduction
Standouts fluoride Method of Preparation
To prepare 8% SnF – 0.8 gms is dissolved in 10 ml of
distilled water in a plastic container and shaken.
Standouts fluoride Technique of application
(Muhler Tech)
Polishing
Teeth are isolated with cotton rolls
SnF is applied with cotton
tipped applicators
Patients are allowed to expectorate
after cotton rolls are removed
A six monthly interval treatment schedule is advised.
Solution is applied continuously keepingthe
teeth moist for 4 min
Instructed not to eat, drink or rinse for 30min
Standouts fluoride No. of application and disadvantages
6 mts or 12 mts
Disadvantages :
Unstable
Metallictaste
May cause gingivalirritation
Causes brown pigmentation of teethparticularly
in hypocalcified area
Causes staining on margins ofrestorations
Acidulated phosphate fluoride (solution) Method of preparation
20 gms of NaF is dissolved in 1 litter of 0.1 phosphoric acid
To this 50% hydro fluoride acid is added to adjust the pH at
3 & fluoride conc. at 1.23%
Paint on technique
For pt. who can not tolerate tray
application
may used for gels and
foams
• Seat the pt. upright
• Isolate the teeth on one side of
mouth by inserting cotton rolls
when needed, use cotton roll
holder
• Insert saliva ejector on the
opposite side where application
take place ,dry teeth with air
syringe
• Quickly apply fluoride
with cotton-tipped
applicator to moisten
all teeth
• Wait for 1 to 4 min.
• Ensure tooth surface
remain wet with
product by applying
continuously
• Remove saliva ejector,
cotton rolls
• Gently proceed suction
on all teeth surfaces or
wipe the teeth with
gauze to remove the
residual product
• Ask pt. to expectorate
• Instruct pt. to not eat ,
drink, or brush teeth at
least 30 min.
Acidulated phosphate fluoride no. Of application, advantages and disadvantages
1 or 2 per year
Advantages :
Stable
Cheap
50% more effective than NaF
Disadvantages :
Teeth must be kept wet for 4 min
Acidic, sour and bitter to taste
Acidulated phosphate fluoride (gel)
Method of preparation and recommended application time
A gelling agent methylcellulose or hydrox-ethyl
cellulose is to be added to the solution and pH is
adjusted between 4 – 5
recommended application time is 4 minutes
Do not use acidulated phosphate fluoride on pt. with …. Because ??
porcelain and composite restoration
changes in translucency – which can
affect aesthetics – roughened surfaces can accumulate stains and
organic debris
Tray technique
• Allow simultaneous application to
both max. and mand. Teeth
• The most appr. For gel and foams
• Seat the pt. in up right position
• Chose comfortable tray cover
patient dentition
• Place the fluoride gel or foams
without over loading, the biting
process will cause the product to
flow sufficiently to cover the tooth
surface
• Isolate the mand. Teeth using
cotton rolls, then dry with air
syringe
• Insert the mand. Tray
,pressing it against occlusal
,facial ,and lingual surface to
force the product to flow
• Insert the max. tray ,using the
same technique
• Carefully place saliva
ejector between the trays
• Instruct the pt. to close the
mouth and bite gently on
the trays
• Leave the trays in place for
about 1 to 4 minutes
• To remove the trays, tilt the chin
downward, this allow excess
product to flow forward and
facilitate removal
• Ask pt. to expectorate, then suction
any residual fluoride by saliva
ejector
• Instruct the pt. to not eat ,drink
,rinse ,or brush teeth at least for 30
min.
acidulated phosphate fluoride advantages and disadvantages
Advantages
Requires only 2 application in a year;
The gel preparation can be self applied and thus the cost of application also gets
reduced;
It has the ability to deposit fluoride in enamel to a deeper depth;
Disadvantage
Practical difficulties like the teeth should be
kept wet for for 4 minutes;
It is acidic, sour and bitter in taste;
It cannot be stored in glass containers.
Semi slow release and slow release such as
fluoride varnishes, glassionomer
cements.
• Examples of fluoride varnishes are:
Duraphat ,Fluor Protector and Bifluorid
Fluoride varnish is
Protective coating that is painted on child’s teeth to prevent cavities , can also be painted on teeth that already have cavities
It is recommended that the initial varnish application be repeated…
3 times within 7-10 days in patient with caries risk
Fluoride varnish advantages and disadvantages
Advantages :
Forms a water tight protective film insulating against
thermal and chemical influences
Varnish remains on tooth for several days
Disadvantages :
Pt co-operation is required
Yellow discolouration
Undesirable taste
Expensive Advantages :
Forms a water tight protective film insulating against
thermal and chemical influences
Varnish remains on tooth for several days
Disadvantages :
Pt co-operation is required
Expensive
Fluoride varnish indications
1- for moderate, high risk
2- as a primary preventive measure
3- as a treatment for hypersensitive teeth
4- to decrease post- operative sensitivity
5- used as a cavity liner
