Role of fluoride in dental caries Flashcards
(24 cards)
What happens when fluoride is ingested?
systemic absorption through stomach occurs quickly
absorbed as HF through mucosa into bloodstream (can then enter saliva too from there)
incorporated into calcifying tissues (bone, teeth)
excretion from body is mainly renal
How does fluoride affect enamel?
decreased demineralisation
- less calcium lost when fluoride is present
increased remineralisation
incorporated into developing enamel
interferes with metabolism of some plaque bacteria
At what pH does enamel dissolve?
5.5
What does ions do enamel require to remineralise?
calcium and phosphate
Where can calcium and phosphate be sourced from?
saliva
dairy food
CP-ACP
How is fluoride incorporated into developing enamel as?
fluoridated hydroxyapatite
fluorapatite
not enough to protect enamel and must be used daily
What are some sources of systemic fluorides?
swallowed toothpastes
water - natural and added
foods (fish, tea - natural)
tablets/drops
milk - added
salt - added
What is the difference in fluoride concentrations in supermarket and prescription toothpastes?
supermarket - 450,1000, 1450ppm
prescription - 2800 and 5000ppm
What is the concentration of fluoride in varnishes?
7000 - 22600 ppm
What is the concentration of fluoride in rinses?
226 and 910 ppm
What is the concentration of fluoride in silver diamine fluoride?
44,800 ppm
results in black stained arrested lesions
only approved in UK as desensitising agent
How much fluoride should be placed in children up to 3 years old?
1000ppm
smear of toothpaste
parents brush
How much fluoride should be placed in children 3-6 years old?
1350-1500ppm
pea-size toothpaste
parents help with brushing
How much fluoride should be applied daily in teenagers and adults?
1450ppm
or 2800/5000ppm is high caries risk
if there is little fluoride in water and high risk, then add daily fluoride mouthwash
How much fluoride is in mouthwash?
daily - 0.05%
weekly - 0.2%
What must prescribers consider with fluoride mouthwash?
age
appropriate instructions
does mouthwash have alcohol
What are 3 forms of professional topical fluorides?
fluoride prophylaxis paste
fluoride varnish (colophony free if patient has asthma)
silver diamine fluoride
apply 3-6 monthly depending on caries risk
What dental materials contain fluoride?
GIC
compomers
some fissure sealants
some resin cements
What happens in dental fluorosis?
more than trace amounts of fluoride ingested during tooth development
enamel has higher protein content
prevents effective removal of protein matrix during maturation
How do teeth with dental fluorosis appear?
chalky looking enamel with hypo mineralised streaks
enable becomes more thinner and brittle with severity
What are the most likely causes of dental fluorosis?
water with naturally high levels of fluoride
deliberate eating of fluoride toothpaste
How can dental fluorosis be prevented?
children should learn to spit properly (struggle around ages 3-4)
avoid additional systemic fluoride before age of 3
parents should make sure only a smear of toothpaste is used
parents should not share mouthwash or high concentration toothpaste with preschool children
Where is the highest risk for dental fluorosis?
permanent anteriors
ages 18 months and 3 years of age
What should be considered when deciding which fluoride products to use?
age
caries risk
is there sufficient calcium and phosphate in saliva
oral hygiene
dental materials in the mouth
what can patient / parent manage?
does dental team need to apply fluoride or supply
cost
safety considerations
