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107 Cards in this Set

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  • Back
When can Fl dose given?
from 6 mos to 16 yrs if they have F source deficiency
What are flouride sources used in
F Rx supplements
first determine F content fo water. If lo then use. Rx supplements based on current schedule
for a child under 3 yrs of age living in a community with less that 0.3 ppm F in the water, what dose of F supplement should be given?
0.25 mg
the only time you should give a child under 3 years of age a F supplement is when?
if their water is less than 0.3ppm of F. then give .25mg of F.
when should you give a 3-6 yr old F supplements?
give 0.5 mg if water is under 0.3 ppm

give 0.25 mg if water is 0.3-0.6 ppm
When should a child age 6-16 get F supplements?
if water has less than 0.3ppm give child 1 mg of F

if water has 0.3-0.6 ppm give 0.50 mg of F
What is max of Fl dentists prescribe at one time?
no more than 264 mg of NaFl at one time

with only a total of 120 mg F
when writin F Rx what should you consider?
be conservative
be aware of pediatiricains Rx
.10% flouride ion equals how many ppm?
dietary Fluoride
green veggies
dentrifice formulation
40-50% abrasive
20-30% humectant
20-30% water
1% detergent
1% flavoring
.5% preservative
.5-1% therapuetic agent
types of fluorides
stannous flouride
sodium fluride
monofluorophosphate MFP
what percent of reduction in DMFT was seen in those using fluoridated toothpaste?
18-48% reduction in DMFT
therapeutic claims of dentrifices
caries protection
retard calculus formation
reduce gingival inflam
improve periodontal health
desensitize exposed root
whiten teeth
freshen breath
what are fluoride varnishes?
5% Na Fl in a resin carrier
Where are fluoride varnishes mainly used?
in europe for over 25 years
benefits of rinsing with fluoride mouthrinse
30-40% reduction in caries

greatest benefit on newly erupted teeth
CLD centainly lethal dose of Flouride
adult CLD is 5-10 g of NaF at one time which is 32-64 mg F/kg body weight

for child .5-1.0 g but variable for child size
signs and symptoms of acute toxic dose of F
nausea, vomiting, diarrhea
ab pain, increased thirst

hypocalcemia,CNS problems
like hyperreflexia,convsuls

CV and resp depression
Emergency treatment if ingest too much F
make yourself throw up either by sticking your finger down your throat or using the drug Ipecac syrup
Skeletal Fluorosis
osteosclerosis from chronic toxicity after long term use of water with 10-25 ppm F
Dental flurosis
excess fl
during development years
dental caries
lifelong disease that affects 95% of population
Risk indicators for caries
history of caries
oral hygeine status
rooth exposure
salivary dysfunction
bacterial virulence
use spit tobacco
Fl needs assessment form
pt needs to complete it in reception area

it self educates by check box answers

reveals non obvious factors to help you individualize Tx
intraoral Fluoride ion reservior
releases fluoride for increased remineralization

it bonds to enamel and makes stronger surface
how much enamel does prophy remove?
3-4 microns of enamel so after propy use flouide foam
who should you give a Fl Rx to?
caries pt
root sensitive
what percent of US has fluoidated water
benefit of having F in water
50-65% caries reduction
Role of CaF
stable in oral environment

provides pH dependent fluoride reservoir

hi deposition with lo pH

lower bacterial colonization and decreased acid production

increased formatin of cementum and dentin in demineralized areas
ppm in office of F
hi conc 9000 to 22000 ppm
promotes remineraliztion via CaF
at home F ppm
225 to 5000 ppm F
you can use these daily
F in NaF
F in MFP
F in Stannous Fl
types of Fluoride cmpds
acidulated phosphate fluride

neutral sodium fluoride

stannous Fluoride
who should you use APF on?
v. caries prone pts

it promotes remineralizatoin and reduced enamel solubility
who should use NaF
ages 3,7,11,18

it decrease demineralization
F strength in APF
12,300 ppm
F strength in NaF
9000 ppm
pH of APF and NaF
APF is 3.0

NaF is 7.0
F uptake of APF
v. fast 12000 in one minute
F uptake with NaF
slow 1000ppm in 4 min
pt comes in with ceramic restoration, composites, and implant. What F should be used on him?
NaF bc APF causes etching
difference in APF foam and gel
the APF foam has 12.5 mg of F per treatment and after treatment 1.2 mg is retained on teeth

the APF gel has 50 mg per full mouth treatment and 6.95 mg is retained on teeth
indications for professional F treatment
after coronal polishing
after air polishing
after placing sealants or restorations
F strenth of 1.1% NaF for at home use
F strength of Stannous F
1000 ppm
first community to add F to drinking water
Grand rapids, MI
conc of F added to community water is:
the per capita cost of water fluoidation in most US communities during the last few years has been:
less than a dollar a year
the most active and vocal national antifluoridation group is:
national health federation
who endorses F?
American public hlth ass.
percentage of Oklahomans who drink F water?
How much F does ADA say is max in single Rx?
120 mg of F
type of F that is v. astingent and irritating
stannous F
F most widely used in private practice
APF gels
What F discolors hypomineralized enamel?
stannous F
when are topical F most important?
in communites wo fluoridated water
conc of F ion in most dentfices
1 part per thousand
% of F in over counter F rinses
0.05% F
how does F promote anticaries?
bc of its ability to inhibit enzymes essential to pathogens
a once a wk F mouthrise used in F deficint communties results in what?
20-40% decrease in caries
where is F most effective in preventing carious lesions?
on smooth surface of teeth
most important achievement of dental public health
water fluoridation
critical ph
What has greater uptake of F, root or enamel?
role of saliva
produce salivary pellicle
clears bacteria and carb
buffers acid
contains Ca,P, and F
Lubricates oral mucosa
mediates taste acuity
causes of Xerostomia
cancer treatment
sjorgrens syndrome
chronic diseawe
block of salivary gland
% of kids 5-11 that have caries

% of kids 12-17 with caries
25% of 5-11 yr olds have caries

62% of 12-17 yr olds have caries

canidate for both office and at home Fluorides
adults with hi risk for caries
% of caries that can be arrested by use of F
percent of peoople by age 45 that have root caries

percent of people by the age of 64 with root caries
by age 45, 33% have root caries

by age 65, 60% have root caries
% of pts with ortho that get demineralized areas
2 approaches to caries control
1. surgical mode where use restorative dentistry

2. medical mode where restorative dentistry is merely an adjunct route of treatment
highes reported baby bottle caries in world
navajo reservation in NM

70% of kids
preventive caries techniques
F varnishes
Caries vaccine
water F
topical F
what does F do?
enhances strength of outer enamel by increasing Fluorhydroxyapetite bc stronger enamel has better chance of wining demin-remin battle
can F fight caries alone?
Hell NO! you need oral hygeine, and goo diet too!
F Varnish
lo percent F in sticky carrier

painted on bucall and lingual surface of teeth

dries in one min

use only one mil and stays on teeth 4-6 hrs
ideal canidates for F varnish
incipient white lesions wo detectable evidence of enamel breakdown
Gross Caries Debridement
1. restoring carious tooth
2. limiting spread of disease of othe means

excavate teeth with spoon or slow speed handpiece

goal is to have suffiecit depth in cavity to insure retention of temporary
Zinc oxide Eugenol benefits
long lasting
easily mixed
set up fast
ART technique
atraumatic restorative technique for caries control

same as gross caries removal

started by World health Organization in Asia

to train non dental people to allow them to debride carious lesions wo hand instruments then restore with glass ionomers
is ART used in US
yeah on limited basis like is Alaska villages

ADA does NOT want this!!!!
types of F equiptment
F saturator
F dry feeder
F acid feeder
what does F acid feeder use?
Fluorosilic acid
last water system in state to get F
broken arrow
what is F and why is it so important?
F is neg charges and it easily combines with postively charged elements like Ca and Na to form CaF and NaF to prevent caries
most cost effective way to get F to community
water fluoridation
Problems seen in Bauxite AR
kids had v.mottled enamel thought problem with water well so closed it.

in 1930 HV churchill a chemist found v. hi levels of F in water of abondaned well

Dr. mcKay sent Fl samples to chrurchill Dr. McKay helped find problem of dental fluorsis
Dr. H Trendley Dean (1893-1962)
established denal hygiene unit at NIH to study association between F and mottled enamel

1938 first proposed adding F to drinking water

1942 documented prevalence of fluorosis in US

did study in towns w/naturally occuring F
Very mild fluorosis on F index
small opaque area affecting less than 25%
mild fluorosis
26-50% of tooth surface affected
moderate flurosis
all surfaces involved are brown and stained
server flourosis
pitting of enamel and widespread brown stains with corroded appearance
recommended optimum range of F to water
.7-1.2 ppm based on region

lower conc in warmer climates
higher conc in cool climates
topical action of F
inhibit demineralization

enhance remineralization by absorbing tooth surface and attracting Ca ions in saliva. F binds with Ca and P making flurapatite so less soluble to bacteria

inhibits bacteria bc F enters bacterial cells and interfeses with enzymes activity of bacteria and changes pH. reducing acid production causing decrease in demineralization
cost of water F
ranges from 50 cents in communities w/ more than 50000 people to 3 bones per person in communities with less than 10000
% of communities in US with population greater than 100,000 with F water
EPA max amt of F in water
4 ppm over 200,000 americans have water with over 4 ppm
CDC report
states that 1/2 of US has hi conc of natural F in water over 2 ppm

people who consure water w/hi F over limetime are more likely to get bone fractures

water F is safe in range of .7-1.2 ppm
problem with CDC report
didnt apply to many people
21 CFR federal laws of bottled water
max level of F added

max level of natural F

do pour through pitchers removes F from tap water?