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27 Cards in this Set

  • Front
  • Back
Water fluoridation
~Define:
~History:___ ___ ___
Water fluoridation
~Define: controlled addition to public water supply
~History: Colorado brown stain
In the us: over ___ % of population drink fluoridation water
In the us: over 50% of population drink fluoridation water
What are the requirement for public health program fluoridation?
~Requirement of public health program: low cost, effective, safe, available to large numbers, requires minimum compliance
Fluoridation Benefits:
~__-___% reduction in caries (children)
~___-___% reduction today
~___-___% reduction of coronal and root caries (adult)
~Benefits ____ when fluoridation discontinued
~Benefits ___ surfaces primarily
~Benefits ___ and ____teeth
~Prevents ____
~Indirectly reduces _____
Fluoridation Benefits:
~60-65% reduction in caries (children)
~20-35% reduction today
~20-40% reduction of coronal and root caries (adult)
~Benefits lost when fluoridation discontinued
~Benefits smooth surfaces primarily
~Benefits primary and permanent teeth
~Prevents osteoporosis
~Indirectly reduces periodontitis
Fluoridation Critical period~Greatest benefits in ___ to age ___
~___ to age ___
~Late secretion or early maturation stage of enamel
Fluoridation Critical period
~Greatest benefits in birth to age 12
~Birth to age 4
~Late secretion or early maturation stage of enamel
Fluoridation Cost
~__ to ___ per person annually
~Average is ___ per person
~Cost vary to size of community
~Vary according to equipment paid for
~Results in ___% saving in treatment cost
Fluoridation Cost
~.12 to 5.41 per person annually
~Average is .51 per person
~Cost vary to size of community
~Vary according to equipment paid for
~Results in 50% saving in treatment cost
Fluoridation Optimal Concentration
~Range of __ to __ ppm
~Optimal depends on the ___ as it relates to water consumption
~Average optimal concentration in U.S. is _ ___F
Fluoridation Optimal Concentration
~Range of .7 to 1.2ppm
~Optimal depends on the climate as it relates to water consumption
~Average optimal concentration in U.S. is 1ppm F
Fluoridation 3 compounds used?
Fluoridation compounds used:
~Sodium Fluoride (solid)
~Sodium Silicofluoride (solid)~Hydrofluorisilic acid (solution)
This is a type of compound used for Fluoridation:
~Most popular chemical
~Byproduct of production of fertilizers
~Least expensive
Fluoridation Sodium Silicofluoride (solid)
~Most popular chemical
~Byproduct of production of fertilizers
~Least expensive
What type of fluoridation compound is this?~Most expensive
~Consider metals used and more expensive to maintain equipment
Type of compound used in fluoridation:
Hydrofluorisilic acid (solution)
~Most expensive
~Consider metals used and more expensive to maintain equipment
Fluoridation Safety
~___at optimum level
~Studies show ___ relationship between F and cancer, heart disease, or any other
~Equipment controls in place
~Annual training
Fluoridation Safety
~Safe at optimum level
~Studies show NO relationship between F and cancer, heart disease, or any other
~Equipment controls in place
~Annual training
Fluoridation Defluoridation
~definition
~___ process
~____ by EPA if concentration 2-4 ppm
~____ by EPA if flouride is concentration > 4 ppm
Fluoridation Defluoridation
~Removal of excess naturally occurring F
~Costly process
~Recommended by EPA if concentration 2-4 ppm
~Require by EPA is concentration > 4 ppm
Fluoridation help with prevention of caries in the community:
~___ppm
~Range of .__ to __ ppm based on climate
~Is it medicine?
~___ in dental fluorosis
Fluoridation in the community:
Community
~1ppm
~Range of .7 to 1.2 ppm based on climate
~Is it medicine? NO
~Increase in dental fluorosis
School based Fluoridation
~Concentration ___ times greater than recommended level
~Fluoride ____ 1mg (typically not used)
~Mouth rinse (swish and spit)
o10 ml solution __% neutral sodium weekly (more popular)
o10 ml solution __% neutral sodium daily
School based Fluoridation
~Concentration 4.5 times greater than recommended level
~Fluoride tablets 1mg (typically not used)
~Mouth rinse (swish and spit)
o10 ml solution .2% neutral sodium weekly (more popular)
o10 ml solution .05% neutral sodium daily
Fluoride Metabolism
~Body rapidly ____ F
~Absorbed in ____ and ____ primarily
~Deposited in ___ and ___ ___
~As none saturation approached, fluoride excreted through ___,___,___
~Renal clearance ___
~Salivary content __ as F intake __
Fluoride Metabolism
~Body rapidly absorbs F
~Absorbed in stomach and intestine primarily
~Deposited in bones and developing enamel
~As none saturation approached, fluoride excreted through kidneys, sweats, feces
~Renal clearance rapid
~Salivary content increase as F intake increase
Fluoride Mechanism of Action
~___ and ___ effects
~Incorporated into hydroxyapatite crystals
~Continued ____
~___ acid production
~___ plaque adherence
~____ effect
Fluoride Mechanism of Action
~Systemic and topical effects
~Incorporated into hydroxyapatite crystals
~Continued remineralization
~Inhibits acid production
~Reduces plaque adherence
~Bactericidal effect
Toxicity of fluoride
~Toxic dose: __mg F per kg (2.3#) body weight
~Lethal dose
___ g F or 2.2 mg per 44# of body weight
~___-___ mg F/kg body weight is CLD
~__-___ g is lethal for adult male
Toxicity of fluoride
~Toxic dose: 5mg F per kg (2.3#) body weight
~Lethal dose
1 g F or 2.2 mg per 44# of body weight
~32-64 mg F/kg body weight is CLD
~5-10 g is lethal for adult male
Symptoms of toxicity of fluoride (4)
Treatment for toxicity?
Symptoms of toxicity of fluoride
~Nausea
~Vomiting
~Diarrhea
~Abdominal cramping
Treatment
~Induce vomiting
~Administer Ca+ to bind (milk)
Physiological effect of fluoride?
(2)
Physiological effect fluoride
~Chemical burns
~Inhibition of enzymes systems
School water fluoridation
- all kids in school that live in non fluoridated water@ home
- F is added to water @ __ optimum level
- __ % reduction in caries
School water fluoridation
- all kids in school that live in non fluoridated water@ home
- F is added to water @ _4.5x optimum level
- _ 40% reduction in caries
School Fluoride Tablet Program
~ 1mg __ daily- swish/swallow
~ __% in caries

School Rinse Program
~ 0.05% NaF daily
~ 0.2% F preferred
~ ___% reduction in caries
School Fluoride Tablet Program
~ 1mg _F daily- swish/swallow
~ _35% in caries

School Rinse Program
~ 0.05% NaF daily
~ 0.2% F preferred
~ _25% reduction in caries
Fluoride supplement
Not recommended as public health measure due to noncompliance and cost
Drops: 10 drops = ____
Tablets
o 1 tablets= _____
o Swish & swallowed
Amount of RX limited (264 mg F)
Same systemic effectiveness as water F
Compliance is problem
Fluoride supplement
Not recommended as public health measure due to noncompliance and cost
Drops: 10 drops = 1 mg F
Tablets
o1 tablets= 1 mg F 2.2 mg NaF
oSwish swallowed
Amount of RX limited (264 mg F)
Same systemic effectiveness as water F
Compliance is problem
Promotion of Fluoride
 political arena includes___
 leadership in campaign
o scientific base, be informed, educate
 opposition based on claims
~what are they (4)?
Promotion of Fluoride
 political arena
o local political action; referendum
 leadership in campaign
o scientific base, be informed, educate
 opposition based on claims
o unsafe (poison)
o infringement of right
o ineffective for adults
o emotional appeal
Fluorosis......
Definition= ____
 Occurrence
o Early maturation period of enamel
 Level= __ is mild flurosis / __ is mod- severe fluorosis
o 1-2 ppm will cause mild fluorosis
 Prevalence= __ %
 Prevention= ___
 Treatment= ____
Fluorosis
Definition
oHypomineralization/ hypocalcification
 Occurrence
o Early maturation period of enamel
Level
o 1-2 ppm will cause mild fluorosis
o >2ppm mod-severe fluorisis
Prevalence
o 50% prevalence very mild
Prevention
o Control swallowing of excess F
Treatment
o Polish/ grind enamel to smooth
Sealant programs
 Recommended for ____ populations
 Select community that is __ School within community
o ____ benefit most
 Children within the school
o Seal __ & __ graders
o Seal __ before ___
o ____ before Anglo children
 Select teeth within the children
o Teeth with ____ morphology
Sealant programs
 Recommended for high risk populations
 Select community
o Lower socioeconomic
 School within community
o Lower socioeconomic benefit most
 Children within the school
o Seal 1st and 6th grader
o Seal females before males
o African American before Anglo children
 Select teeth within the children
o Teeth with deep Occlusal morphology
Sealant programs
 Recommended for ____ populations
 Select community that is __ School within community
o ____ benefit most
 Children within the school
o Seal __ & __ graders
o Seal __ before ___
o ____ before Anglo children
 Select teeth within the children
o Teeth with ____ morphology
Sealant programs
 Recommended for high risk populations
 Select community
o Lower socioeconomic
 School within community
o Lower socioeconomic benefit most
 Children within the school
o Seal 1st and 6th grader
o Seal females before males
o African American before Anglo children
 Select teeth within the children
o Teeth with deep Occlusal morphology
ADA supplement dosage chart
pg. 553 wilkins
age <.3ppm .3-.6ppm >.6ppm
-6mo 0mg 0mg 0mg
6mo-3yr .25mg 0mg 0
3-6yr .50mg .25mg 0mg
6-16yrs 1.0mg .5mg .25mg