Dental Hygiene Ii--Fluoride-Midterm

Front 1

What types and concentrations of fluoride should be recommended to a head & neck cancer patient for home-care custom tray use?

Back 1

0.4% Stannous (Sn)
or
1.1% Sodium Fluoride (Na)

Front 2

What is the range of the optimum concentration of fluoride in community drinking water?

Back 2

0.7-1.2 ppm

Front 3

When ingested, 90-95% of fluoride is absorbed through the (WHAT?) and (WHAT?)

Back 3

Stomach and Small Intestines

Front 4

At age 11, an individual who has lived in a non-fluoridinated community since birth moves to an area in which the water contains 10 ppm of fluoride. At age 35, he is likely to exhibit (WHAT?)

Back 4

Skeletal Fluorosis

Front 5

What factors are most important to consider in determining the appropriate fluoride level for a public water supply?

Back 5

Average Water consumption and average maximum daily air temperatures.

Front 6

What Fluoride Regimen enhances reminerilization?

Back 6

Frequent use of low concentration Fluorides:
-Dentifrices
-Mouth rinses
-Home Fluoride Gels

Front 7

Acidulated phosphate fluoride is contraindicated for use on (WHAT?), (WHAT?), and (WHAT?).

Back 7

Porcelain, Composites, and Veneers

Front 8

Name the approved fluoride compounds found in over the counter dentifrices.

Back 8

Sodium fluoride, Stannous Fluoride, Sodium Monofluorophosphate, and Amine Fluoride

Front 9

Name the two most common causes of death in acute fluoride poisioning.

Back 9

Cardiac Failure and Respiratory Paralysis

Front 10

A 14 year old girl with generalized, moderate gingivitis, who bleeds upon probing should be instructed to use what?

Back 10

Soft toothbrush and Floss

Front 11

Which dosages of a fluoride tablet supplement should be prescribed for a preschooler who consumes optimally fluoridated drinking water?

Back 11

None

Front 12

What are advantages of a school-based fluoride rinse program?

Back 12

-Effective in reducing decay
-Implemented by non-dental personnel

Front 13

Fluorosis may result if excessive fluoride is consumed during which stage of tooth development?

Back 13

Mineralization

Front 14

Repeated topical application of a fluoride agent does not produce tooth mottling (fluorosis)

Back 14

True

Front 15

Which of the following arguments against fluoridating public water supplies are used by antifluoridationists? (True or False they are used)
a. Fluoride increases the risk of birth defects
b. Fluoride increases the risk of cancer
c. The addition of fluoride to public drinking water is unconstitutional

Back 15

a. True
b. True
c. True

Front 16

Fluoridation of municipal water supplies is often accomplished by adding appropriate amounts of what type of fluoride to the water?

Back 16

Hydrofluorosilicic Acid, Sodium Silicofluoride, and Soduim Fluoride

Front 17

A 63 year old patient has been recieving radiation therapy for head and neck cancer. Examination reveals multiple area of cervical caries. What caused this condition?

Back 17

Dysfunctional Salivary Glands or Salivary Gland Hypofunction

Front 18

The most common adverse reaction to fluoride toxicity is (are)

Back 18

Nausea

Front 19

72 yr old male, recession, and 1 previous restoration. Uses Listerine, brushes with baking soda. Forgot to tell RDH at last visit that he was taking antihypertensice and diuretic for about 1 year. Denies any changed in OH. Exam reveals several areas of facial root caries with low plaque score. What represents the MOST important reason for these findings?

Back 19

Side effects of prescribed Medications

Front 20

The pH range of acidulated fluoride gels is in the range of

Back 20

3-5 pH

Front 21

What stable reaction is produced by a topical application of fluoride?

Back 21

Fluorapatite

Front 22

Name the Fluoride mechanisms that are thought to protect teeth from caries.

Back 22

-Antibacterial action
-Inhibition of glycolysis
-Reduction of plaque adhesion
-Reduction in enamel solubility
-Enhancement of remineralization

Front 23

A 3 year old child who lives in a nonfluoridated area has rampant decay. Which home-care regimens with parental supervision is suitable for this child?

Back 23

Fluoride supplement tablets and Fluoride Dentifrices

Front 24

Which areas of the teeth are most likely to have the greatest uptake of topical fluoride?

Back 24

Areas of Demineralization

Front 25

How does the fluoride ion affect crystal size and solubility of teh hydroxapatite crystal?

Back 25

Increases Crystal size and Decreases solubility of Crystal

Front 26

Ingestion of fluoridated water from birth has been shown to reduce tooth decay in children by approximately what percent?

Back 26

60%

Front 27

Staining of carious and precarious tooth surfaces occurs with the use of which fluoride?

Back 27

Stannous Fluoride

Front 28

In communities without fluoridated water supplies, the most cost effective method of delivering systemic fluoride to 6-12 year old children is through what?

Back 28

School Fluoridated Water

Front 29

Name a system of chronic fluoride toxicity.

Back 29

Enamel hypoplasia

Front 30

If a child accidentally ingests a toxic quanity of fluoride, the hygienist should...?

Back 30

Induce vomiting by physical or chemical means

Front 31

The existing fluoride content of a water supply in the desert Southwest is 0.3 ppm, what amount of fluoride should be added to achieve the optimum recommended level?

Back 31

0.4ppm

Front 32

Fluorides are chiefly eliminated through the (WHAT?)

Back 32

Kidneys

Front 33

Daily use of fluoride gel in custom trays is indicated for whom?

Back 33

-Radiation to Head & Neck patients
-Overdenture
-Severe Caries

Front 34

Which method of fluoride therapy may affect morphology of the dentition?

Back 34

-Water Fluoridation
-Diet Supplement Program

Front 35

Most inorganic matter of the teeth occurs as (WHAT?)

Back 35

Hydroxyapatite

Front 36

Current research suggest that antimicrobial agents. (True or False)
a. Alter the bacterial cell wall
b. Reduce the formation of pellicle
c. Change the metabolism of bacteria
d. Increase the specifiicity of microbes
e. Decrease the bacteria's attachment to tooth surfaces

Back 36

a. True
b. True
c. True
d. FALSE
e. True

Front 37

In addition to professionally-applied fluoride, what should be recommended for a caries-prone 10 year old child who resides in a fluoridated community?

Back 37

-Fluoridated toothpaste
-Mouth rinses

Front 38

What factors should be considered in deciding whether pediatric fluoride supplements should be prescribed?

Back 38

-Age of patient
-Amount of fluoride in drinking water
-Conscientiousness of patient or parent

Front 39

What are the side effects of a topical application of stannous fluoride solution?

Back 39

Brown Staining and Gingival Reaction

Front 40

A mother routinely gave her 2 year old child a bottle at bedtime containing a variety of liquids. The practice resulted in the rampant decay of the child's teeth. What liquids could have contributed to the child's condition?

Back 40

Juices, Formula, Any Carbohydrate Fluids, or Milk

Front 41

What procedures should be followed to reduce the likelihood of ingestion of fluoride during a professionally-applied topical fluoride application?

Back 41

-Seat pt upright
-Use trays with absorptive liners
-Limit the amount of gel placed in each tray to no more than 2.5 ml (1/2 teaspoon)
-Use suction during and after treatment
-Have patients expectorate thoroughly after trays are removed

Front 42

Does fluoride fight plaque?

Back 42

-High Concentrations: reduce growth of plaque; inhibit their metabolism of fermentable carbohydrates

Front 43

Is fluoride equally effective in preventing dental caries on all types of tooth surfaces?

Back 43

Yes, but MOST effective on smooth surfaces than on pits and fissures.
Combining with sealants for maximum caries protection

Front 44

Should expectant mothers use fluoride supplements?

Back 44

-Primary teeth could benefit
-Permanent teeth unlikely to benefit
-Not recommended as conclusive evidence of reducing decay in offspring is lacking

Front 45

Why is it recommended that fluoride supplementation be started six months of age?

Back 45

Crowns of primary teeth and the crowns of permanent incisors and that of molars have begun developing.

Front 46

Should there be concern about the use of fluoride dentifrices by young children?

Back 46

Yes. Susceptible to fluorosis.
-Supervision of toothbrushing
-Use child-size toothbrush
-Only pea-size portion of ADA approved dentifrice
-Should rinse and spit out thoroughly

Front 47

What first-aid treatments are recommended in case of accidental overdose of fluoride?

Back 47

-Induce vomiting
-Ingest large amounts of fluoride-binding liquids--ie: milk, lime water, gel antacids, aluminum or magnesium hydroxide
-Take to hospital for evaluation

Front 48

What is dental fluorosis?

Back 48

Discoloration in dental enamel which range in intensity from small whitish "clouds" or lines on teeth to defects of enamel with pitting and staining.

Front 49

Should there be concern about the use of fluoride dentifrices by young children?

Back 49

Yes. Susceptible to fluorosis.
-Supervision of toothbrushing
-Use child-size toothbrush
-Only pea-size portion of ADA approved dentifrice
-Should rinse and spit out thoroughly

Front 50

What first-aid treatments are recommended in case of accidental overdose of fluoride?

Back 50

-Induce vomiting
-Ingest large amounts of fluoride-binding liquids--ie: milk, lime water, gel antacids, aluminum or magnesium hydroxide
-Take to hospital for evaluation

Front 51

What is dental fluorosis?

Back 51

Discoloration in dental enamel which range in intensity from small whitish "clouds" or lines on teeth to defects of enamel with pitting and staining.

Front 52

Where is Fluoride absorbed?

Back 52

In the blood stream form the gastrointestinal tract. Them from there its deposited into the bone and teeth, or its excreted by the kidneys.

Front 53

Which fluoride may stain teeth (demineralized enamel), grooves, and margins of restoration; has a bitter taste, and causes gingival irritation?

Back 53

Stannous Fluoride (8.0%)

Front 54

Which fluoride etches or dulls composites with repeated application?

Back 54

Acidulated Phosphate Fluoride (1.23%)

Front 55

What are the symptoms of Acute Fluoride toxicity?

Back 55

- Nausea, vomiting, diarrhea
-Abdominal Pain
-Increased salivation, thirst
-Convulsions, hyperreflexia
-Cardiac Arrhythmias
-Coma
-Death resulting from cardiac failure or respiratory failure

Front 56

What are the Acute Toxic Doses?

Back 56

-Certainly Lethal Dose (CLD)=32-64 mg F/kg body weight
-Safely Tolerated Dose (STD)=8-16 mg F/kg body weight
-Proabably Toxic Dose (PTD)=5 mg F/kg body weight

Front 57

What is the recommended emergency treatment for ingestion of <5 mg per kg

Back 57

1. Administer fluoride binding liquid. Observe for a few hours.
2. Induced vomiting not necessary

Front 58

What is the recommeded emergency treatment for ingestion of > or equal to 5 mg per kg.

Back 58

1. Induce vomiting.
2. Administer fluoride binding liquids.
3. Admit to hospital for observation

Front 59

What is the recommeded emergency treatment for ingestion >15 mg per kg.

Back 59

1. Admit to hospital immediately
2. Induce vomiting.
3. Cardiac Montoring
4. IV 10% calcium gluconate
5. Maintain adequate urine output.
6. Supportive measures for shock.

Front 60

How does fluoride make the tooth stronger?

Back 60

Fluoride may react with hydroxyapatite (systemically and topically) creatin Fluorapitite, which is stronger and more resistant to acid attack than hydroxapatite.

Front 61

When does the most rapid uptake occur?

Back 61

Within the 1st minute of application

Front 62

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Sodium Fluoride (NaF) Aqueous Soluton

Back 62

Percent used: 2%
Concentration: 9,040 ppm (0.90% F ion)
Application Mode: Paint on

Front 63

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Sodium Fluoride- Gel

Back 63

Percent: 2%
Concentration: 9,040 ppm (0.90% F ion)
Application mode: Tray

Front 64

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Sodium Fluorde-Foam

Back 64

Percent: 2%
Concentration: 9,040 ppm (0.90% F ion)
Application Mode: Tray

Front 65

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Sodium Fluoride-Varnish

Back 65

Percent used: 5%
Concentration: 22,600ppm (2.3% F ion)
Application Mode: Paint on

Front 66

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Acidulated Phosphate (AFP)-Aqueous Solution

Back 66

Percent used: 1.23%
Concentration: 12,300 ppm
Application Mode: Paint on

Front 67

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Acidulated Phosphate (APF)- Gel

Back 67

Percent used: 1.23%
Concentration: 12,300 ppm
Application Mode: Tray

Front 68

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Acidulated Phosphate (APF)- Foam

Back 68

Percent used: 1.23%
Concentration: 12,300 ppm
Application Mode: Tray

Front 69

Professionally Applied Topical: What is the percent, concentration and applicatoin mode for :

Stannous Fluoride (SnF)- Aqueous Solution

Back 69

Percent used: 8%
Concentration: 19,360 ppm
Application mode: Paint on

Front 70

Which Professional Topical Fluoride needs to be mixed daily and is no longer used due to the disadvantages?

Back 70

Stannous Fluoride (SnF)

Front 71

What is the pH of Stannous Fluoride?

Back 71

2.4-2.8 pH

Front 72

What is the pH of Acidulated Phosphate (APF)?

Back 72

3.5 pH

Front 73

What is the pH of Sodium Fluoride (NaF)?

Back 73

Nuetral

Front 74

Which fluoride should you NOT use if composites, porcelain, or sealants are present?

Back 74

Acidulated Phosphate (APF)

Front 75

Dental Fluorosis occures during which stage of development?

Back 75

During enamel calcification, minerilization. Its critical period is birth to 6 yrs old. But pt is at highest risk from 18-24 months.

Front 76

What fluoride therapy would cause fluorosis?

Back 76

Systemic fluoride: ingenstion thru food or beverages, supplements, lonzenges, topicals that were ingested, dentifrices that were ingested, and/or mouth rinses that were ingested.

Front 77

What is the optimum fluoride level for water in momderate climates?

Back 77

1 ppm, the amount is adjusted from warmer or colder climates from 0.7 to 1.2 ppm.

Front 78

What is the correlation between bone cancer and fluoride?

Back 78

1,000 mice & rats tested, 5 showed signs of bone cancer after ingesting 45 ppm and 79 ppm. A 150lb human would have drink 380 & 667 8 oz glasses of water to equal that many ppm and they would die of water poisoning before that would even happen.

Front 79

What is the most effective delivery system for Fluoride?

Back 79

?-Ask someone

Front 80

What are the mineral in saliva?

Back 80

Contains Calcium, Phosphate, and Fluoride

Front 81

Fluoride combines with calcium= decrease of blood calcium, bad because calcium is essential for intensity of nervous system. Symptoms that develop: muscle tetany and parasthesia.

Back 81

Hypocalcium

Front 82

Less than normal circulation of potassuim. Onset of the Three C's: Coma; Convulsions; and Cardiac Arryhythmias

Back 82

Hyperkalemia

Front 83

This reverses tooth decay process by depositing lost minerals back intot he demineralized tooth. It produces crystals larger than those present in sound enamel, making a stronger, less soluble enamel structure. It is more resistant to acid attack adn less prone to caries.

Back 83

Remineralization

Front 84

Home Topical Fluorides:

Contains .22% NaF; .76% MFP, or .4% SnF. They are recommended for individuals of all age groups residing in both fluoridated and non-fluoridated communities. They should be used at least once a day.

Back 84

Fluoride Dentifrices

Front 85

Home Topical Fluorides:

Fluoride concentrations used mostly in these are 0.05% NaF and .2% NaF. The 0.05% which is 225 ppm is available otc and recommended to use daily.
The .2% requires a prescription and should be used on a weekly basis, because it contains 900 ppm. These types of fluorides aids are specifically beneficial for caries active and caries risk patients.

Back 85

Fluoride Mouth Rinses

Front 86

Home Topical Fluorides:

The concentration of these fluoride aids are .5% APF; 1.1% NaF and .4% SnF. Daily application via brushing or using a custom tray is recommended. Parental supervision is needed. 1.1% NaF contains 5000ppm and requires a prescription for dispensing, and is recommended for HIGH risk caries pts.

Back 86

Fluoride home gels

Front 87

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Acidulated Phosphate Fluoride (APF)?

Back 87

Concentration: 1.23%, 12,300 ppm
Mechanism: Inhibits enamel demineralization and bacterial protiens; Enhances enamel remineralization; Forms water-soluble fluoride layer
Delivery/Duration: Prof. applied using tray; 2-4x per year, 1-4 mins in tray; no food, beverages, or rinsing for 30 mins post-tx

Front 88

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Neutral Sodium Fluoride (NaF)

Back 88

Concentration: 2%, 9,040 ppm
Mechanism: Inhibits enamel demineralization and bacterial protiens; Enhances enamel remineralization; Forms water-soluble fluoride layer
Delivery/Duration: Prof applied up to 4 x per year for 4 mins in tray; no food, beverages, or rinsing for 30 mins post tx.

Front 89

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Neutral Sodium Fluoride Varnish (NaF)

Back 89

Concentration: 5%, 22,600 ppm
Mechanism: Inhibits enamel demineralization and bacterial protiens; Enhances enamel remineralization; Dentinal tubule blocking effect; forms nonwater-soluble varnish layer
Delivery/Duration: Prof applied paint-on varnish solidifies on contact; patient may rinse and eat soft foods immediately; for hypersensitivity, 1+ applications; for anticaries regimens, 2-4x per year

Front 90

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Neutral Sodium Fluoride as-mouthrinses, mouthrinses Rx and toothpastes

Back 90

Concentration: 0.05% OTC mouthrinses, 225 ppm
0.2% RX mouthrinses, 900 ppm
1,000-1,500 ppm in toothpastes
Mechanism: Replenishes soluble fluoride layer
Delivery/Duration: Daily application by pt for OTC products; 0.2% mouthrinses may be used weekly or daily

Front 91

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Acidulated Phosphate Fluoride (APF) in mouthrinses and toothpastes

Back 91

Concentration: 0.044% in mouthrinses, 440 ppm
Toothpastes, 1,100 ppm
Mechanism: Replenishes soluble fluoride layer
Delivery/Duration: Daily application by patient

Front 92

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Neutral Sodium Fluoride (NaF) as a commonly prescribed RX

Back 92

Concentration: 1.1% RX, 5,000ppm
Mechanism: Forms water-soluble fluoride layer; Can reverse incipeint caries
Delivery/Duration: Daily application by patient; Applied using tray or other application device; no food, beverages, or rinsing for 30 min post tx

Front 93

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Acidulated Phosphate Fluoride (APF) as a RX

Back 93

Concentration: 0.5% RX, 5,000 ppm
Mechanism: Forms water-soluble fluoride layer
Delivery/Duration: Daily application by patient with brush

Front 94

Topical Fluoride Utilization:

What is the concentration, mechanism, and delivery/duration of:
Stannous Fluoride as a gel and rinse

Back 94

Concentration: 0.4% gel OTC or RX, 1,000 ppm
0.63% rinse, 3,000 ppm
Mechanism: Tin (stannous) component can retard bacterial metabolism; forms nonwater-soluble stannous fluoride layer
Delivery/Duration: Daily patient- applied gel using tray or brush, no restrictions on food or liquid intake; Prescription rinse can be used daily