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Fluoride can be delivered
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Fluoride works in three ways to reduce and prevent tooth decay
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CLINIC DHYI
FLUORIDE
| Question | Answer |
|---|---|
| Fluoride can be delivered | Delivered systemically and/or topically. |
| Fluoride works in three ways to reduce and prevent tooth decay | 1)incorporated into the tooth during tooth development (systemic) 2)promotes remineralization and inhibits demineralization (topical) 3)inhibits carbohydrate metabolism (thus acid production) by saccharolytic bacteria (topical) |
| Fluoride, Systemic Delivery (how?) | Systemic delivery: 1)water (commercially or naturally fluoridated) 2) supplements including prenatal 3) Inadvertent (непреднамеренный, случайный) |
| When fluoride is ingested during tooth development it has a (what effect, delivered how?) | When fluoride is ingested during tooth development it has a pre-eruptive, systemic effect delivered to the forming teeth via the blood stream |
| Topical Delivery of Fluoride | Topical delivery of fluoride fluoride is applied to exposed surfaces of erupted (post-eruption) teeth provides the greatest effect on reducing/preventing tooth decay |
| Fluoride delivered systemically can have topical effects.. (HOW?) | Fluoride delivered systemically can have topical effects if there are erupted teeth chewing fluoride tablets swallowing fluoridated water or liquid supplements |
| Fluoride delivered topically can have systemic effects (HOW?) | Fluoride delivered topically can have systemic effects if there are unerupted teeth swallowing any form of topically applied fluoride provides a source of systemic fluoride |
| What is fluoride? | Fluorine (F) is the 13th most common element in the Earth’s crust; highly reactive, pale yellow gas the most electronegative element combines with other elements to form fluoride compounds |
| Fluoride ion combines with... to form what compounds | combines with cations (+ charge) to form various inorganic fluoride compounds found in minerals in rocks and soil Calcium fluoride Sodium fluoride Magnesium fluoride Potassium fluoride |
| Fluoride ion (F-) is a reduced form of | Fluoride ion (F-) is a reduced form of fluorine |
| Reduced form of fluorine | Fluoride ion (F-) |
| free fluoride ion is found in ... | free fluoride ion is found in water |
| Dissassociation (fluoride | Water passes through the soil and over rock formations, dissolves the fluoride compounds, breakup is referred to as disassociation; *free fluoride ions are released *Fluoride ions are present to some extent in all food and water |
| Fluoride Intake (ways): | 1)Naturally (via water or food that contains fluoride naturally) 2)Commercially *fluoridated water supplies *prescription supplements *swallowing fluoride designed for topical use (primarily toothpaste) |
| Fluoride Absorption, Gastrointestinal Tract, time, absorption is inhibited when fluoride is taken with... | *Absrbd bypassve diffusn instomach ashydrogen fluoride, rate &amount depends onsolublty offluoride product, gastric acidity *most absorbed within 60m *small intestine absorbs what isnot absorbd instomach absorptn isinhibited when fl istaken w/milk, fo |
| Fluoride Absorption, Blood Stream; peak levels, | *Blood plasma carries fluoride for distribution & elimination peak levels within 30 minutes of intake: *normal plasma levels are low rise and fall according to intake |
| Fluoride is distributed by the plasma to ...fluoride has strong affinity for..majority of fluoride in what tissues of the body... | Distributed by the plasma to all tissues and organs strong affinity for calcified tissue 99% is located in the mineralized tissues of the body, including mineralized tooth structures |
| Teeth and fluoride storage | teeth store small amounts highest levels at the tooth surface |
| Amount of fluoride ion stored varies with...teeth and fluoride storage | amount of fluoride ion stored in the crystal lattice (решётка, сетка) of teeth and bone varies with intake, time of exposure, and the age and stage development *teeth store small amounts highest levels at the tooth surface |
| fluoride deposited during tooth development can only be altered by... | fluoride deposited during tooth development can only be altered by *cavitated carious lesions *erosion *mechanical abrasion |
| Fluoride Excretion | *Mainly through the kidneys *Limited transfer from plasma to breast milk |
| Teeth can acquire fluoride during three periods of tooth development: | Teeth can acquire fluoride during three periods of tooth development 1)Pre-eruptive mineralization stage (systemic) 2)Pre-eruptive maturation stage (systemic) 3)Post-eruptive stage (topical) |
| Fluoride is deposited during the formation of enamel when it is | Fluoride is deposited during the formation of enamel available to the developing teeth via the blood stream |
| Pre-eruptive fluoride effect on occlusal grooves | Pre-eruptive fluoride also results in the development of shallower occlusal grooves reduces risk of pit and fissure caries |
| Excessive systemic fluoride (from any source) during this period results in hypomineralization (enamel hypoplasia) dental fluorosis. | Pre-eruptive: mineralization stage |
| Pre-eruptive:mineralization stage and excess fluoride | Excessive systemic fluoride (from any source) during this period results in hypomineralization (enamel hypoplasia) dental fluorosis. |
| After mineralization and prior to eruption, additional fluoride is... during this stage much more fluoride is acquired... what children benefit | addtnl fl is deposited on the tooth surface; *during this stage much more fluoride is acquired by the outer surface of enamel than the underlying surfaces. *children who are exposed to fluoride for the first time within 2 years prior to eruption benefit |
| After eruption and throughout the life span of the tooth concentration of fluoride in the enamel is dependent on: | After eruption and throughout the life span of the tooth concentration of fluoride in the enamel is dependent on topical sources: 1)concentration 2)frequency of exposure (fluoridated water becomes a topical source) |
| Fluoride on the outermost surfaces of the tooth is available (to do what?)... Uptake is most rapid during the... | Fluoride on the outermost surfaces of the tooth is available to inhibit demineralization and enhance remineralization Uptake is most rapid during the first few years after eruption |
| What part of the tooth has the highest concentration of fluoride | surface of enamel has the highest concentration |
| What enamel will absorb fluoride better? | poorly mineralized enamel absorbs fluoride better than sound enamel remineralized enamel will have a greater concentration of fluoride than sound enamel |
| Dentin and Fluoride Content: concentration higher in... what dentin absorbs fluoride rapidly | Dentin *may be higher in exposed dentin than in enamel *high concentration at the DEJ *newly formed dentin absorbs fluoride rapidly |
| Cementum and fluoride content | Cementum *level high and increases with age (recession) root surface is exposed to sources containing fluoride |
| Plaque may contain how much fluoride | plaque may contain from 5 to 100 ppm F (Fluoride affects both the microflora and hard tissue in a positive way plaque may contain from 5 to 100 ppm F influenced by the amount of fluoride taken in by the individual) |
| Reservoir for fluoride in mouth; concentration depends | Saliva is a reservoir for fluoride concentrations vary dependent on concentration and frequency of fluoride product used |
| fluoride levels as low as _____ ppm enough to produce beneficial anti-caries effect through remineralization. beneficial levels can be sustained for ... (how long?), depending on what? | fluoride levels as low as 0.04 ppm enough to produce beneficial anti-caries effect through remineralization. beneficial levels can be sustained for as long as 2 to 6 hours depending on the product used and the individual |
| Effects of Fluoride in Biofilm and Saliva | *Demin &reminer process*Inhibits theway cariogenc bactria metablze carbohydrts: -inhibts enzymeenolase,bacteria need4metabolsm ofcarbohdrts -inhibts acidprodctn (low concntrtns offl cnstntly present s.mutans producs<acid) *high concentratns canbebactr |
| Fluoride delivered to the tooth: | 1)Systemically *fluoridated water and beverages *food *supplements *inadvertent means 2) Topically *OTC products *professionally applied products *systemic sources |
| Systemic Fluoride, pre-eruption effect | Pre-eruption effect: *fluorapatite produced is less soluble than hydroxyapatite. *improves the quality of the mineralized tooth structures. *fluorosis can occur during the pre-eruptive, mineralization stage |
| Systemic Fluoride, post-eruption effect | Post-eruption:provides a topical benefit: *incorporated in saliva – thus plaque; *baths the teeth as you swallow the water or liquid containing the fluoride |
| Fluoridation, protection/risk | Fluoridation: The adjustment of the naturally occurring fluoride ion content of a domestic water supply to an optimum concentration. *maximum protection against dental caries, minimum risk for dental fluorosis |
| Whose research resulted in use of term "dental fluorosis" | (1930s) Dr. H. T Dean’s research resulted in use of the term “dental fluorosis” to describe the condition created an index /classification system for describing dental fluorosis |
| Dr. H.T. Dean determined determined optimal level of fluoride necessary to prevent/reduce decay without causing fluorosis | determined optimal level of fluoride necessary to prevent/reduce decay without causing fluorosis approximately 1 ppm 1 part of fluoride per 1 million parts of water |
| First long-term fluoridation study | 1945, long term fluoridation study Grand Rapids, MI and Newburg, NY fluoridatd; control cities – not fluoridated. Baseline info gathered &study continued over years; results showed a signif reductn in the fluoridated communities as well as safety |
| In 2011, the US Department of Health and Social Services updated their recommendations for the optimal concentration of water fluoridation | In 2011, the US Department of Health and Social Services updated their recommendations for the optimal concentration of water fluoridation .7 ppm for all communities; the range (colder/warmer climate) was eliminated |
| Fluoride, Dietary Supplements, Assess Needs: | Assess need *primary water supply contains less than 0.6 ppm of F *high risk for caries *reassess at frequent intervals - needs may change over time |
| Fluoride, Prenatal Supplements | prenatal supplements not recommended even though fluoride crosses the placenta during the 5th and 6th months of pregnancy not shown to be beneficial permanent tooth development does not occur in utero |
| Fluoride in salt; recommended by...supplies what amount of fluoride... | Recommended by WHO as one alternative to fluoridated water to target underprivileged populations supplies about 1/2 to 1/3 of amount of fluoride ingested daily from 1 ppm fluoridated water *reduced incidence in caries in users of fluoridated salt; |
| Bottled water and fluoride content | Bottled Water usually does not contain optimal fluoride unless has a label indicating it is fluoridated fill water bottle from fluoridated water supply |
| Water Filters and Fluoride... Is fluoride removed? | Water filters remove fluoride reverse osmosis and water distillation systems carbon filters with activated alumina do not remove fluoride water softeners maybe carbon filters on the end of a faucet or pitcher vary in the amount of fluoride removed |
| Fluoride in Infant formula, ADA recommends | Level of fluoride in the water supply used to mix the formula determines the amount of fluoride in the formula *ADA recommends using optimally fluoridated water to reconstitute infant formula (be aware of possible risk of mild fluorosis in primary teeth) |
| Effect & Benefits of Systemic Fluoride | *#of lesions reduced (40-65% if exposed to fl H2O from birth on) *Rate of caries slowed *Ant teeth receive more protection than post teeth *50% decrease in root caries in people lifelong residents of fl community; *Less tooth loss due to decay |
| Dental fluorosis, describe | >than optimal amounts of systmc fl during pre-eruptive mineralztn stage*microscopiclly demonstrates as well minrlzd surface layerof enamel overlying subsurface ofporous enamel. clinic: matte white/opaque areas ontooth surface(symmetrclly throughout mouth |
| Varying degrees of fluorosis: | Varying degrees of fluorosis. *mildest form “snowcapping” involves the incisal edges or cusps of posterior teeth. *more severe flecks, white spots, streaks, veining, pitting, or corroded appearance. |
| Dental fluorosis, staining | Tan to dark brown staining due to post-eruptive intake of exogenous stain |
| Timing of Dental Fluorosis; permanent dentition susceptible... central incisors susceptible... | Entire permanent dentition susceptible between the ages of 11 months to 8 years pre-eruptive, mineralization stage *Maxillary central incisors between 15 and 30 months old |
| Treatment of dental fluorosis | *In severe cases you can try to remove the stain and/or cover it. *Bleaching, microabrasion, composites, veneers, crowns. |
| Fluoridation Controversy, From an anti-fluoridationist point of view, fluoride.. | From an anti-fluoridationist point of view: toxic research doesn’t support claims that topical fluoride much more beneficial than systemic fluoride forced medication |
| How is topical Fluoride delivered to the tooth? | By direct contact on exposed tooth surfaces: *prof applied(foams/gels/varnish/ rinses) *self-applied OTC products (TP, rinses) *self-applied Rx products(pastes, rinses) *indrctly via dent plaque &saliva fl products passing overteeth as they areswal |
| Fluoride uptake greatest | *Uptake greatest during the first few years after eruption *enamel on newly erupted teeth not completely calcified *enamel calcification continues for about 2 years following eruption |
| application of F to sound, fully maturated enamel results in... | application of F to sound, fully maturated enamel results in very little fluoride deposition that lasts more than 24 hours |
| Topical Fluoride Applications: Indications for professional application of high-concentration fluoride. (Low/moderate/high caries risks) | Indications for professional application of high-concentration fluoride: *low caries risk- use professional judgment *moderate caries risk-application at least every 6 months *high risk- application every 3 to 6 months |
| Root Caries, Risk Indicators | *Age *% Of sites with gingival recession *Retention of natural teeth (increased risk of exposed root surfaces) *Poor oral hygiene *Failure to visit dentist within 12 months *History of coronal caries *Minimum fluoride exposure |
| Fluoride, Professional Application; Forms generally available for professional application: | Forms generally available for professional application *2% Neutral Sodium Fluoride (NaF) Gel or Foam *1.23% Acidulated Phosphate (APF) Gel or Foam *5% Neutral Sodium (NaF) Varnish |
| Fluoride mouthrinses CI in | Mouthrinses CI in children 6 and under |
| Fluoride rinses categorized as: | Categorized as *low potency/high frequency OTC *high potency/low frequency RX |
| Who should not use fluoride rinses? | Children under 6 should not use F rinses |
| Fluoride Safety: Certainly Lethal Dose: | Certainly Lethal Dose (CLD): *adult: 5 to 10 g of NaF at one time (32-64mg F/kg) *child: .5 to 1.0 g, varies with size and weight |
| Symptoms of Acute Toxicity | May begin within 30 minutes of ingestion and last for as long as 24 hours |
| Symptoms of Acute Toxicity: fluoridec acts with... to form (what); Symptoms... | Fluoride acts with hydrochloric acid in the stomach to form hydrofluoric acid nausea, vomiting, diarrhea abdominal pain increased salivation and thirst |
Created by:
EdmondDantes