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Topical Fluoride

Topical Fluoride. Mayra Aguilar and Kathy Cronin. What is fluoride?. Comes from the element fluorine Exist only as a fluoride compound Fluorine is a part of minerals in rocks and soil. A small amount of soluble fluoride is present in all water sources.

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Topical Fluoride

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  1. Topical Fluoride Mayra Aguilar and Kathy Cronin

  2. What is fluoride? • Comes from the element fluorine • Exist only as a fluoride compound • Fluorine is a part of minerals in rocks and soil. • A small amount of soluble fluoride is present in all water sources. • Fluoride is also present in all foods and beverages, to some extent.

  3. Benefits of Fluoride • Prevents and reverses the early signs of decay • Makes the tooth structure stronger and more resistant to acids formed from bacteria • Remineralizes areas in which acid attacks have already begun.

  4. Topical Fluoride • Topical fluorides are applied directly to the tooth enamel • It strengthens teeth and makes them more resistant to decay • Topical fluorides include toothpastes, mouth rinses, and fluoride treatments in the dental office

  5. Types of Professionally Applied Fluoride • Varnish • Gel • Foam

  6. Fluoride Varnish • 5% NaF (pH 7.0) = 22,600ppm Fluoride • Easier to apply in younger children • Takes less time • Less patient discomfort • Greatest patient acceptability • Fast drying • Reduce sensitivity Up to 24 weeks

  7. Fluoride Gels • Acidulated phosphate fluoride (APF)(pH 3.5) = 12,300 ppm Fluoride or • 2.0% NaF (pH 7.0) = 9040 ppm Fluoride • Higher patient acceptability compared to foam • 4 Minute Application Time

  8. Fluoride Foams • APF (pH 3.5) = 12,300 ppm Fluoride or • 2.0% NaF (pH 7.0)= 9040 ppm Fluoride • 4 minute application time • Bad taste, less patient acceptability • Requires 1/5 the quantity by weight to cover the same arch compared to gel

  9. Who Benefits from Topical Fluoride? • All people benefit from topical fluoride applications • People who are moderate to high caries risk benefit most

  10. Caries Risk Categories • Low risk all ages • No incipient or cavitated primary or secondary carious lesions during the last 3 years and no factors that increase caries risk*

  11. Caries Risk Categories • Moderate risk (0-6 years old) • No incipient or cavitated primary or secondary carious lesions during the last 3 years but the presence factors that increase caries risk*

  12. Caries Risk Categories • Moderate risk (older than 6 years old) • 1 or 2 incipient or cavitated primary or secondary carious lesions during the last 3 years but the presence factors that increase caries risk*

  13. Caries Risk Categories • High risk (0-6 years old) • Any incipient or cavitated primary or secondary carious lesions during last 3 years • Multiple factors that increase caries risk* • Low socioeconomic status • Suboptimal fluoride exposure • Xerostomia

  14. Caries Risk Categories • High risk (older than 6 years old) • 3 or more incipient or cavitated primary or secondary carious lesions during last 3 years • Multiple factors that increase caries risk* • Low socioeconomic status • Suboptimal fluoride exposure • Xerostomia

  15. Some Factors that Increase Caries Risk include • High titers of cariogenic bacteria • Poor oral hygiene • Prolonged nursing or bottle use • Poor family dental health • Irregular dental care • Presence of exposed root surfaces • Physical or mental disability • Alcohol / drug abuse, eating disorders

  16. Clinical Recommendations for Application Intervals • Low caries risk (all ages) • May not benefit from additional topical fluoride • Fluoridated water and fluoride toothpaste may be enough • Moderate risk (0-6 years) • Varnish application every 6 months • Moderate risk (6 and older) • Varnish or (1.23% APF) gel every 6 months

  17. Clinical Recommendations for Application Intervals • High Risk (0-6 years old) • Varnish every 3 months or 6 months • High Risk (6 and older) • Varnish or (1.23% APF) gel every 3 or 6 months

  18. Our Recommendations: Fluoride Varnish for All Ages! • Easy to apply • Better patient tolerability • Faster to apply • Applied directly to each tooth • Fluoride compound is less acidic • Dries fast so young kids don’t ingest excess fluoride • Great for dentin hypersensitivity

  19. References • Adair, S.M., Bowen, W.H., Burt, B.A., Kumar, J.V., Levy, S.M., and Pendrys, D.G., et.al. (2001). Recommendations for using fluoride to prevent and control dental caries in the United States. Morbidity and Mortality Weekly Report 50 (RR14) 1-42. • American Dental Association. (2005). An alternative technique for applying fluoride varnish. Retrieved November 23, 2008, from www.ada.org/goto/jada • American Dental Association. (2007). Fluoride treatments in the dental office. Retrieved November 23, 2008, from http://jada.ada.org • American Dental Association Council on Scientific Affairs. (2007). Professionally applied topical fluoride: evidence-based clinical recommendations. Journal of Dental Education, 71(3), 393-402. Retrieved November 20, 2008, from http://www.jdentaled.org/cgi/content/full/71/3/393 • Benton-Franklin Health District. (2008). Fluoride. Retrieved November 20, 2008, from http://www.bfhd.wa.gov • Jiang, H., Tai, B., Du, M., and Peng, B (2005). Effect of professional application of APF foam on caries reduction in permanent first molars in 6-7-year-old children:24 month clinical trial. Journal of Dentistry, 33 469-473. • Marinho, V. C. C., Higgins, J. P. T., Sheiham A., & Logan, S. (2004). One topical fluoride (toothpaste, or mouthrinse, or gels, or varnish) versus another for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews, Issue 1. Art.No.: CD002780. • Ritter, A. V., Dias, W, Miguez, P, Caplan, D. J, & Swift Jr., E. J (2006). Treating cervical dentin hypersensitivity with fluoride varnish: A randomized clinical study. The Journal of the American Dental Association, 137 1013-1020 • Weintraub, J.A., Ramos-Gomez, F., Jue, B., Shain, S., Hoover, C.I., Featherstone, J.D.B., Gainsky, S.A. (2006). Fluoride varnish efficacy in preventing early childhood caries. Journal of Dental Research, 85(2), 172-176. Retrieved November 23, 2008, from http://jdr.iadrjournals.org/cgi/content/full/85/2/172?maxtoshow=&HITS=10&RESULTSFORMAT=&author1= Ramos-Gomez&fulltext=Fluoride&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

  20. References • Topical fluoride application uploan.wikimedia.org • Application of topical fluoride (baby) www.communityhealth.dhhs.state.nc.us • Application of topical fluoride (tooth and paint brush) www.communityhealth.dhhs.state.nc.us • Fluoridex bottles www.discusdental.com • colg_fluorofoam_hero.jpg www.colgateprofessional.com • Duraphat decs.nhgl.med.navy.mil

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