flouride application


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Khushbu    on Aug 07, 2012 Says :

nice presentation on floride applications in dentistry.
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1 : FLOURIDE APPLICATION Dr. SWECHCHHA SHAH (BDS,MHCM)
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4 : Every day, minerals are added to and lost from a tooth's enamel layer through two processes, demineralization and remineralization. Minerals are lost (demineralization) from a tooth's enamel layer when acids -- formed from plaque bacteria and sugars in the mouth -- attack the enamel. Minerals such as fluoride, calcium, and phosphate are redeposited (remineralization) to the enamel layer from the foods and waters consumed. Too much demineralization without enough remineralization to repair the enamel layer leads to tooth decay.
5 : Fluoride helps to prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay. In children under six years of age, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Fluoride also helps speed remineralization as well as disrupts acid production in already erupted teeth of both children and adults.
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8 : All children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm (parts per million). After three years old they should use a toothpaste that contains 1350ppm to 1500ppm. Parents should supervise their children's tooth brushing, and use only a pea-sized smear of fluoride toothpaste until they are about 7 years old.
9 : DENTIFRICE (TOOTHPASTE,TP) Gels: Better interdental penetration More acceptable to children Pastes Key ingredients in TP: F salt Abrasive
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11 : Some people are more likely to have tooth decay, and the dentist may also advise using fluoride supplements as well as fluoride toothpaste for extra protection. It is very important to take fluoride supplements on the advice of a dentist, and that you use them in the way they say. Supplements are suitable for children from about 3 onwards and can help reduce decay.
12 : FLUORIDE SUPPLEMENTS Fl in drinking water F Academy of Pediatric Dentistry current recommendations
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15 : FLUOROSIS F F Excess F affects mineralization of developing teeth Up to age 6 is the critical age for fluorosis. After age 8, risk is past. Enamel prism
16 : FLUOROSIS F in excess of 0.1mg/ kg body weight = fluorosis Maxium safe dose for a 5 year old = 2 mg F / day Maxium safe dose for a 2 year old = 1 mg F / day 1 2 3 4 mg F supplements toothpaste fluids food DW Banting JADA 123:86,1991 Daily F intake of a 20 kg 4 year olds with different water F 0.5 ppm water F 1.2 ppm water F
17 : moderate severe mild pitting
18 : WHAT IS FLOURIDE APPLICATION? It is the delivery of Flouride to teeth topically or systemically in order to prevent Dental caries .
19 : TYPES OF FLOURIDE APPLICATION: Non-professional fluoride administration 1. Systemic 2. Topical gels 3. Rinses 4. Dentifrice B. Professional administration 1. Topical 2. Varnish
20 : In What Forms Is Fluoride Available? As mentioned, fluoride is found in foods and in water. It can also be directly applied to the teeth through fluoridated toothpastes and mouth rinses. Mouth rinses containing fluoride in lower strengths are available over-the-counter; stronger concentrations require a doctor's prescription.
21 : A dentist in his or her office can also apply fluoride to the teeth as a gel, foam, or varnish. These treatments contain a much higher level of fluoride than the amount found in toothpastes and mouth rinses. Varnishes are painted on the teeth; foams are put into a mouth guard, which is applied to the teeth for 1 to 4 minutes; gels can be painted on or applied via a mouth guard. Fluoride supplements are also available as liquids and tablets and must be prescribed by your dentist, pediatrician, or family doctor
22 : Goals of Fluoride (F) Administration 1) Do not harm the patient. 2) Prevent decay on intact dental surfaces. 3) Arrest active decay. 4) Remineralize decalcified tooth surfaces. TEXT
23 : GOALS OF FLUORIDE (F) ADMINISTRATION Do no harm Prevent decay on in tact dental surfaces F F Arrest active decay Remineralize decalcified teeth 1. 2. 3. 4. F Fluorosis or toxicity
24 : MECHANISM OF ACTION: Deposition of fluorapatite (FHA) in sound tooth structure: Caries protection results from FHA being more acid resistant than pure hydroxyapatite (HA). Deposition takes place when F replaces hydroxyl groups in HA. This can occur pre- or post-eruption at neutral pH, or post-eruptively at neutral or acidic pH. At low pH, HA dissolves, then re-precipitates as new crystals which are larger and more acid-resistant due to higher FHA and lower magnesium and carbonate content. Deposition of FHA is accomplished both by systemic intake of F during tooth development, and topical F administration after eruption. 1. TEXT
25 : Professional topical F treatments with concentrated acidulated phosphate fluoride (APF) gels (2.72% APF gel contains 12,300 ppm F), is the most efficient way to accomplish this, especially when applied to newly erupted teeth (i.e., age 2 for primary molars; age 6 to 8 for permanent first molars and anterior teeth; age 11 to 14 for permanent premolars and second molars).
26 : MECHANISMS OF F PROTECTION F F F F F F F F F F F F Saliva (S) Plaque (P) Tooth (T) DEPOSITION Increase FHA levels maximally in intact dental surfaces. Theory: Topical F is the best method for deposition.
27 : SOURCES OF BIOAVAILABLE F 1. saliva 0.08 0.02 ppm F in saliva after drinking 1 3 5 h F F F F S P T 4. RESIDUAL F ACT 2. Fluoridated water 3. Home care products Calcium Fluoride F F F F F Topical F CaF2 precipitates in plaque during topical F treatment
28 : FLUORIDE SUPPLEMENTS F in drinking water F Academy of Pediatric Dentistry current recommendations TEXT
29 : ARREST OF ACTIVE DECAY incipiencies Root caries Indications: Cases difficult to treat. Interproximal caries in low or moderate risk patients.
30 : Recommendations: Determine total F exposure. Determine caries risk. Administer as indicated by # 1 and 2. (Timing may be monthly, 1, 2, 3 or 4 times a year or even contra-indicated.) Apply for 4 minutes. Add no more than 2ml to the gel tray and make every effort to keep patient from swallowing the gel. Have patient refrain from rinsing, eating or drinking for 30 minutes after application. Professional Topical F TEXT
31 : FLUORIDE VARNISH Duraflor – 5% NaF, 26,000 ppm F, 3-6 mg F per dose. Fluor-Protector – 0.7% silane F. Used as a cavity varnish
32 : FLUORIDE VARNISH White spots or other incipiencies All teeth in the OR Exposed roots and root caries Margins of restorations Erupting teeth Carious anterior teeth in young children Indications: 2. 3. 4. 5. 1. 6.
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34 : HOME F RINSES ACT 0.05% NaF, 0.023% free F, 230 ppm F, 2.3 mg F / dose Daily Rinse: PHOS-FLOR 0.02% APF, 0.02% free F, 200 ppm F, 2 mg F / dose. Weekly Rinse PREVI-DENT 0.2% NaF, 0.091% free F, 910 ppm F, 9.1 mg F / dose. Indications: High caries risk Exposed roots Prevention programs
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36 : HOME GELS GEL-CAM – 0.4% SnF2, 0,097% free F, 970 ppm F, 2-3mg F/ dose. PREVIDENT – 1.1% NaF, 0.5% free F, 5000 ppm, 10-25 mg F/ dose. Indications: Severe caries Root caries Prevention programs Radiation caries
37 : When Is Fluoride Intake Most Critical? It is certainly important for infants and children between the ages of 6 months and 16 years to be exposed to fluoride. This is the timeframe during which the primary and permanent teeth come in. However, adults benefit from fluoride too. New research indicates that topical fluoride -- from toothpastes, mouth rinses, and fluoride treatments -- are as important in fighting tooth decay as in strengthening developing teeth. .
38 : In addition, people with certain conditions may be at increased risk of tooth decay and would therefore benefit from additional fluoride treatment. They include people with: Dry mouth conditions : Dry mouth caused by diseases such as Sjögren's syndrome, certain medications (such as allergy medications, antihistamines, anti- anxiety drugs, and high blood pressure drugs), and head and neck radiation treatment makes an individual more prone to tooth decay. The lack of saliva makes it harder for food particles to be washed away and acids to be neutralized. Gum disease : Also called gingivitis, gum disease can expose more of your tooth and tooth roots to bacteria increasing the chance of tooth decay.
39 : History of frequent cavities : If you have one cavity every year or every other year, you might benefit from additional fluoride. Presence of crowns and/or bridges or braces : These treatments can put teeth at risk for decay at the point where the crown meets the underlying tooth structure or around the brackets of orthodontic appliances
40 : Are There Risks Associated With Fluoride Use? Fluoride is safe and effective when used as directed but can be hazardous at high doses (the "toxic" dosage level varies based on an individual's weight). For this reason, it's important for parents to carefully supervise their children's use of fluoride-containing products and to keep fluoride products out of reach of children, especially children under the age of 6.
41 : In addition, excess fluoride can cause defects in the tooth's enamel that range from barely noticeable white specks or streaks to cosmetically objectionable brown discoloration. These defects are known as fluorosis and occur when the teeth are forming -- usually in children under 6 years. Fluorosis, when it occurs, is usually associated with naturally occurring fluoride, such as that found in well water. If the well water is being used and people are uncertain about the mineral (especially fluoride) content, a water sample should be tested. Although tooth staining from fluorosis cannot be removed with normal hygiene, your dentist may be able to lighten or remove these stains with professional-strength abrasives or bleaches.
42 : POTENTIAL HARM 5 mg F / kg body weight 20 kg 6 year old, PTD= 100 mg F 10 kg 2 year old PTD = 50 mg F 230 mg F/ tube toothpaste ACT 91-97 mg F/ container of F mouthrinse Symptoms: Vomiting Excess salivary and mucous discharge Cold wet skin Convulsion at higher dose Probable toxic dose: Topical F, 12,300 ppm F pH= 3.5 61.5 mg F/ 5 ml
43 : F Ca F Ca Counter Measures: Emetics 1% calcium chloride Calcium gluconate milk Divalent cations like Ca cause precipitation, of F and prevent absorbtion in the intestine. F Ca F Ca F Ca F Ca F Ca F Ca A serious systemic consequence is binding of F to Ca which needed for heart function. POTENTIAL HARM F Ca F Ca F Ca F Ca
44 : THE POTENTIAL RISK OF HIGH FLOURIDE INTAKE. GIT discomfort Skeletal flourosis Renal failure Neurologigal manifestation. Note: (these complication occur when more than 8 ppm of fluoride is ingested. More than 20 mgf/day for more than 20_30 years)
45 : A few useful reminders about fluoride include: Store fluoride supplements away from young children . Avoid flavored toothpastes because these tend to encourage toothpaste to be swallowed. Use only a pea-sized amount of fluoridated toothpaste on a child's toothbrush. Be cautious about using fluoridated toothpaste in children under age 6. Children under 6 years of age are more likely to swallow toothpaste instead of spitting it out
46 : FLUOROSIS Children under 2 years swallow 50% of toothpaste 5 year olds swallow 25% of toothpaste Toothpaste = 1 mg F / gram (1000 ppmF) 1 to 3 grams “pea” size amount (0.5g) is recommenred for fluorosis susceptible children.
47 : F USE CONSIDERATIONS F F F F F F Evidence shows that increased F use and F concentration increases bioavailability in stagnation sites. (Note: be aware of fluorosis susceptible patients.) F S P T F S P T F F F F awake asleep High salivary flow Low salivary flow Brush before bedtime Rinsing after brushing reduces F effectiveness by 50%. Recommendations: Do not rinse after brushing or rinse with a F rinse.
48 : Table 2. Commonly Used Fluoride Products Commonly Used F Products
49 : Table 2. Commonly Used Fluoride Products Commonly Used F Products

 

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this is the presentation prepared by DR. rajendra pd bhatt he is the chir person of th himal dental    more
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