DENT 1180 DENT 1180 Prevention & Prevention &

NutritionNutritionTopical FluorideTopical Fluoride

1. 3 types of F for professional 1. 3 types of F for professional TopicalTopical application application

• Sodium Fluoride NaF 2% aqueous paint on solution, gel or foam in tray neutral

• Stannous Fluoride SnF 8% aqueous unstable, taste, stain acidic pH

• Acidulated Phosphate APF 1.23%sol paint on solution, gel or foam in tray thixotropic acidic pH

2. At Risk Patient2. At Risk Patient• Patients prone to caries• Patients with Non Fluoridated water• Patients with xerostoma- dry mouth

• CONTRAINDICATIONS• Before bonding ( seal, ortho)

3. Water F3. Water F• 1 PPM of Sodium F• http://www.ada.org/public/media/vide

os/minute/fluoridation_benefitsoffluoride_broadband.wmv

• SYSTEMIC

Review of Excess Systemic Review of Excess Systemic FF

• Fluorosis- mottled enamel

4. 2 Methods of application4. 2 Methods of application• trays • Brush on

• Varnish

• Swish

VarnishVarnish• Fluoride varnish is a topical agent containing a high concentration

of fluoride (5 percent sodium fluoride (NaF) or 22,600 ppm of fluoride) in a resin or synthetic base. Professionally applied fluoride varnishes were first developed in the 1960s, and have been in use for over 30 years.

• Fluoride varnishes are painted directly onto teeth and are intended to remain in close contact with enamel for several hours. Fluoride varnish sets on contact with intraoral moisture, so thorough drying prior to application is not required. Application time runs from one to four minutes, depending on the number of teeth within the oral cavity. In a typical varnish application, 0.3 to 0.5 milliliters (mL) of varnish are painted directly onto the teeth (0.1 mL of varnish was applied per arch in the UCSF study). Varnish may be applied with any convenient applicator (e.g., a disposable brush or cotton-tipped applicator, or the syringe-type applicator included with the product). After application, the fluoride varnish remains on the tooth surfaces for several hours, which facilitates maximal fluoride uptake. Fluoride varnish also minimizes the risk of inadvertent fluoride consumption and is easy to use on very young children.

Fluoride trays in placeFluoride trays in place

photo courtesy of www.drspiller.com

5. Steps in F tray application5. Steps in F tray application• Patient is seated upright• Give preop instruction• DRY teeth• Insert tray with F gel• Insert saliva ejector• Watch time (1 min)• Remove tray and evacuate• Give Post op instructions

6. Instructions6. Instructions• Preop and during

Do Not Swallow the material

• Post Op

Do Not Swallow the material

Do not eat, drink, brush for half hour

If upset stomach- drink milk

Severe- induce vomit

7. How often7. How often• Per patient needs• Most insurance companies pay only

on children and once per year!

8. Systemic v Topical8. Systemic v Topical• INGESTED in water,

food and carried to cells through bloodstream

• Strengthens crystalline structure of enamel as it forms

• Applied to already erupted teeth

• Incorporates into enamel and helps strengthen

VocabVocab• Bulimia- an eating disorder, binge

eating and self induced vomiting. Vomit has low pH and erodes the enamel. Topical F treatment in office and at home rinses may be Rx.