Cariology Lec 66: Caries Management 1

promote remineralization
inhibit demineralization
bacterial interaction

fluoride acts in 3 ways:

hydroxyl (OH)

Fluoride ions replace _______ ions in hydroxyapatite to form fluorapatite in the tooth enamel

5.5

In a cariogenic challenge, when the pH drops below ___, the biofilm fluid becomes undersaturated with phosphate ion and enamel dissolves to restore balance

4.5

when fluoride is incorporated into demineralized enamel, subsequent demineralization in enamel now can only happen when the pH is below ____

tooth development

when does fluorosis occur?

0.7 ppm F

what is the current ADA recommendation for water?

1,000 ppm - 1,500 ppm F

how much fluoride is in over the counter toothpaste?

5,000 ppm NaF

how much fluoride is in prescription toothpaste?

0.05% NaF

for high risk patients, daily rinse should contain what % of Rx fluoride?

0.2% NaF

for high risk patients, weekly rinse should contain what % of Rx fluoride?

22,600ppm F (5% NaF)

how much fluoride is in topical varnish?

12,300 ppm (1.23% NaF)

how much fluoride is in fluoride gel?

44,800 ppm (38% NaF)

how much fluoride is in SDF?

6 years

mouth rinse is not recommended for children under the age of:

acute

nausea and vomiting is a ________ effect of fluoride toxicity

acute

hypocalcemia is a ________ effect of fluoride toxicity

acute

tetany is a ________ effect of fluoride toxicity

acute

mixed metabolic and respiratory acidosis is a ________ effect of fluoride toxicity

acute

coma and convulsions leading to death is a ________ effect of fluoride toxicity

chronic

dental fluorosis is a ________ effect of fluoride toxicity

chronic

skeletal fluorosis is a ________ effect of fluoride toxicity

chronic

hypersensitivity reactions is a ________ effect of fluoride toxicity

chronic

dyspepsia is a ________ effect of fluoride toxicity

chronic

numbness is a ________ effect of fluoride toxicity

chronic

birth defects and cancer is a ________ effect of fluoride toxicity

0.05-0.07mg F/kg body weight

what is the optimal dose of fluoride for children and adults?

5 mg F/kg body weight

what is the toxic dose of fluoride for children and adults?

32 mg F/kg body weight

what is the lethal dose of fluoride for children?

64 mg F/kg body weight

what is the lethal dose of fluoride for adults?

milk, observation

if a child ingests less than 5 mg/kg of fluoride, what is the treatment?

hospitalization

if a child ingests more than 5 mg/kg of fluoride, what is the treatment?

IMMEDIATE hospitalization

if a child ingests less than 15 mg/kg of fluoride, what is the treatment?

concentration of F
weight of toothpaste ingested (gm)
weight of child (kg)
symptoms

what 4 pieces of information do you need to assess the severity of a fluoride toxicity?

2.26% fluoride varnish or 1.23% fluoride gel (in office)
prescription-strength, home-use 0.5% fluoride gel or paste or 0.09% fluoride mouth-rinse

For patients 6 years or older at risk of developing dental caries you would recommend:

Only 2.26% fluoride varnish (in office)

For patients under 6 years old at risk of developing dental caries you would recommend:

true

t/f: Sealants with NaF varnish is more effective than just NaF varnish or just sealants.