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What are professional topical fluoride applications?

1. Topical fluorides are used to speed the rate and increase the

concentration of Fluoride acquisition above the level, which occurs

naturally.

2. Best time to apply is soon after eruption.\

3. Initial caries lesion, characterized by a white spot, is porous and

accumulates fluoride at a much higher concentration than sound

enamel.

4. Periodic application of fluoride would enable vulnerable enamel sites

that are partiall demineralised to accumulate fluoride.

2 Fluorides in preventivedentistry

y Topical fluoride applications

yFluoridation

yBrief note on Fluoride mouthwashes and dentrifices.

yDietary fluoride supplements

y Tray technique for home application of fluorides

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Characteristic NaF SnF2 APF

1. Percent

fluoride

2% 8% 1.23%F

2. Ppm fluoride 9200 19500 123003. Frequency of

application4 at weeklyintervals at

ages3,7,11,&13

1 or 2 years 1 or 2years

4. Taste Bland Disagreeable Acidic

5. Stability Stable Unstable Stable inplastic

containers6. Tooth

PigmentationNo Yes No

7. Gingivalirritation No Occasionaltransient No

8. Averageeffectiveness( cariesreduction)

29% 30% 28%

Procedures for Topical Fluoride Applications

y A) Preparation of tooth:- Scaling and Polishing of teeth.

y B) Application:- 2 methods.

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y Cotton roll isolation with paint on gel or Soln.

y Trays that over the teeth of each dental arch.

y Apply F for 4 minutes without dilution by Saliva and do not swallow.

1.Paint-On Technique: Soln or Gel

y Seat the patient upright.

y Isolate teeth with cotton rolls.

y Use high power suction and Dry teeth with air.

y Apply quickly F prep for 04 minutes, use timer.

y Advise not to rinse, drink for 30 minutes.

2. Tray Technique - Gel

y Type of tray, custom made, thermoplastic.

y Seat the patient upright.

y Dry teeth.

y Insert tray with 2-5 ml gel loaded.

y Set timer 4 minutes, high power suction.

y Patient not to rinse, eat, drink, brushing for 30 minutes.

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ySelf Application of Fluoride

y A) Tray Technique.

y

B) Rinsing.y C) Tooth brushing.

1. Tray Technique

y Rampant caries, Xerostomia, Radiation therapy,

hypersensitivity.

y Gel: APF 0.5%, NaF 1.1%, SnF2 0.4%

y Use disposable or custom-made polyvinyl tray.

y Use tooth brush and floss before applying tray.

y Apply for 04 minutes, do not swallow.

y Patient not to rinse, eat, drink, brushing for 30 minutes.

y Can be used daily, weak prep of F.

2. Fluoride Mouth Rinses

y Gen Prevention of Caries, root exposure, rampant caries,

p/denture xerostomia, school dental, health programme.

y NaF 0.05% (F contents 0.025%, F-225ppm)

y Rinse not to be used by children under 6 years of age.

y Rinse daily for 60 seconds with 5 ml after brushing.

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3. Oral Rinse Supplements

y A) Acidulated NaF (0.04%), swished and swallowed to provide

daily systemic supplement.

y B) Can be used for rampant caries and hypersensitivity.

y C) NaF 0.2%, use weekly 5 ml for 60 seconds.

y D) Weekly rinse in school based programme.

What is fluoridation?

Adjustment of fluoride concentration in the domestic water supply to the optimum physiological

concentration that will provide max protection against dental caries and enhance the

appearance of the teeth with a minimum possibility of producing objectionable

Brief note on Fluoride mouthwashes and

dentrifices.

Dentrifices have been classified as

y

therapeutic ( which has cosmetic effects) andy cosmetic ( which has therapeutic effects).

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FUNCTIONS:

a) Physico-Mechanical Function:

Usual brushing even when accompanied by flossing leavesa significant amount of plaque in proximal areas, around the

necks of the teeth and in the occlusional fissures.

Using tooth brush and dentrifice may reduce the

cariogenecity of the remaining plaque by rinshing or flushing

action that removes fermentable materials, disrupts the

delicate balance of environmental conditions necessary foracid-formation and hence prevent the formation of thicker,

more cariogenic plaues.

Using a fluoride containing dentrifice, deposits fluoride in

residual plaque thus providing it, when most needed, for the

possible inhibition of acid formation and enamel dissolution.

b) Chemical functions:

Function based on the potential anticaries

mechanism of F. it includes reactions mediated thru

the deposition of F into the enamel and plaque.

Deposition of the F into enamel as fluorapatite

increases the acid resistance of the enamel.Although it is important that this occur in sound

enamel, so that it can withstand the attack of acid of

a caries attackF from dentrifices is deposited in the

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largest amounts in the porous enamel of incipient

lesions ( i.e the site where it is most needed.)

COMPOSITION:

Generally a mixture of :

1. An abrasion or polishing agent

2. A detergent

3. Humectants

4. Binding or thicking agents

5. Surface active agents

6. Flavouring agents

7. Substances necessary to facilitate their preparation and use.

Mouthwashes:

F mouthwashes act by inhibiting the bacterial metabolism

and plaque acid formation. Caries are prevented by an

efficient delivery of ionic F to the site in adequate

concentration and duration.

The mouthwash/rinse can be used for patients in F-deficientcommunities.

Mouthwashes are available as NaF rinses, Acidified NaF

rinses, Stannous Fluoride rinses. However research has

proven that NaF rinses most sufficient cariostatic activity.

Dietary Fluoride Supplements

Most common method of systemic/ dietary supplements are:

1. Fluoride drops with/without vitamins

2. Fluoride tablets with/without tablets

3. Lozenges, intended to be sucked slowly or permitted to dissolve slowly in the mouth

4. Oral rinse supplements ( swish and swallow)

Compounds use are: NaF and APF ( acidulated phosphate fluoride).

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Frequency of use of supplements is they should be taken on a daily basis according to the

prescribed dosage schedule

These dietary supplements are intended for use in:

1. Areas where there are no central water supplies

2. As an interim measure in these communities with a central water system that have not

yet implemented community water fluoridation

3. In areas where water fluoridation or salt fluoridation cannot be implemented.

4. In families where there is a high degree of mobility, inv frequent changes in the place of

work and where parents wish to ensure daily F supplements themselves.

Supplements provide systemic and topical beneficial effects for primary and permanent teeth.