3. FLUORIDE :-
is the negatively charged ionic form of the element fluorine that has a high
affinity for calcium. It plays an important role in the prevention of dental caries.
Is a mineral that occurs naturally in many foods and water, which
is one of the minerals which added to and lost from a tooth's enamel layer
through two processes, demineralization and remineralization.
compound form of fluoride.
A trace element, halogen .
very reactive gas .
not found in free elemental form in nature .
WHAT IS THE
FLUORDE ?
5. Fluoride in drinking water
the optimal fluoride level for public water supplies is
about (0.1_1.0 ppm).
Supplements of fluoride
AGE <0.3ppm 0.3-
0.6ppm
>0.6pp
m
6m-3y 0.25 0 0
3-6y 0.5 0.25 0
6-16y 1.0 0.5 0
6. Supplements should be considered
especially for patients at high risk for
dental caries whose community water
source is suboptimal.
Supplements are available in liquid,
tablet, or lozenge form.
-fluoride tablets ,drops, lozenges are
not available over the counter but
prescribed by the dentist to individual
patients or as a part of school or home
based preventive dentistry program.
Fluoride Supplements
7. Fluoridated salt
use salt as a vehicle for fluoride in the diet .
salt is about 2/3 as effective as the water.
8. Is the addition of a measured quantity of
fluoride to bottled or packaged milk to be
drunk by children.
Milk fluoridation :
10. Topicall
y
home use _ frequently
(low concentration)
toothpastes
mouth
rinses
periodical_Professional
use
(high concentration
varnishes
gels form
Topically : its to make the fluoride substance
in direct contacts with the tooth
service.
11. Toothpastes
toothpastes:
They are considered as one of the most common forms of topical
Fluoride.
Its contain:
sodium fluoride
Sodium monofluorophosphate
flavoring agent.
The toothpaste usually contain about (1000 to 1100)PPM
in children 5 years old (500-600)PPM and 8 years and above
(1450)PPM of Fluoride.
and has offered( 15 _30 %) reduction in dental caries.
12. They could be used on daily or weekly .
Rinse fore( 1 minute with 10ml).
Caries reduction is about (20% to 35 %).
Indication:
1- children over the age of 6 years.
2- orthodontic.
3-salivary flow has been reduced.
Contraindication:
children or people who are unable to
effectively expectorate the product from
They should not be used by very young
their mouths.
Mouth rinses
13. VARNISHES
Fluoride varnishes ( 5% sodium fluoride).
varnishes:
protector coating is painted on the teeth to prevents the
formation of new decay and stop the growth of new cavities.
Carice reduction is( 40%-56%)
It is applied twice a year and frequently
use is not recommended
Painted varnishes ( 3_4 minutes).
patients are advised not to rub their teeth for 24 hours and eat soft
foods in the varnishes day
Could turn varnishes a yellow but it will disappear after 24 hours with
the brushing.
14. Painted varnishes ( 3_4 minutes).
It is applied twice a year and frequently use is not
recommended.
patients are advised not to rub their teeth for 24 hours and eat
soft foods in the varnishes day
varnishes could a yellow but it will disappear after 24 hours
with the brushing.
Application of the fluoride varnish cont.
15. Fluorides gels
gels are use fore :
individuals who are at high risk for caries.
orthodontic patients .
patients with decreased salivary flow.
Some gels are made for home application, and are used in a
manner similar to toothpaste.
16. The gel is applied by the use of the mouth tray
The tray is held in the mouth by biting Application
generally takes about four minutes, and patients should
not rinse, eat, smoke, or drink for at least 30 minutes
after application.
17. Mechanism of fluoride to prevent
the dental caries
Increase the enamels resistance to acid
solubility : When the enamel exposed to low
concentration of fluoride, a layer called flourapatite
form on the hydroxyapatite.
18. Increase the re-mineralization and decrese
the demineralization :
The fluoride ions that released from the dental
plaque and saliva stop the demineralization and
promote the re-mineralization.
19. The antibacterial effect of fluoride:
- The bactericidal or anti-enzymatic effect of the
fluoride inhibit the enzymes that produce acid from
bacteria. And it has a toxic effect of some bacterial
like the streptococcus mutant.
- change the morphology of tooth.
20. FLUOROSIS
( Mottling of enamel)
Fluorosis : is a developmental disturbance of dental
enamel caused by excessive exposure to high
concentrations of fluoride during tooth development
22. VERY MILD-Small
opaque, paper white
areas covering less than
25% of the tooth surface.
MILD-Opaque white
areas covering less than
50% of the tooth surface.
23. MODERATE-All tooth
surfaces affected marked
wear on biting surfaces;
brown stain may be
present.
SEVERE-All tooth
surfaces affected; discrete
or confluent pitting; brown
stain present
26. TOXICITY
1) Toxicity of fluoride occurs in case deliberate or
accidental or dosage .
2) The acute lethal dose is approximately 15 mg/kg
body weight.
3) Symptoms of sub lethal poisoning are salivation ,
nansea and vomitiy .
4- Death from respiratory or cardiac failure occurs
within 24 hours of lethal dose .
5- A small quantity of fluoride { less then 5mg/kg body weight }
is neutralized by drinking a large volume
of milk .
6-Topical fluoride preparation shooed be applied
carefully because of their potential toxic effect .
27. Summary of recommendation for
fluoride delivery methods :-
1) Brush your teeth at least twice a day with fluoride
toothpaste.
2) do not brush your teeth for at least 30 minutes after
meal
as this can damage your teeth.
3) Using mouthwash that contain fluoride can prevent
tooth decay. How ever this should not be used
directly after tooth brushing.
4) choose separate time to use mouth wash such as
after lunch.
5) do not eat or drink for 30 minutes after using a
fluoride mouthwash .
