1. Fluoride has been used extensively to prevent dental caries since the early 1900s. Both systemic and topical fluoride administration are effective ways to reduce caries risk.
2. Current recommendations include community water fluoridation at 0.7 ppm, fluoride toothpaste in rice-sized amounts for young children, and professionally applied topical fluoride treatments every 3-6 months for those at high risk.
3. New advancements like silver diamine fluoride show promise in arresting cavitated caries lesions and may provide an alternative to conventional restorative techniques.
INTRODUCTION, METHOD OF ADMINISTRATION,WATER FLUORIDATION,SCHOOL WATER FLUORIDATION,SALT FLUORIDATION,MILK FLUORIDATION,FLUORIDE SUPPLEMENTS,DIETARY SUPPLEMENTS,PRENATAL FLUORIDE SUPPLEMENTS,RECENT STUDY
This document discusses various topics related to fluoride and its role in preventing dental caries. It begins by explaining the mechanism of action of fluoride and how it can be incorporated into enamel. It then discusses different types of topical fluoride agents and techniques used in clinics, including professionally-applied and self-applied options. Sodium fluoride, stannous fluoride, and acidulated phosphate fluoride are some of the agents mentioned. The document provides details on concentrations and application procedures for various fluoride treatments. Advantages and disadvantages of different agents and techniques are also summarized.
This document discusses the historical evolution and use of fluorides for dental caries prevention. It begins with early discoveries of fluoride in enamel in 1805 and the isolation of fluorine as an element in 1771. It then covers fluoride chemistry, sources of fluoride intake from water, food, beverages and air. The document discusses fluoride metabolism, distribution in tissues, and excretion. It also addresses water fluoridation, which began in 1945 in Grand Rapids, USA and defines water fluoridation as the controlled adjustment of fluoride in communal water to maximize caries prevention with minimal fluorosis risk.
Salt fluoridation involves adding fluoride, usually sodium or potassium fluoride, to salt during manufacturing to help prevent tooth decay. Fluoride is added at levels of 200-350mg per kg of salt. It was introduced in Switzerland in 1948 and over 75% of salt sold was fluoridated by 1967. Salt fluoridation provides fluoride systemically and is popular in some countries as an alternative to water fluoridation for mass prevention of dental caries. While it has limitations, it can reduce tooth decay by up to 50% and is cheaper than water fluoridation.
The document discusses the relationship between sugars and dental health. It notes that sugars and fermentable carbohydrates provide substrate for oral bacteria to produce acid, which begins the process of tooth demineralization if not balanced by remineralization. Frequent consumption of sticky, sucrose-containing foods between meals is most cariogenic, while liquid foods and those consumed with meals are less so. The document also discusses factors like food texture and stickiness, saliva flow, and buffers that determine a food's cariogenic potential.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
Fluoride is a trace element found naturally in water sources and soils. It is beneficial for dental health when consumed in optimal amounts. Fluoride strengthens tooth enamel and promotes remineralization. It is most effectively delivered through community water fluoridation but can also be obtained through foods, supplements, and topical treatments like toothpaste. Both low and high fluoride intake can pose health risks like dental fluorosis. Careful monitoring of intake levels is important, especially for young children, to maximize dental benefits and avoid risks.
INTRODUCTION, METHOD OF ADMINISTRATION,WATER FLUORIDATION,SCHOOL WATER FLUORIDATION,SALT FLUORIDATION,MILK FLUORIDATION,FLUORIDE SUPPLEMENTS,DIETARY SUPPLEMENTS,PRENATAL FLUORIDE SUPPLEMENTS,RECENT STUDY
This document discusses various topics related to fluoride and its role in preventing dental caries. It begins by explaining the mechanism of action of fluoride and how it can be incorporated into enamel. It then discusses different types of topical fluoride agents and techniques used in clinics, including professionally-applied and self-applied options. Sodium fluoride, stannous fluoride, and acidulated phosphate fluoride are some of the agents mentioned. The document provides details on concentrations and application procedures for various fluoride treatments. Advantages and disadvantages of different agents and techniques are also summarized.
This document discusses the historical evolution and use of fluorides for dental caries prevention. It begins with early discoveries of fluoride in enamel in 1805 and the isolation of fluorine as an element in 1771. It then covers fluoride chemistry, sources of fluoride intake from water, food, beverages and air. The document discusses fluoride metabolism, distribution in tissues, and excretion. It also addresses water fluoridation, which began in 1945 in Grand Rapids, USA and defines water fluoridation as the controlled adjustment of fluoride in communal water to maximize caries prevention with minimal fluorosis risk.
Salt fluoridation involves adding fluoride, usually sodium or potassium fluoride, to salt during manufacturing to help prevent tooth decay. Fluoride is added at levels of 200-350mg per kg of salt. It was introduced in Switzerland in 1948 and over 75% of salt sold was fluoridated by 1967. Salt fluoridation provides fluoride systemically and is popular in some countries as an alternative to water fluoridation for mass prevention of dental caries. While it has limitations, it can reduce tooth decay by up to 50% and is cheaper than water fluoridation.
The document discusses the relationship between sugars and dental health. It notes that sugars and fermentable carbohydrates provide substrate for oral bacteria to produce acid, which begins the process of tooth demineralization if not balanced by remineralization. Frequent consumption of sticky, sucrose-containing foods between meals is most cariogenic, while liquid foods and those consumed with meals are less so. The document also discusses factors like food texture and stickiness, saliva flow, and buffers that determine a food's cariogenic potential.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
Fluoride is a trace element found naturally in water sources and soils. It is beneficial for dental health when consumed in optimal amounts. Fluoride strengthens tooth enamel and promotes remineralization. It is most effectively delivered through community water fluoridation but can also be obtained through foods, supplements, and topical treatments like toothpaste. Both low and high fluoride intake can pose health risks like dental fluorosis. Careful monitoring of intake levels is important, especially for young children, to maximize dental benefits and avoid risks.
This seminar includes features of the normal periodontium seen in children along with various gingival and periodontal diseases seen in children with updated classifications along with clinical features and treatment modalities and a note on clinical assessment of oral cleanliness and periodontal diseases
Oral Healthcare for Pregnant Women | Maneesh GuptaManeesh Gupta
It's essential for you to take excellent care of your tooth and gums while pregnant.Listed below are some guidelines to support you manage good oral health before, throughout, and after pregnancy.
This document discusses fluoride and its role in pediatric dentistry. It begins by outlining the mechanisms of action of fluoride, including both pre-eruptive and post-eruptive effects. The main caries preventive mechanisms are through post-eruptive or topical effects, where fluoride is incorporated during remineralization to make enamel less soluble. The document then discusses various methods of fluoride application in pediatric dentistry, including professionally-applied and self-applied topical fluoride treatments as well as silver diamine fluoride and systemic fluoride.
- The document discusses various oral habits in children including tongue thrusting, mouth breathing, bruxism, lip biting, nail biting, cheek biting, and self-injurious habits.
- It provides classifications of tongue thrusting by various authors, describes the differences between infantile and adult swallowing patterns, and lists features of simple and complex tongue thrusting.
- Diagnosis methods for tongue thrusting including history, functional examination, and palpatory examination are explained. Treatment considerations and management techniques such as myofunctional exercises and appliances are also outlined.
Early childhood caries (ECC) as the presences of one or more decayed (noncavitated or cavitated), missing (as a result of caries), or filled tooth surface in any primary tooth in a child 71 months of age or younger.
Topical Fluorides- Professionally applied & Self appliedDrSusmita Shah
An overview of Topical Fluorides. Includes mechanism of action of topical application of fluorides- professionally and self applied. Recommendations of use of Fluorides in pediatric dentistry.
This document provides information about stainless steel crowns (SSCs), including their history, objectives, indications, contraindications, types, composition, clinical procedure, and references. Some key points:
- SSCs were first described in the 1950s and became commonly used in the 1960s to restore primary and permanent teeth.
- Objectives are to achieve a biologically compatible restoration that maintains tooth form and function.
- Indications include restoring teeth after pulpotomy/pulpectomy, with large/deep caries, or when 3+ surfaces need restoration.
- Clinical procedure involves evaluating occlusion, selecting correct crown size, tooth preparation to provide space and remove caries, and cementing the crown
This document provides an overview of fluorides and their role in dental health. It discusses the historical evolution of fluorides from their discovery in the early 1900s as the cause of mottled enamel. It describes how fluorides are naturally present in the environment and metabolism in our bodies, acting to strengthen tooth enamel and reduce cavities. The key mechanisms of action are increasing enamel resistance, promoting remineralization of early cavities, and interfering with cariogenic bacteria. While fluorides provide dental benefits when consumed in optimal amounts, both insufficient and excessive intake can impact health.
gingiva and periodontal problems in childrenGarima Singh
This document provides an overview of gingival and periodontal diseases in children. It begins with an introduction stating that many periodontal diseases originate during childhood, so early detection and treatment are important. It then covers topics such as the normal periodontium in children, classifications of gingival diseases including gingivitis, acute gingival diseases like herpetic gingivostomatitis, and gingival enlargement. It also discusses periodontitis, specifically aggressive periodontitis which can occur in adolescents, as well as systemic diseases associated with periodontal problems. The conclusion emphasizes that early detection and treatment of periodontal issues in children can prevent more advanced diseases and also identify underlying systemic conditions.
This document provides an overview of topical fluorides. It defines topical fluorides as fluoride treatments applied directly to tooth surfaces. Topical fluorides are classified as professionally applied or self-applied. Professionally applied fluorides discussed include sodium fluoride solution, stannous fluoride solution and gel, and acidulated phosphate fluoride gel. Sodium fluoride and stannous fluoride solutions are painted on teeth and allowed to dry, forming protective layers. Stannous fluoride may have additional antibacterial properties. Topical fluorides strengthen tooth enamel and make it more resistant to decay.
Dental fluorosis is caused by excessive fluoride intake during tooth development and results in hypomineralization of enamel. It ranges from mild to severe. Several indexes exist to measure and classify fluorosis severity, including Dean's Index and the Tooth Surface Index of Fluorosis. Risk factors include age, water fluoridation, fluoride supplements, and toothpaste usage. Mild to moderate fluorosis may be associated with lower caries rates.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
RECENT ADVANCES IN PEDIATRIC DENTISTRYShaik Gousia
1. Recent advances in pediatric dentistry include the use of silver diamine fluoride to arrest dental caries, zirconia crowns for their esthetics, and lasers which provide benefits for both patients and clinicians.
2. Silver diamine fluoride is effective at arresting existing dental caries and helps prevent new caries from forming or spreading. It provides an alternative to traditional restorative treatments.
3. Zirconia crowns offer superior esthetics compared to other crown materials used in pediatric dentistry. However, they require more chair time and cooperation from patients.
4. Lasers can be used for both soft tissue and hard tissue procedures in pediatric dentistry. They provide less fear
Fluoride helps prevent tooth decay through several mechanisms. It inhibits demineralization, promotes remineralization, alters the action of plaque bacteria, and improves enamel crystallinity and reduces solubility. Both pre-eruptive and post-eruptive exposure to fluoride provides caries prevention benefits, with maximal effects seen from high exposure both before and after tooth eruption. Community water fluoridation was first introduced in the 1940s and has been shown to reduce tooth decay rates by 40-59% in both primary and permanent teeth.
HISTORY & MECHANISM OF ACTION SYSTEMIC FLUORIDES.pptxRUCHIKA BAGARIA
EVERYTHING YOU NEED TO KNOW ABOUT SYSTEMIC FLUORIDES.
HISTORY, MECHANISM OF ACTION, METABOLISM, DIETARY SUPPLEMENTS AND RECENT ADVANCES.
LETS STUDY SYSTEMIC FLUORIDE TOGETHER.
LETS LEARN AND SHARE OUR KNOWLEDGE.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
Silver diamine fluoride (SDF) is a colorless solution containing silver ions and fluoride ions that has been used since the 1960s in Japan and China to arrest dental caries. It works by interacting with bacterial proteins and DNA to inhibit their function and growth. When applied to teeth, SDF releases calcium fluoride and silver phosphate, forming insoluble precipitates that occlude dentinal tubules and increase tooth mineralization and resistance to acid. SDF has shown promise as a low-cost option for managing dental caries, especially in young children, as it can halt the progression of cavities without the need for advanced dental procedures. More research is still needed to fully understand its mechanisms and safety.
The document discusses several theories on how fluoride reduces dental caries. The pre-eruptive theory states that fluoride taken during tooth formation can change tooth composition and morphology by replacing hydroxyl groups in tooth enamel with fluoride. The post-eruptive theory explains that fluoride in saliva and plaque reacts with tooth enamel to enhance remineralization and form calcium fluoride or fluorapatite crystals. Topically applied fluoride at high concentrations can also interfere with bacterial growth and metabolism. Fluoride reduces caries by increasing enamel resistance, promoting remineralization of early lesions, and interfering with cariogenic plaque bacteria.
The document discusses fluoride in preventive dentistry. It provides information on the following:
- Fluoride content in the environment including soil, water, and atmosphere.
- Types of systemic and topical fluoride therapies including water fluoridation, supplements, and professionally-applied varnishes, gels, and foams.
- Details on commonly used topical fluoride agents like sodium fluoride, stannous fluoride, acidulated phosphate fluoride, and fluoride varnishes.
This seminar includes features of the normal periodontium seen in children along with various gingival and periodontal diseases seen in children with updated classifications along with clinical features and treatment modalities and a note on clinical assessment of oral cleanliness and periodontal diseases
Oral Healthcare for Pregnant Women | Maneesh GuptaManeesh Gupta
It's essential for you to take excellent care of your tooth and gums while pregnant.Listed below are some guidelines to support you manage good oral health before, throughout, and after pregnancy.
This document discusses fluoride and its role in pediatric dentistry. It begins by outlining the mechanisms of action of fluoride, including both pre-eruptive and post-eruptive effects. The main caries preventive mechanisms are through post-eruptive or topical effects, where fluoride is incorporated during remineralization to make enamel less soluble. The document then discusses various methods of fluoride application in pediatric dentistry, including professionally-applied and self-applied topical fluoride treatments as well as silver diamine fluoride and systemic fluoride.
- The document discusses various oral habits in children including tongue thrusting, mouth breathing, bruxism, lip biting, nail biting, cheek biting, and self-injurious habits.
- It provides classifications of tongue thrusting by various authors, describes the differences between infantile and adult swallowing patterns, and lists features of simple and complex tongue thrusting.
- Diagnosis methods for tongue thrusting including history, functional examination, and palpatory examination are explained. Treatment considerations and management techniques such as myofunctional exercises and appliances are also outlined.
Early childhood caries (ECC) as the presences of one or more decayed (noncavitated or cavitated), missing (as a result of caries), or filled tooth surface in any primary tooth in a child 71 months of age or younger.
Topical Fluorides- Professionally applied & Self appliedDrSusmita Shah
An overview of Topical Fluorides. Includes mechanism of action of topical application of fluorides- professionally and self applied. Recommendations of use of Fluorides in pediatric dentistry.
This document provides information about stainless steel crowns (SSCs), including their history, objectives, indications, contraindications, types, composition, clinical procedure, and references. Some key points:
- SSCs were first described in the 1950s and became commonly used in the 1960s to restore primary and permanent teeth.
- Objectives are to achieve a biologically compatible restoration that maintains tooth form and function.
- Indications include restoring teeth after pulpotomy/pulpectomy, with large/deep caries, or when 3+ surfaces need restoration.
- Clinical procedure involves evaluating occlusion, selecting correct crown size, tooth preparation to provide space and remove caries, and cementing the crown
This document provides an overview of fluorides and their role in dental health. It discusses the historical evolution of fluorides from their discovery in the early 1900s as the cause of mottled enamel. It describes how fluorides are naturally present in the environment and metabolism in our bodies, acting to strengthen tooth enamel and reduce cavities. The key mechanisms of action are increasing enamel resistance, promoting remineralization of early cavities, and interfering with cariogenic bacteria. While fluorides provide dental benefits when consumed in optimal amounts, both insufficient and excessive intake can impact health.
gingiva and periodontal problems in childrenGarima Singh
This document provides an overview of gingival and periodontal diseases in children. It begins with an introduction stating that many periodontal diseases originate during childhood, so early detection and treatment are important. It then covers topics such as the normal periodontium in children, classifications of gingival diseases including gingivitis, acute gingival diseases like herpetic gingivostomatitis, and gingival enlargement. It also discusses periodontitis, specifically aggressive periodontitis which can occur in adolescents, as well as systemic diseases associated with periodontal problems. The conclusion emphasizes that early detection and treatment of periodontal issues in children can prevent more advanced diseases and also identify underlying systemic conditions.
This document provides an overview of topical fluorides. It defines topical fluorides as fluoride treatments applied directly to tooth surfaces. Topical fluorides are classified as professionally applied or self-applied. Professionally applied fluorides discussed include sodium fluoride solution, stannous fluoride solution and gel, and acidulated phosphate fluoride gel. Sodium fluoride and stannous fluoride solutions are painted on teeth and allowed to dry, forming protective layers. Stannous fluoride may have additional antibacterial properties. Topical fluorides strengthen tooth enamel and make it more resistant to decay.
Dental fluorosis is caused by excessive fluoride intake during tooth development and results in hypomineralization of enamel. It ranges from mild to severe. Several indexes exist to measure and classify fluorosis severity, including Dean's Index and the Tooth Surface Index of Fluorosis. Risk factors include age, water fluoridation, fluoride supplements, and toothpaste usage. Mild to moderate fluorosis may be associated with lower caries rates.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
RECENT ADVANCES IN PEDIATRIC DENTISTRYShaik Gousia
1. Recent advances in pediatric dentistry include the use of silver diamine fluoride to arrest dental caries, zirconia crowns for their esthetics, and lasers which provide benefits for both patients and clinicians.
2. Silver diamine fluoride is effective at arresting existing dental caries and helps prevent new caries from forming or spreading. It provides an alternative to traditional restorative treatments.
3. Zirconia crowns offer superior esthetics compared to other crown materials used in pediatric dentistry. However, they require more chair time and cooperation from patients.
4. Lasers can be used for both soft tissue and hard tissue procedures in pediatric dentistry. They provide less fear
Fluoride helps prevent tooth decay through several mechanisms. It inhibits demineralization, promotes remineralization, alters the action of plaque bacteria, and improves enamel crystallinity and reduces solubility. Both pre-eruptive and post-eruptive exposure to fluoride provides caries prevention benefits, with maximal effects seen from high exposure both before and after tooth eruption. Community water fluoridation was first introduced in the 1940s and has been shown to reduce tooth decay rates by 40-59% in both primary and permanent teeth.
HISTORY & MECHANISM OF ACTION SYSTEMIC FLUORIDES.pptxRUCHIKA BAGARIA
EVERYTHING YOU NEED TO KNOW ABOUT SYSTEMIC FLUORIDES.
HISTORY, MECHANISM OF ACTION, METABOLISM, DIETARY SUPPLEMENTS AND RECENT ADVANCES.
LETS STUDY SYSTEMIC FLUORIDE TOGETHER.
LETS LEARN AND SHARE OUR KNOWLEDGE.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
Silver diamine fluoride (SDF) is a colorless solution containing silver ions and fluoride ions that has been used since the 1960s in Japan and China to arrest dental caries. It works by interacting with bacterial proteins and DNA to inhibit their function and growth. When applied to teeth, SDF releases calcium fluoride and silver phosphate, forming insoluble precipitates that occlude dentinal tubules and increase tooth mineralization and resistance to acid. SDF has shown promise as a low-cost option for managing dental caries, especially in young children, as it can halt the progression of cavities without the need for advanced dental procedures. More research is still needed to fully understand its mechanisms and safety.
The document discusses several theories on how fluoride reduces dental caries. The pre-eruptive theory states that fluoride taken during tooth formation can change tooth composition and morphology by replacing hydroxyl groups in tooth enamel with fluoride. The post-eruptive theory explains that fluoride in saliva and plaque reacts with tooth enamel to enhance remineralization and form calcium fluoride or fluorapatite crystals. Topically applied fluoride at high concentrations can also interfere with bacterial growth and metabolism. Fluoride reduces caries by increasing enamel resistance, promoting remineralization of early lesions, and interfering with cariogenic plaque bacteria.
The document discusses fluoride in preventive dentistry. It provides information on the following:
- Fluoride content in the environment including soil, water, and atmosphere.
- Types of systemic and topical fluoride therapies including water fluoridation, supplements, and professionally-applied varnishes, gels, and foams.
- Details on commonly used topical fluoride agents like sodium fluoride, stannous fluoride, acidulated phosphate fluoride, and fluoride varnishes.
This document provides information on the prevention of dental caries through the use of fluoride. It discusses that fluoride can be used systemically by ingesting it or topically by direct application. Fluoride works to prevent dental caries by strengthening enamel, inhibiting bacteria, and enhancing remineralization. Sources of fluoride include water, foods, dental products, and professional treatments. Both optimal levels and methods of delivery are covered.
This document discusses various methods of fluoride delivery for dental caries prevention. It describes topical fluoride delivery methods including toothpastes, mouthwashes, varnishes and professionally applied gels and foams. It also discusses systemic fluoride delivery through community water fluoridation, salt fluoridation, milk fluoridation and fluoride tablets. The document outlines the advantages and disadvantages of different fluoride compounds and delivery methods. It also discusses the potential toxicity of excessive fluoride intake and prevalence of dental fluorosis in India.
Topical fluorides for home use, Professionally applied fluoride products, Planning a preventive programmes in the practice, Dental fluorosis, Fluoride toxicity,
This document discusses topical fluoride delivery methods for preventing dental caries. It begins by introducing different types of topical fluorides including professionally-applied options like sodium fluoride, stannous fluoride, and acidulated phosphate fluoride as well as self-applied options like dentifrices and mouthwashes. It then covers the preparation, application procedures, mechanisms of action, advantages, and disadvantages of each professionally-applied fluoride type. The document concludes by comparing the characteristics of the different professionally-applied fluoride options and providing recommendations for topical fluoride application.
This document discusses various treatment modalities in dentistry including fluoride utilization. It emphasizes that dental caries is an infectious disease that is reversible if treated early, often with fluoride. Fluoride is presented as both a preventative treatment and necessary treatment for dental caries. The document recommends professionally-applied fluoride varnish every 3-6 months according to ADA guidelines and notes the importance of patient education regarding their individual risk factors and benefits of fluoride therapy.
The document discusses policies and recommendations regarding different methods of fluoride use for preventing dental caries. It states that community water fluoridation is safe, cost-effective and should be introduced where feasible to reduce dental caries. It also supports salt fluoridation as an alternative where water fluoridation is not possible. The use of fluoride toothpaste is endorsed as the most widely used and effective preventive method, and efforts should be made to develop affordable fluoride toothpastes in developing countries.
Fluoride is a mineral found in nature that helps prevent cavities. It is present in small amounts in foods and drinks, and in higher amounts in seafood and tea leaves. The main sources of fluoride are drinking water, toothpaste, and professionally applied gels, foams, and rinses. Fluoride strengthens tooth enamel, enhances remineralization, alters the activity of plaque bacteria, and helps develop strong teeth. It can be delivered topically through products like toothpaste or professionally through gels, foams, varnishes, and rinses.
Diagnosis and prevention of dental caries, DEVELOPMENT OF DENTAL CARIES, CARIES DETECTION AND DIAGNOSIS, DEVELOPMENT OF DENTAL CARIES, PREVENTION OF DENTAL CARIES, Nutrition and diet in caries control, Fluoride and caries control, Water fluoridation, Fluoride supplements, Other methods for providing systemic fluoride, Fissure sealing, TREATMENT PLANNING FOR CARIES PREVENTION,
Fluoride plays an important role in dental health by strengthening tooth enamel and preventing cavities. It is found naturally in water, soil, and plants. Adding fluoride to water reduces tooth decay risk. Fluoride is also available in toothpaste, mouthwash, supplements, and professionally applied gels and varnishes. The document discusses the mechanisms by which fluoride prevents cavities, including affecting bacteria, increasing enamel resistance, and enhancing remineralization. It provides recommendations for fluoride intake from various sources based on age, including using only a smear of toothpaste under age 3 and a pea-sized amount for older children.
This document summarizes fluoride metabolism and toxicity. It discusses the history of fluoride use and poisoning cases. Fluoride is toxic in large amounts but provides dental benefits in small, regular amounts. The document outlines fluoride absorption, distribution, and excretion in the body. Both acute and chronic fluoride toxicity are addressed. Acute toxicity can cause death, while chronic exposure can lead to dental and skeletal fluorosis depending on the amount consumed over time. The critical period for fluorosis development is during the maturation phase of tooth development.
This document discusses a preventive dentistry program focused on fluoride and fissure sealants presented by Heidi Emmerling. It covers the goals of fluoride administration, recommended fluoride levels in water, potential toxicity of fluoride ingestion, emergency treatment, topical fluoride applications, and fissure sealant indications and limitations. The goals are to prevent decay, arrest active decay, and remineralize teeth using optimal fluoride levels tailored to climate. Potential fluoride toxicity and treatments are also outlined.
- For a 4 year old child at low risk of caries, the guidelines recommend applying fluoride varnish to their teeth two times per year.
- For a 4 year old child at high risk of caries, the guidelines recommend applying fluoride varnish to their teeth two or more times per year.
- Topical fluoride in the form of varnish or gel is supported by the strongest evidence for caries prevention in primary teeth. Application frequency depends on the child's caries risk level.
Prevention of dental disease and pit and fissureMohamed Alkeshan
This document discusses prevention of dental diseases in children ages 6 to 12. It focuses on two main diseases: dental caries and periodontal disease. During this transitional age, children experience oral changes as primary teeth are replaced by permanent teeth. Their diet and snacking habits are also challenged. The document recommends fluoride administration through water, supplements, toothpastes, and mouth rinses to prevent cavities in developing permanent teeth. It also discusses the importance of home oral care and provides guidance on diet and care for children with developmental disabilities. Pit and fissure sealants are recommended due to their effectiveness in reducing dental caries by over 75% through micromechanical retention in the tooth enamel.
This document discusses fluorides in dentistry. It describes the sources of fluoride, mechanisms of how fluoride prevents tooth decay, and methods of fluoride delivery topically and systemically. It also addresses the indications for topical fluoride use, recommended dosages of fluoride tablets/drops, and potential toxicities like dental and skeletal fluorosis from inadequate or excessive fluoride intake. When used appropriately, fluoride is an effective cariostatic agent for improving dental health.
learning objectives
Introduction
History Of Water Fluoridation
How Does Fluoride Act In Dental Caries Prevention?
Goals Of F Administration
Fluoride Administration
Appropriate Levels Of Fluoride in Drinking Water
Methods of water fluoridation
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Efficacy Of topical fluorides
Range Of therapeutic fluoride concentrations used to prevent caries
Recommended doses
Topical and systemic fluorides including sodium fluoride, stannous fluoride and APF in detail. It comes as long question in BDS final year(CCS University)
1. Topical fluorides provide fluoride ions that are incorporated into dental enamel, enhancing remineralization and inhibiting demineralization.
2. Common topical fluoride treatments include varnishes, gels, foams, rinses, and mouthwashes. Fluoride varnish is the only topical treatment recommended for young children.
3. Newer treatments like silver diamine fluoride can arrest dental caries by killing bacteria, depositing a protective layer, and converting enamel to a more acid-resistant form. Slow-release fluoride devices provide long-term fluoride exposure without high serum levels.
overview of flouride with detailed information on their pharmacological action, mechanism, uses and adverse effect for both medical and dental students.
The Dentists Act of India was passed in 1948 to regulate the dental profession. It established the Dental Council of India and State Dental Councils. The Dental Council of India sets standards for dental education, maintains the register of dentists, and recognizes dental qualifications. It is comprised of members elected from state dental registers and nominated by state governments and dental institutions. The Act also provides for the registration and regulation of dentists, dental hygienists, and dental mechanics.
Pits and fissures are enamel faults such as depressions or cracks that are vulnerable to dental caries. Fissure sealants are materials placed in pits and fissures to prevent caries. They have evolved from early dental cements to modern resin-based sealants cured with light. Sealants are indicated for teeth with deep fissures and those opposite teeth with caries. The procedure involves isolating and drying the tooth before applying the sealant. Preventive resin restorations integrate sealants with restorative resin to treat early caries in fissures.
The Consumer Protection Act was introduced in 1986 to better protect consumers in India. It established a three-tier system for consumer dispute redressal at the district, state and national levels to provide simple and speedy remedies to consumer complaints. The act defines consumers and covers goods and services, including healthcare. It aims to make consumers aware of their rights and provides recourse in the form of consumer courts. Recent amendments in 2019 have strengthened provisions regarding product liability, mediation and regulation of misleading advertisements. Continued awareness among healthcare professionals about their obligations under this legislation is important.
This document provides an overview of medical ethics. It begins with definitions of ethics and discusses the history of ethics including the Hippocratic Oath and Nuremberg Code. The principles of ethics such as beneficence, non-maleficence, respect for persons, and justice are explained. Dental ethics codes and guidelines for research ethics to protect human subjects are also reviewed. The conclusion emphasizes that ethics is important in healthcare and professionals must place patient interests above all else.
This document discusses the roles and classifications of dental auxiliaries. It defines auxiliaries as non-dentists who assist dentists in providing dental care. Auxiliaries are classified as either non-operating or operating. Non-operating auxiliaries include dental assistants and lab technicians, while operating auxiliaries perform treatments like dental therapists and hygienists. The duties and training of common auxiliaries like dental nurses, hygienists, and expanded function dental assistants are also outlined. The document concludes with descriptions of new proposed auxiliary roles and levels of supervision for auxiliaries.
This document summarizes key aspects of school oral health programmes (SOHP). It defines SOHP and lists their objectives as improving dental health knowledge and practices for students. The ideal requirements, advantages, and elements of SOHP are described. Elements include community involvement, dental screenings, education, preventive programs like fluoride and sealants, referrals, and follow-ups. Incremental and comprehensive models of dental care delivery in SOHPs are also outlined. Global initiatives by organizations like WHO are mentioned, as are some examples of national SOHPs.
Oral cancer is a major public health problem worldwide and in India. Key risk factors include tobacco use (smoking, smokeless tobacco, betel quid), alcohol consumption, and HPV infection. Precancerous lesions include leukoplakia and erythroplakia. Prevention focuses on education about risk factors, screening of high-risk individuals, and regulatory policies like graphic health warnings and advertising bans on tobacco products.
Social sciences play a major role in understanding individuals, communities, and their environments. They aid in program planning and evaluation by understanding how social and cultural factors influence health behaviors. Social sciences include disciplines like sociology, cultural anthropology, social psychology, economics, and political science. Health behaviors directly and indirectly impact individuals' health and are shaped by their social environment, including cultural values, education, socioeconomic status, and community. Proper understanding of social and cultural determinants of health is necessary for effective public health programs and utilization of dental services.
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
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4. Describe the influences of the Pneumotaxic and Apneustic centers
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2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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2. CONTENTS 2
• Introduction
• History of Flouride Use
• Mechanism of action of fluoride
• Ways of administration of fluorides
• Systemic administration
• Topical Administration
• New advancements
• Conclusion
• References
4. 4
• Fluorides have been extensively employed to control dental caries.
1900s
• H. Trendley Dean proposed the optimum level of exposure to fluoride to provide the maximum protection
against caries, with minimum dental fluorosis.
1942
• Fluoride's systemic action was found to be inadequate to prevent decay, as the amount absorbed wasn't
sufficient. However, low fluoride levels in oral fluids inhibited demineralization and enhanced
remineralization. This discovery led to the concept of fluoride's "topical" action, where it is constantly present
at low concentrations in the oral environment.
1980s
• The current concept regarding the mechanisms of action of fluorides against caries was questioned, and the
possibility to obtain caries protection even with low levels of fluoride intake was recognized. Thus, controlling
the fluoride intake rapidly came into focus in different areas of the world.
1980s-1990s
HISTORY
5. MECHANISM OF ACTION OF FLUORIDE
• Remineralization of Enamel
• Inhibition of Demineralization
• Antimicrobial Effects
• Enhancing the Formation of Fluorapatite
5
6. 6
Pre-eruptive Flouride
• Development and
maintenance of strong,
healthy enamel
• Systemic fluoride
• Incorporated into the
developing enamel as the
tooth forms within the
jawbone.
• Reducing the risk of
caries.
• Eg: community water
fluoridation
Post-eruptive Fluoride
• Development and
maintenance of strong,
healthy enamel
• Topical fluoride exposure
• On exposure to fluoride-
containing products, in
outer surfaces of the
enamel, which helps to
strengthen and protect it
from acid attack.
• Reducing the risk of
caries.
• Eg: topical fluoridation
7. 7
ETIOLOGY AND RISK FACTORS
• Dental fluorosis, is caused by
excessive fluoride intake during tooth
development, with the most vulnerable
period being the first 6 to 8 years of
life, and the most critical period for
permanent maxillary central incisors
being the first 3 years.
• To minimize the risk of dental fluorosis,
fluoride intake in children should be
monitored during the first three years
of life.
• However, for the control of dental
caries, fluoride exposure should be
maintained throughout life.
8. 8
Genetic Factors
Studies :
• Genetic factors may predispose individuals to dental fluorosis, inbred mice strains have been
found to have different susceptibilities to dental fluorosis due to differences in fluoride
metabolism.
• Histological examination of maturing enamel showed that amelogenins accumulated in the
enamel of susceptible mice exposed to fluoride, but not in the resistant mice.
9. 9
Biomarkers of Exposure to Fluoride
• Biomarkers of fluoride exposure are essential for identifying and monitoring deficient or
excessive intakes.
• These biomarkers are classified as contemporary (assessing present or recent exposure) or recent
and historical (assessing chronic or subchronic exposure).
• The most useful contemporary biomarker is daily urinary fluoride excretion, while fluoride
concentrations in parotid and submandibular saliva are proposed to be related to plasma fluoride
concentrations.
• Fingernail fluoride concentrations in ages 2 to 7 have been validated as predictors for dental
fluorosis.
11. 11
Fluoride can improve the crystallinity of enamel by increasing crystal size and reducing strain in the crystal lattice.
Flouride can fill voids in hydroxyapatite crystals, which increases stability and chemical reactivity by forming stronger
hydrogen bonds. The decreased solubility of fluoridated enamel can be attributed to the presence of fluorapatite, which is
less soluble than hydroxyapatite.
However, the amount of fluoride in surface enamel from individuals living in a fluoridated area is only a fraction of the
theoretical amount of fluoride in fluorapatite, and the actual difference in the amount dissolving is usually negligible.
Studies have shown that individuals living in high fluoride areas have smaller cusp height and less convexity in their teeth,
indicating an influence of fluoride on tooth morphology.
Systemic Effect of Fluoride
SYSTEMIC ADMINISTRATION
12. 12
Updated recommendations for systemic fluoride
use
• The recommended fluoride concentration in
public water supplies is now 0.7 ppm.
• This recommended level updates and replaces
the previously recommended range of 0.7-1.2
milligrams of fluoride ion per litre (i.e., parts
per million fluorides [ppm F]).
(American Academy of Pediatric Dentistry (AAPD), the
ADA and the American Academy of Pediatrics)
Systemic Administration
Water
fluoridation
Community
Water
fluoridation
School Water
fluoridation
Other
fluoridations
Salt
fluoridation
Milk
fluoridation
Fluoride
Tablet
15. 15
Topical fluoride can have low or high concentrations and can be either frequently or sporadically exposed to have
an effect on oral bacteria.
Fluoride inhibits enzymes such as enolase and glucose transport, leading to a reduction in acid production. It also
suppresses bacterial growth and has antibacterial properties.
Fluoride can be incorporated into tooth enamel pre-eruptively or post-eruptively, resulting in the formation of
fluoride-rich crystals that are less soluble in acid.
The specific plaque hypothesis suggests that the elimination or reduction of S. mutans, a specific pathogen,
through topical fluoride treatment can lead to lasting cariostatic effects.
Topical Effect of Fluoride
TOPICAL ADMINISTRATION
16. 16
5% sodium fluoride varnish (22,600 ppm)
Neutral sodium fluoride (9,050 ppm) and APF
(12,300 ppm) foams/gels
2% sodium fluoride rinses (9,050 ppm) and dual
rinses (3,300 ppm)
Professionally Applied Topical Fluorides
Current recommendations for professionally-applied topical fluorides
For low-risk patients, a fluoride dentifrice may offer sufficient protection, although clinical judgment
should be used to determine whether an in-office topical fluoride is necessary.
Topical application
Dentifrice
Fluoride
rinses
Pastes
Gels &
Solution
NaF
Applicatio
n
SnF
Applicatio
n
APF
Applicatio
n
Source: Current Concepts in Fluoride Therapy - ACT Professional
18. WHO Global School-based Student Health Survey:
The survey on 75 low- and middle-income countries revealed that :
• 35–94% (12-15-year-olds)- brush their teeth 1 - 3 times a day
• 2% - 38% - not brushing their teeth at all
18
Fluoride dentifrices
Current recommendations: 1,000 – 1,100 ppm dentifrices
• Children age 2 until age 6: Use of a pea-sized amount twice daily, brushing under supervision
(rinsing and expectorating after brushing)
• Age 6 onward: Twice-daily brushing with toothpaste; may require supervision until age 10 or
11
Over-the-counter (OTC) Topical Fluorides
20. 20
1. For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they
begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or
the size of a grain of rice (Figure).
2. For children 3 to 6 years of age, caregivers should dispense no more than a pea-sized amount
(Figure) of fluoride toothpaste.
3. It is especially critical that dentists provide counseling to caregivers that involves the use of oral
description, visual aids and actual demonstration to help ensure that the appropriate amount of
toothpaste is used.
21. 21
Fluoride rinses
0.05% sodium fluoride rinse
0.044% acidulated phosphate fluoride rinse
Current directions for OTC fluoride rinses
• Fluoride rinses are not recommended for the under-6 age group, due to the risk of swallowing
• 0.05% sodium fluoride and 0.044% acidulated phosphate fluoride are recommended for daily use
• 0.02 – 0.21% fluoride rinses must be used twice daily
• Plaque and salivary fluoride levels are higher with the use of higher-ppm fluoride rinses
• Nighttime use results in prolonged fluoride retention in whole saliva compared to daytime use
Source: Current Concepts in Fluoride Therapy - ACT Professional
22. 22
Prescription Home-use Pastes, Gels and Rinses
1.1% sodium fluoride (5,000 ppm)
pastes/gels
0.2% sodium fluoride rinse (920 ppm)
0.63% stannous fluoride rinse
Current directions for 1.1% sodium fluoride
• Not recommended for children under age 6
• Recommended for twice-daily use in patients at high risk for caries
• Patients should expectorate after use, not rinse, to maintain a higher level of bioavailable fluoride
Source: Current Concepts in Fluoride Therapy - ACT Professional
24. 24
Young children
• Fluoride varnish every 6
months for moderate risk,
and 2 to 4 times per year for
high-risk patients
• Age-appropriate OTC fluoride
dentifrice use
• Topical fluoride rinses are
NOT recommended due to
the risk of swallowing and
fluorosis.
Orthodontic patients
• Fluoride varnish or gel every
6 months for moderate risk,
and 2 to 4 times per year for
high-risk patients.
• Home-use topical fluoride:
• For patients with no
cavitated lesions, twice-
daily OTC dentifrice use and
daily use of 0.05% sodium
fluoride rinse
• For patients with cavitated
lesions, 1.1% prescription-
strength sodium fluoride
paste/gel
• Daily use of 0.05% fluoride
rinse inhibits enamel lesions
adjacent to FOA.
Xerostomic patients
• In-office fluoride varnish or
fluoride gel 2 to 4 times per
year
• Home-use topical fluoride:
• 5,000 ppm fluoride
paste/gel once- or twice-
daily (if once daily, fluoride
dentifrice should be used
the second time daily) AND
daily use of a 0.05% sodium
fluoride rinse as well as
when the mouth feels dry
or after eating/drinking.
Recommendations on Topical fluoride therapy:
25. 25
• Research shows that fluoride uptake in enamel is time-dependent, and the full four minutes of
application with the gel tray method provides the best topical benefit.
• The ADA recommends professional topical fluoride applications based on caries risk factors, with
sodium fluoride varnish or APF gel being applied every 3-6 months for children at risk for
caries.
• While sodium fluoride varnish has a higher fluoride concentration, fluoride's efficacy is
enhanced with an acidic environment, making APF gel effective as well.
• Dental professionals should determine if professional fluoride applications are appropriate for all
patients based on their caries risk factors.
One-minute vs. Four-minute fluoride applications
Source: https://www.dentalcare.com/en-us/ce-courses/ce334/one-minute-vs-four-minute-fluoride-application
26. 26
The panel recommends the following for people at risk of
developing dental caries: 2.26 % fluoride varnish or 1.23
% fluoride (acidulated phosphate fluoride) gel, or a
prescription-strength, home-use 0.05 % fluoride gel or
paste or 0.09 % fluoride mouth rinse for patients 6
years or older. Only 2.26 % fluoride varnish is
recommended for children younger than 6 years. The
strengths of the recommendations for the recommended
products varied from ”in favor“ to ”expert opinion for.“
These recommendations are an update of the 2006 ADA recommendations.
27. 27
1. Fluoride use for the prevention and control of caries is both safe and highly effective in
reducing dental caries prevalence.
2. Fluoride dietary supplements are effective in reducing dental caries and should be considered
for children at caries risk who drink fluoride-deficient (less than 0.6 ppm) water.
3. Professionally applied topical fluoride treatments as 5% NaFV or 1.23 % F gel preparations
are efficacious in reducing caries in children at caries risk.
Current recommendations of Fluoride therapy (Evidence- based)
Source: American Academy of Pediatric Dentistry. Fluoride therapy. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of
Pediatric Dentistry; 2022:317-20.
28. 28
4. Fluoridated toothpaste is effective in reducing dental caries in children. Using no more than
a smear or rice-size amount of fluoridated toothpaste for children less than three years of age
may decrease risk of fluorosis. Using no more than a pea-size amount of fluoridated
toothpaste is appropriate for children aged three to six.
5. Prescription-strength home-use 0.5 % fluoride gels and pastes and prescription-strength
home-use 0.09 % fluoride mouthrinse also are effective in reducing dental caries.
6. Recommend the use of 38 % silver diamine fluoride for the arrest of cavitated caries
lesions in primary teeth as part of a comprehensive caries management program
Source: American Academy of Pediatric Dentistry. Fluoride therapy. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of
Pediatric Dentistry; 2022:317-20.
29. New Advancements
Silver Diamine Fluoride (SDF)
Fluoride Varnish
Nano-Fluoride
Fluoride-releasing dental implants
29
Source: The Global Status Report on Oral Health 2022 (WHO)
30. SILVER DIAMINE FLUORIDE (SDF) 30
• Silver diamine fluoride (SDF) is a colorless liquid used to treat tooth
sensitivity and is a Class II medical device cleared by the FDA.
• SDF can be used for caries control and management, although it is not
specifically FDA-labeled for this use (i.e., "off-label use").
• SDF may be a preferred option for caries arrest in deciduous teeth, older
individuals, and when access to conventional restorative techniques is
not available or advanced sedation techniques are not desired.
31. 31
SDF for Treatment of Dentin Sensitivity
• SDF has been cleared by the FDA as a dentin
desensitizing agent.
• When applied to areas with sensitive dentin
surfaces, a layer of silver and dentin organic
matrix protein conjugates forms.
• This squamous layer formed on the exposed
dentin surface partially closes the exposed
dentin tubules.
32. 32
SDF effectively
reduces the growth
of cariogenic
bacteria, such as
Streptococcus
mutans, on dentine
surfaces. SDF results
in significantly
lower colony-
forming unit counts
of mono- and dual-
species biofilms,
with a higher dead-
to-live ratio of
bacteria. SDF has
also been found to
inhibit the
adherence of S.
mutans to tooth
surfaces.
SDF has shown to
promote
remineralization of
demineralized tooth
surfaces. It
increases surface
microhardness and
reduces the depth
of carious lesions,
slowing down their
progression.
SDF promotes
calcium absorption
and inhibits calcium
dissolution from
enamel. It also
results in the
formation of silver
chloride, metallic
silver, calcium
fluoride, and silver
phosphate.
Elemental analysis
shows that
demineralized
dentine treated with
SDF has higher
calcium and
phosphorus
content, with less
mineral loss.
SDF has also been
found to inhibit the
enzymatic
degradation of
collagen by matrix
metalloproteinases
and cysteine
cathepsins. Overall,
SDF has shown
promise as an
effective treatment
for caries, with
antibacterial and
remineralization
properties.
Actions of SDF
(cariogenic bacteria, mineral content of enamel and dentine, and organic content of dentine)
33. 33
• AAPD made a conditional recommendation for SDF use in managing caries in children and
adolescents.
• Application of 38% SDF prevents root caries in adults with higher success rates than placebo
treatment.
• Disadvantages of SDF include potential pulpal and oral soft tissue irritation and dental staining.
• Further restoration may be needed after SDF treatment to recover the form and function of a cavitated
tooth.
• Limited evidence on the adhesive performance of traditional restorative options following caries arrest
with SDF.
• Once-yearly SDF application is more effective in preventing caries than more frequent
application of fluoride varnish, and SDF is only more effective in preventing caries if continuously
applied when compared to occlusal sealants.
Uses of SDF
34. 34
Systematic reviews consistently supported SDF’s
effectiveness for arresting coronal caries in the
primary dentition and arresting and preventing
root caries in older adults for all comparators.
There is insufficient evidence to draw conclusions
on SDF for prevention in primary teeth and
prevention and arrest in permanent teeth in
children. No serious adverse events were reported.
35. Fluoride varnish is a thin, protective coating that is applied to the teeth to prevent tooth decay in
both primary and permanent teeth. It is a quick and easy procedure that can be performed by a
dentist or dental hygienist.
FLUORIDE VARNISH 35
36. 36
Fluoride varnish painted onto
enamel or cementum forms a
clear or slightly yellowish film
Slow release of fluoride ion to
the tooth surface
Fluoride in liquid phase
around apatite crystallites
blocks crystalline dissolution
and reduces demineralization
Increased fluoride ion activity
enhances mineral deposition
and promotes remineralisation
in sound or carious enamel
Greater fluoride
concentrations attainable with
varnishes produce deposits of
calcium fluoride, depositing
fluoride in porosities and
microchannels in enamel
Fluoride reservoirs gradually
release fluoride into dental
plaque, saliva, or apatite
structure of the tooth when
the pH drops
Mechanism of Action
37. Amorphous Calcium Phosphate (ACP):
• ACP promotes remineralization of enamel, balances saliva pH, and
reduces sensitivity.
• Combined with fluoride, ACP increases calcium and phosphate levels in
tooth structure.
• ACP benefits orthodontic, high-risk caries, and acid erosion patients.
• ACP with fluoride toothpaste decreases bacteria and increases
mineralization.
• Custom mouthguards extend application time.
37
39. Nano-fluoride is a form of fluoride that has been
broken down into very small particles. These small
particles can penetrate deeper into the tooth enamel,
making them more effective in preventing tooth decay.
Recent studies have shown that nano-fluoride is more
effective in preventing tooth decay than traditional
fluoride treatments.
NANO-FLUORIDE
39
41. Dental implants are used to replace missing
teeth. Recent advancements in implant
technology have resulted in the development
of fluoride-releasing dental implants. These
implants release fluoride into the
surrounding tissues, which can help to
prevent tooth decay and implant failure.
FLUORIDE RELEASING DENTAL IMPLANTS
41
43. • Regular use of fluoride-containing dentifrice is effective in preventing
caries on an individual and community level as it combines oral
hygiene with fluoride supplementation.
• Fluoride-containing mouth rinses, varnishes, and gels can provide
additional protection for people with moderate to high caries
activity.
• Fluoride tablets or lozenges can also be used as a topical fluoride
application for those who cannot or will not use a fluoridated
dentifrice.
• In areas with fluoridated drinking water, the use of fluoride tablets is
not recommended due to potential toxicity concerns, and children
using fluoride dentifrice in these areas should be able to spit out
adequately after brushing.
43
Summary
44. 1. Rosenblatt A, Stamford TC, Niederman R. Silver Diamine Fluoride: A Caries "Silver-Fluoride Bullet". Journal of
Dental Research. 2009;88(2):116-125. doi:10.1177/0022034508329406
2. American Dental Association. Fluoride Varnish. https://www.ada.org/en/member-center/oral-health-
topics/fluoride-varnish
3. Singhal A, Pal N, Kulkarni DD, Dutt K, Malik A, Singh R. Nano-fluoride in preventive dentistry: A new paradigm
in dental caries management. Journal of Clinical and Diagnostic Research. 2017;11(8):ZE21-ZE25.
doi:10.7860/JCDR/2017/28094.10352
4. Subramani K, Jung RE, Molenberg A, Hammerle CHF. Bioactive ceramics for periodontal regeneration: A
review of material properties and clinical outcomes. International Journal of Periodontics and Restorative
Dentistry. 2017;37(5):e261-e269. doi:10.11607/prd.3099
5. https://www.dentalcare.com/en-us/ce-courses/ce334/current-theories-regarding-fluoride-use
44
References
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Almost two-third states are fluoride endemic.
Inadequate ingestion of fluoride is associated with dental caries.
Excessive intake of fluoride can lead to dental skeletal flourosis
Fluorides have been studied for over 70 years in various forms including toothpaste, water fluoridation, and community-based programs. They are safe, effective, cost-effective, and feasible for populations.
Topically, low levels of fluoride in plaque and saliva inhibit the demineralization of sound enamel and enhance the remineralization of demineralized enamel.
It was believed that fluoride exerted its protective effect against caries through a "systemic" action, after being absorbed and taken up in the apatite crystals of the forming teeth. However, it was observed that the amount of fluoride that could be taken up in the apatite was not enough to provide significant protection against acid dissolution. On the other hand, the presence of low levels of fluoride in the oral fluids surrounding the enamel was effective to inhibit demineralization and enhance remineralization. The concept that fluoride interferes in the dynamics of caries formation mainly when it is constantly present at low concentrations in the fluid phases of the oral environment became broadly accepted ("topical" action).
Under cariogenic conditions, carbohydrates are converted to acids by bacteria in the plaque biofilm. When the pH on the tooth surface becomes acidic or drops below 5.5, phosphate in oral fluids combines with hydrogen ions (H+) to form hydrogen phosphate species (see below.) Under these conditions, phosphate is “pulled” from tooth enamel to restore phosphate levels in the saliva, and the hydroxyapatite dissolves. As pH returns to normal, the calcium and phosphate in saliva can recrystallize into the hydroxyapatite, remineralizing the enamel. When fluoride (F–) is present, fluorapatite is incorporated into demineralized enamel and subsequent demineralization is inhibited.
During the tooth development and at the time of enamel maturation, the fluoride reacts with the hydroxyapatite crystal and forms fluoroapatite crystal which is resistant to acid attack.
It reacts with the mineral element on the surface of the teeth to make more insoluble to the acid end products of bacterial metabolism.
It may enter the dental plaque and there effect the bacteria by depressing their production of acids and thus reducing the process of demineralization.
It facilitates the remineralization (Repair) of teeth that has been slightly demineralized by acid end products.
It also makes the deep pit and fissure as shallow.
Fluoride promotes remineralization of enamel by attracting minerals such as calcium and phosphate to the surface of the tooth. This process can repair early stages of tooth decay and prevent the formation of dental caries.
Inhibition of Demineralization: Fluoride can also inhibit the demineralization of enamel by reducing the amount of acid produced by bacteria in the mouth. Fluoride can interfere with the metabolism of bacteria and reduce their ability to produce acid. This process can slow the progression of tooth decay and prevent the formation of dental caries.
Antimicrobial Effects: Fluoride has been shown to have antimicrobial effects on bacteria in the oral cavity. Fluoride can disrupt the cell walls of bacteria and inhibit their growth. This process can reduce the number of bacteria in the mouth and lower the risk of dental caries.
Enhancing the Formation of Fluorapatite: Fluoride can enhance the formation of fluorapatite, a more resistant form of hydroxyapatite that makes up the mineral structure of teeth. Fluorapatite is more resistant to acid attacks from bacteria and can protect the enamel of the teeth.
Overall, the mechanism of action of fluoride in dentistry involves a combination of remineralization, inhibition of demineralization, antimicrobial effects, and enhancing the formation of fluorapatite. These processes work together to strengthen tooth enamel and prevent dental caries. It is important to use fluoride in appropriate amounts, as excessive fluoride intake can lead to dental fluorosis.
F can be incorporated pre-eruptively and post eruptively
However the posteruptive (topical) effect of fluoride has played an even more vital role in reducing dental caries.
To achieve a balance between protection from caries and the risk of dental fluorosis, we must consider the causes and susceptibility windows of both conditions.
Caries is a multifactorial disease resulting from the interaction of dietary sugars, dental biofilm, and host factors over time.
Unfavorable imbalances can cause initial caries lesions, which can occur at any age when risk factors outweigh protective factors.
Studies have suggested that
This range was based on the scientific understanding that Americans in warmer climates drank more water than those in cooler climates consumed.
The recommendations of the ADA Council on Scientific Affairs are presented in Table 1.
2006
2013
The International Organization for Standardization (ISO) sets minimum standards for content declaration and labeling, but industry compliance is voluntary.
WHO Global School-based Student Health Survey (GSHS), analysed data from 75 low- and middle-income countries. The survey revealed that
35–94% (12-15-year-olds)- brush their teeth between one and three times a day
2% - 38% - not brushing their teeth at all .
Events taking place at the subsurface of enamel upon a cariogenic acidic challenge.
Fluoride (FL) penetrates at the subsurface along with the acids, adsorbs to the surface of the crystal
and protects it from dissolution (left chart). When coverage is partial, uncovered portions of the
crystal will dissolve (right chart). Modified from Arends and Christoffersen [25].