Fluoride is a mineral that strengthens tooth enamel to prevent cavities, and its primary uses are improving dental health through water fluoridation, toothpaste, mouthwash and supplements. The document outlines the sources and mechanisms of fluoride, as well as guidelines for systemic and supplemental fluoride therapy to reduce tooth decay at different ages, while also addressing fluoride toxicity risks and management.

1. FLUORIDE THERAPY
GLO ARBY ARGUELLES, DMD

2. FLUORIDE
 Mineral, found in bones and teeth.
 Strengthens enamel which prevents caries.
 Mainly used to improve dental health.
 Main factor responsible for the decline in caries prevalence worldwide.
 Local water supply.
 Over-the-counter (OTC) products.

3. SOURCES OF FLUORIDE
TOOTHPASTE
ENHANCED
WITH
FLUORIDE
FLUORIDE
SUPPLEMENTS
FLUORIDATED
WATER
SUPPLIES
MOUTHWASH
ENHANCED
WITH
FLUORIDE
FOOD
PROCESSED
WITH
FLUORIDATED
WATER

4. FLUORIDE METABOLISM
 Absorbed in plasma from GIT.
 Peak plasma occurs 1 hour after ingestion.
 Bone is the major reservoir of Fluoride.
 Excreted in urine and sweat.
 Unabsorbed fluoride is lost in feces.

5. MECHANISM OF ACTION
A. FLUOROAPATITE
Ca (PO4) 6 (OH)2 + 2F  Ca10 (PO4) 6F2 + 2OH
Resistant surface layer:
 Promoting remineralization
 Improving Crystallinity
 Decreasing solubility of the enamel.
B. Acts on cariogenic bacteria by inhibiting GLYCOLYSIS and PLAQUE COLONIZATION.

6. SYSTEMIC FLUORIDE THERAPY
WATER FLUORIDATION
- Adjustment of Fluoride content of communities’ water supply to optimal
concentration.
- Compounds used for water Fluoridation:
Sodium fluoride
Hydrofluosilic Acid
Sodium Silicofluoride

7. SYSTEMIC FLUORIDE THERAPY
WATER FLUORIDATION
 Optimum Fluoride content is 1ppm.
 Caries Reduction : 20-45%
2.2 mg NaF/tab + 1 L H2O = 1 ppm FLUORIDATED WATER

8. SYSTEMIC FLUORIDE THERAPY
SUPPLEMENTAL FLUORIDE THERAPY
- Optimum Fluoride content is <0.3 ppm
- Caries Reduction : 50-80%
6 Months – 3 years old 3 years old – 6 years old 6 years old – 16 years old
0.25 mg 0.5 mg 1.0 mg
FLUORIDE SUPPLEMENTATION

9. SYSTEMIC FLUORIDE THERAPY
SUPPLEMENTAL FLUORIDE THERAPY
DROPS SYRUP
Brandname: Polyviflor Brandname: Polyviflor
Contains 0.25 mg F/mL Contains 1mg F/ 5mL
Preparation: 15 mL bottle Preparation: 60 mL bottle

10. SYSTEMIC FLUORIDE THERAPY
6 Months – 3 years old 3 years old – 6 years old 6 years old – 16 years
old
0.25 mg 0.5 mg 1.0 mg
FLUORIDE SUPPLEMENTATION
6 Months – 3 years old 3 years old – 6 years old 6 years old – 16 years
old
0.25 mg 0.5 mg 1.0 mg
<0.3 ppm
6 mo–3 yo 0.25mg 1mL
3 yo–6 yo 0.5 mg 2.5 mL
6 yo-16 yo 1.0 mg 5 mL

11. SYSTEMIC FLUORIDE THERAPY
SUPPLEMENTAL FLUORIDE THERAPY
Rx
Multivitamins
(Polyviflor)
1mg F/5mL
#1 bot x 60 mL
Sig.: Give 2.5mL once a day
DROPS SYRUP
Brandname: Polyviflor Brandname: Polyviflor
Contains 0.25 mg F/mL Contains 1mg F/ 5mL
Preparation: 15 mL bottle Preparation: 60 mL bottle
<0.3 ppm
6 mo–3 yo 0.25mg 1mL
3 yo–6 yo 0.5 mg 2.5 mL
6 yo-16 yo 1.0 mg 5 mL

12. SYSTEMIC FLUORIDE THERAPY
SUPPLEMENTAL FLUORIDE THERAPY
CHEWABLE TABLETS
1.1 mg Sodium Fluoride (0.5 mg fluoride ion)
2.2 mg Sodium Fluoride (1.0 mg fluoride ion)
6 Months – 3 years old 3 years old – 6 years old 6 years old – 16 years
old
0.25 mg 0.5 mg 1.0 mg

13. FLUORIDE
 Double-edge sword.
 Inadequate amount of Fluoride can lead to dental caries.
 Excessive intake of fluoride can also lead to dental Fluorosis.

14. FLUORIDE TOXICITY
 ACUTE TOXICITY
 CHRONIC TOXICITY

15. ACUTE TOXICITY
 Excessive ingestion of Fluoride over short period of time.
CHRONIC TOXICITY
 Excessive ingestion of Fluoride over long period of time.

16. ACUTE TOXICITY
 Probable Toxic Dose - 5mg F / kg
 Acute Lethal Dose - 36mg F / kg
 Common Symptoms:
 Nausea
 Hypersalivation
 Vomiting
 Abdominal Pain
 Diarrhea
.

17. CHRONIC TOXICITY
 Long term ingestion of fluoride.
 Dental Fluorosis
- a condition that causes changes in the appearance of tooth enamel.
- Hypoplasia or hypomineralization of tooth enamel or dentin produced by the chronic
ingestion of excessive amounts of fluoride during the period when teeth are developing.
 Skeletal Fluorosis
- A disease caused by deposition of fluoride in the hard and soft tissues of the body.

18. MANAGEMENT
 Bleaching and Enamel Micro abrasion.
 Composite Resin and Resin-Modified Glass Ionomer
 Esthetic Veneers and Prosthetic Crowns.

19. EMERGENCY PROTOCOL
 Give milk as can be ingested.
 Administer orally 5% Calcium Gluconate or Calcium Lactate.
 Administer Milk of Magnesia.
 Lethal cases:
Gastric Lavage
.

20. FLUORIDE THERAPY
 DENTAL OFFICE THERAPY
 HOME THERAPY