About FLUORIDES IN DENTISTRY.....

1. FLUORIDES IN DENTISTRY
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2. CONTENTS:-
 Introduction
 Composition
 Source of fluoride
 Mechanism of action of fluoride and their delivery methods.
 Indication for topical fluoride use
 Fluoride tablets/drops,use and dosage.
 Toxicity of fluoride.
 Dental fluorosis.
 Conclusion.

3. INTRODUCTION
The cariostatic efficacy of fluorides has been
convincingly demonstrated and the recent
decline in caries prevalence is primarily
attributed to the increased use of fluoride
agents.

4. composition
Fluoride may occurs in combined form in a wide
variety of minerals.
Fluorspar[fluorite CaF2]- 49%
Fluorapatite[Ca10F2(PO4)6]- 3.4%
Cryolite[Na3ALF6]- 54%

5. SOURCES OF FLUORIDE
 It is estimated that the intake of from fish by populations where fish
represents a significant portion of the diet is about 0.5mg/day.
 Jawar,banana,potatoes also contain substatial quantities of fluoride.
 Certain plants,such as taro,yams,and cassava,have been found to contain
relatively high fluoride levels.
 Fluoride content of rock salt ranges between 40 and 200ppm.
 The dried tea leaves contain 100-400 ppm fluoride.
 Mineral water usually contains considerably higher concentration,from 1.5-
7

7. Mechanism of action of fluoride
 The benefits of fluoride in the reduction of dental caries
have been known for years,but its exact mechanism of action
is not completely understood.
 The mechanisms by which fluoride increases caries resistance
may arise from both systemic and topical application of
fluoride.
 1. increases enamel resistance or reduction in enamel
solubility.
 2. increases rate of posteruptive maturation.
 3. remineralization of incipient lesions.
 4. Interference with plaque microorganisms.
 5. modification in tooth morphology.

10. Fluoride delivery methods
 1. topical fluoride are placed directly on the teeth.
 Topically applied fluoride is used to describe those delivery
system which provide fluoride for a local chemical reaction to
exposed surfaces of the erupted dentition.
 The delivery system includes containing prophylactic
pastes,solutions,gels and varnishes as well as systems
designed for unsupervised home use,such as fluoride
dentifrices and rinses.

11. Indications for topical fluoride use
 1.caries- active individual
 2.children shortly after periods of tooth eruption,especially
those who are not caries free.
 3.Those who take medication that decreases salivary flow or
have received radiation to head and neck.
 4.after periodontal surgery when roots of teeth have been
exposed.
 5.patients with fixed or removable prosthesis and after
placement or replacement of restoration.
 6.patient with eating disorder.
 7.mentally and physically challenged individuals.

12. Fluoride tablets/drops/lozenges:-
 Fluoride tablets/drops/lozenges may be prescribed to individual patient or may be
part of a school or home based public health preventive dentistry program.
Fluoride compound used:-
 Sodium fluoride is most commonly used.
 The other compound used are acidulated phosphate fluoride,potassium fluoride or
calcium fluoride.
 Supplements contains a measured amount of fluoride typically 0.25mg,0.5mg or
1.0mg.

13.  Fluoride drops are dispensed with a measured dropper and are convenient for
infants.
 Tablets and lozenges should be chewed, swished and swallowed.

15. Frequency of use and dosage:-
 The council on dental therapeutic of the dosage schedule for dietary supplement
as shown in the table:-

16. Toxicity of fluorides
 Fluorides is often called as a double-edges sword as an expression for anything
that can simultaneously help and hinder.
 This is because inadequate ingestion of fluoride is associated with dental caries and
an excessive intake of fluoride can lead to dental and skeletal fluorosis.
 ACUTE TOXICITY OF FLUORIDES:-
 Acute fluoride toxicity results from rapid excessive ingestion of fluoride at one
time.
 The speed and severity of the response are dependent on the amount of fluoride
ingested and the weight and age of the individual.

17.  The most frequently encountered adverse effect to topical fluoride encountered
adverse effect of topical fluoride therapy is nausea.
 This is caused by fluoride combining with hydrogen in the gastric juices to form
hydrofluoric acid a stomach irritant.
 Other symptoms of fluoride toxicity include…
 1.abdominal cramps.
 2.vomiting
 3.diarrhea
 4.increased salivation
 5.dehydration and thirst.

18. CHRONIC FLUORIDE TOXICITY
 Chronic fluoride toxicity results from long term ingestion of small amounts of
fluoride.
 The effect of chronic fluoride toxicity on enamel is dental fluorosis.
 other problem such as skeletal fluorosis may occurs.
effect dosages duration
Dental fluorosis >2 times optimal Until 5 years
Skeletal fluorosis 10-25 mg/day 10-20 years

19. DENTAL FLUOROSIS
 Dental fluorosis is caused by excessive intake of fluoride during tooth development.
 Ingestion of water with a fluoride concentration two or three times greater than the
recommended amount causes white flecks and chalky opaque areas on the tooth
enamel.
 Consumption of water containing four times the recommended amount of fluoride
causes a brown pitted corroded appearance on the enamel surface.
 However although these teeth represent cosmetic problems they are highly to carious
attack.

20. CONCLUSION
 When used appropriately, fluoride is s safe and effective
agent that can be used to prevent and control dental caries.
 Fluoride has contributed profoundly to the improved dental
health of persons all over the world.
 Fluoride is needed regularly throughout life to protect teeth
against tooth decay.
 To ensure additional gains in oral health,water fluoridation
should be extended to additional communities and fluoride
toothpaste should be used widely.