2. DENT 1180 Prevention & Nutrition Topical Fluoride

3. 1. 3 types of F for professional Topical application Sodium Fluoride NaF 2% aqueous paint on solution, gel or foam in tray neutral Stannous Fluoride SnF 8% aqueous unstable, taste, stain acidic pH Acidulated Phosphate APF 1.23%sol paint on solution, gel or foam in tray thixotropic acidic pH

4. 2. At Risk Patient Patients prone to caries Patients with Non Fluoridated water Patients with xerostoma- dry mouth CONTRAINDICATIONS Before bonding ( seal, ortho)

5. 3. Water F 1 PPM of Sodium F http://www.ada.org/public/media/vid eos/minute/fluoridation_benefitsofflu oride_broadband.wmvhttp://www.ada.org/public/media/vid eos/minute/fluoridation_benefitsofflu oride_broadband.wmv SYSTEMIC

6. Review of Excess Systemic F Fluorosis- mottled enamel

7. 4. 2 Methods of application traysBrush on Varnish Swish

8. Varnish Fluoride varnish is a topical agent containing a high concentration of fluoride (5 percent sodium fluoride (NaF) or 22,600 ppm of fluoride) in a resin or synthetic base. Professionally applied fluoride varnishes were first developed in the 1960s, and have been in use for over 30 years. Fluoride varnishes are painted directly onto teeth and are intended to remain in close contact with enamel for several hours. Fluoride varnish sets on contact with intraoral moisture, so thorough drying prior to application is not required. Application time runs from one to four minutes, depending on the number of teeth within the oral cavity. In a typical varnish application, 0.3 to 0.5 milliliters (mL) of varnish are painted directly onto the teeth (0.1 mL of varnish was applied per arch in the UCSF study). Varnish may be applied with any convenient applicator (e.g., a disposable brush or cotton-tipped applicator, or the syringe-type applicator included with the product). After application, the fluoride varnish remains on the tooth surfaces for several hours, which facilitates maximal fluoride uptake. Fluoride varnish also minimizes the risk of inadvertent fluoride consumption and is easy to use on very young children.

9. Fluoride trays in place photo courtesy of www.drspiller.com www.drspiller.com

10. 5. Steps in F tray application Patient is seated upright Give preop instruction DRY teeth Insert tray with F gel Insert saliva ejector Watch time (1 min) Remove tray and evacuate Give Post op instructions

11. 6. Instructions Preop and during Do Not Swallow the material Post Op Do Not Swallow the material Do not eat, drink, brush for half hour If upset stomach- drink milk Severe- induce vomit

12. 7. How often Per patient needs Most insurance companies pay only on children and once per year!

13. 8. Systemic v Topical INGESTED in water, food and carried to cells through bloodstream Strengthens crystalline structure of enamel as it forms Applied to already erupted teeth Incorporates into enamel and helps strengthen

14. Vocab Bulimia- an eating disorder, binge eating and self induced vomiting. Vomit has low pH and erodes the enamel. Topical F treatment in office and at home rinses may be Rx.