1. DR. SHAHZADI TAYYABA HASHMI Systemic Fluorides

2. Fluoride supplementation SystemicTopical Dietary fluorides Salt fluoride Fluoride in sugar Water fluoridation School water fluoridation Milk fluoridation Professional application Self application

3. Systemic Fluorides Water fluoridation Milk fluoridation Salt fluoridation Fluoride drops Fluoride tablets Fluoride lozenges

4. Topical Fluorides Sodium fluoride Stannous fluoride Acidulated phosphate fluoride Fluoride varnish Fluoride Dentifrice Fluoride mouth rinse

5. Systemic Fluorides 1) Water Fluoridation: Definition: Defined as ‘upward adjustment of the concentration of fluoride ion in a public water supply in such a way that the concentration of fluoride in the water may be consistently maintained at 1 ppm by weight to prevent dental caries with minimum possibility of dental fluorosis’ Optimum level of fluorides in water: The optimum fluoride level for water is 1ppm ( parts per million)

6. RECOMMENDED CONCENTRATION OF FLUORIDES

7. Benefits of water fluoridation 1) Appearance of teeth Teeth exposed to an optimum or slightly higher level of fluoride are clear, white, shining and without blemishes) 2) Dental caries reduction in primary and permanent teeth 3) Root caries reduction Life-long consumption of fluoridated water reduces the incidence of root caries by approximately 50%) 4) Malocclusion orthodontic problems are less among children 6-14 yrs of age living in fluoride area compared to those living in areas without the benefits of fluorides)

8. Benefits of water fluoridation 5) Interproximal and coronal caries reduction (there is 95% less prevalence of interproximal dental caries and reduction of 60% coronal caries in fluoridated communities compared to those of non- fluorinated) 6) Economy water fluoridation is most economical in reducing the cost of public health expenditure)

9. Feasibility of water fluoridation Water fluoridation is feasible only if: There is a municipal water supply reaching a reasonable number of homes People drink this water rather than from individual wells or rainwater tanks Suitable equipment is present Supply of water is assured Workers available in the water treatment plant to maintain the system Money should be available for initial installation and running costs

10. Salt fluoridation Most effective method to deliver fluoride to a target population where water fluoridation is not possible In this case fluoride is added to salt by spraying concentrated solutions of sodium fluoride on a conveyor belt Advantages: Possibility of fluorosis is minimal Low cost Freely available Supply can be effectively controlled Distribution can be easily monitored Disadvantages: There is now international efforts to reduce sodium intake to control hypertension

11. Milk fluoridation Milk is an excellent source of calcium and phosphorus and when fortified with vitamin D, helps in development of bones and teeth Advantages: Important food for children and infants Disadvantages: Expensive Variation in intake and quantity of milk

12. Fluoride Tablets Reduces caries incidence in both permanent and deciduous dentitions Fluoride tablets are available as NaF tablets of 2.2 mg, o.55mg and 0.25 mg respectively