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TOPICAL FLUORIDES:
Definition: The term topically applied fluorides is used
to describe those delivery systems which provide fluoride
for a local chemical reaction to the exposed surfaces of
erupted dentition.
INDICATIONS
1.Caries active individuals
2.Children shortly after periods of tooth eruption,
especially those who arent caries free.
3.Those who take medication that reduce salivary flow or
radiation therapy.
4.Post periodontal surgery when roots are exposed.
PROFESSIONALLY APPLIED
TOPICAL FLUORIDES:
1.FLUORIDE VEHICLES:
Aqueous solutions & gels
The gel adheres to teeth &
eliminates the continuous wetting
of enamel surfaces required
when solutions are used.
Thixotropic solutions are not
gels, but have a high viscosity
under storage conditions &
become fluid under conditions of
high stress
FLUORIDATED
PROPHYLACTIC PASTES:
If prophylaxis pastes
containing fluoride are used,
the lost fluoride is
replenished & there is a
significant gain in the
concentration of fluoride.
FOAM:
Developed to minimise the risk of fluoride over dosage
as well as to maintain the efficacy of topical fluoride
treatment.
Advantages :
Its lighter than a conventional gel & therefore only a
small amount of agent is needed for topical application
The surfactant has cleansing action by lowering surface
tension, this facilitates the penetration of material into
interproximal surfaces.
It doesnt require suctioning so it offers advantages for
home use
FLUORIDE VARNISH:
Increasing the time of contact between enamel surface & opical
fluoride agents favours the deposition of fluorapatite &
fluorhydroxyapatite.
DURAPHAT:
It s a viscous yellow material, containing 22,600 ppm fluoride as
sodium fluoride in a neutral colophonium base.
FLUORPROTECTOR:
Its a clear polyurethane based product containing 7000 ppm
fluoride from difluorosilane.
Its dispensed in iml ampules each ampule containing 6.21mgof
fluoride.
CAREX:
It has low fluoride concentration than duraphat & has equal efficacy to
that of duraphat as caries preventive agent.
FLOURIDE APPLICATION
FLOURIDE VARNISH
METHOD OF PREPARATION:
It is prepared by dissolving 20 gms of NaF powder in 1L of
distilled water in a plastic bottle
KNUTSONS TECHNIQUE:
At the initial appointment teeth are cleaned with pumice slurry &
then isolated with cotton rolls & dried with compressed air.
Using cotton-tipped applicator sticks ,the 2% NaF is painted on
air dried teeth so that all tooth surfaces are visibly wet. The
solution is allowed to dry for 3-4 min.
This procedure is repeated for each of the isolated segments
until all the teeth are treated.
A 2nd, 3rd and 4th fluoride application, each not preceded by a
prophylaxis, is scheduled at intervals of approximately one week;
The four-visit procedure is recommended for ages 3, 7, 11 and 13
years, coinciding with the eruption of different groups of primary
and permanent teeth.
Technique of application :
Acidulated phosphate fluoride is recommended for application at 6
or 12 months intervals.
Oral prophylaxis is done;
The teeth to be treated are completely isolated and thoroughly
dried with air;
Clinical application of APF gels should be done using trays that fit
the patients upper and lower dental arches. A disposable foamlined tray is preferred;
To reduce ingestion of fluoride, a minimum amount of fluoride gel
that will permit complete coverage of the tooth surfaces should be
dispensed;
After the trays have been properly positioned saliva ejector is
used to evacuate the stimulated saliva and excess fluoride;
It is reapplied every 15-30 seconds so as to keep the teeth moist
with the fluoride solution throughout the 4 minute period;
The patient is instructed to eat, drink or rinse his mouth for
atleast 30 minutes.
FLUORIDE
TRAYS
Disadvantages of acidulated
phosphate fluoride :
Practical difficulties like the teeth should be
kept wet for for 4 minutes;
It is acidic, sour and bitter in taste;
It cannot be stored in glass containers.
DENTIFRICES:
The active agent was NaF which had been added to a
conventional dentifrice containing dicalcium phosphate
as the abrasive.
FLUORIDE MOUTH
RINSES:
Mouth rinsing is a practical
and effective means for selfapplication of fluoride.
Persons excluded from the
practice are :
1.Children under 6 years of
age;
2.Those of any age who
cannot rinse because of oralfacial musculature problems
or other handicap.
Method of use :
1.Rinse daily with 1 teaspoonful (5 ml) after brushing
before bed;
2.Swish between teeth with lips tightly closed for 60
seconds; expectorate.
Flouride rinses can be used as daily mouth rinse by
community and fortnightly in schools.
Advantages :
30-40% average reduction in dental caries incidence.
Disadvantages :
Requires community participation.