3/23/11 Guideline on Fluoride Therapy

Department of Pediatric Dentistry
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence
Article title: Guideline on Fluoride Therapy
Author(s): Council on clinical affairs
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2008.
Major topic: Fluoride
Overview of method of research: Medline search using the words Fl, fluoridation, acidulated phosphate fl, fl varnish, fl therapy, and topical fl.
Findings:
Fl has many caries protective mechanisms of action including remin and altering bacterial metabolism. Daily Fl through water supplies and use of Fl toothpaste are effective preventive procedures. Sources of dietary Fl include tap h20, infant formula, prepared food, soda, juice, and toothpaste. Formulas have varying degrees of Fl. Fluorosis results from cumulative Fl intake during enamel development depending on dose duration, and intake time.
Professionally applied topical Fl is good for moderate to high-risk patients. 2% NaF(9000ppm), 1.23% APF(12,300ppm) solution and gel, and 5% NaFV(22,500ppm) are commonly used. Recommended treatment time is more than 4 minutes.
After determining a child’s exposure to Fl, systemic Fl may be necessary. Keep in mind that we get Fl from numerous vehicles, and prescribing Fl may cause future fluorosis. Use the famous Fl table to determine what dosage the child needs. The child should suck or chew the tablets to optimize topical benefits.
Professionally applied Fl should be based on caries risk. Prophy w/ pumice is not essential. Ensure the child does not swallow any of the Fl. Low risk patients should be seen every 6 months, moderate to high risk patients every 3-6 months.
Therapeutic use of Fl at home should focus on maximizing topical contact in low dose high frequency regime. Fl toothpaste should be used twice daily, as it has shown t be more effective than one time daily. Children 2< should use a smear of toothpaste, and pea size amount for children age 2-5. Rinsing after brushing should be avoided. High risk patients should be prescribed toothpastes with a higher Fl concentration.

Key points/Summary: Fl is da bomb. All of this stuff and more will be on the boards.

Assessment of Article: AAPD guideline. Know it. Cherish it. Do it.