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Fluoride use in Paeds (Systemic (Tablets (chewed/dissolved, then rinse the…

- - - - safe, inexpensive, non-discriminatory, benefits are conferred regardless of background. No cooperation needed.
      - Ideally 0.8-1.2ppm. In Dunedin, 0.75ppm.
    - - Optimally 4.5ppm
      - hard to establish a target level of fluoridation for school water supply because children come from different levels of fluoridation
- - - - prolong contact time between fluoride and enamel (slow-releasing reservoir of fluoride)
      - Duraphat: 5%wt NaF in an alcoholic suspension of natural resins
      - Fluor Protector: polyurethane-based lacquer, 5%wt difluorosilane
      - MI varnish: 5%wt NaF and CPP-ACP
      - Clinpro white varnish: 5% wt NaF, functionalised tri-calcium phosphate
      - substantial caries-inhibiting effect on both primary and permanent teeth
      - Works for 6 hours. Bioavailability of fluoride when ingested is low, Duraphat is lost during chewing.
      - 12 months, high caries risk, every 6 months
    - - silver diamine fluoride
        
        38% SDF is useful for tx and prevention of caries in primary teeth every 6 months
        
        Adv: arrests dentin caries, inexpensive, simple & easy to obtain good cooperation from children
    - - 2% neutral sodium fluoride or 1.23% acidulated phosphate fluoride
      - moderate quality evidence
      - 6yo, high caries risk, 3-6 monthly intervals.
      - neutral sodium fluoride preferable for porcelain and composite
  - - - for: >6yo, high caries risk
      - daily with 230ppm OR weekly with 900ppm
      - not clear evidence
    - - tooth mousse
        
        CPP-ACP + sodium fluoride 0.2%
      - tooth creme
        
        tricalcium phosphate, 0.21% sodium fluoride
    - - clear evidence that it works