Lec 6 Prevention DR - Yamama Adnan

Preventive Dentistry Dr.
Yamama Adnan
Systemic Fluoridation Lec 6
Fluoride Supplements
Fluoride supplements were originally designed to provide the

systemic fluoride that a child would not consume living in a non-
fluoridated area.
However fluoride supplements should be:
1. Prescribe for children ages 6 months to 16 years who are at high
risk for tooth decay and,
2. Whose primary drinking water has a low fluoride concentration.
3. Prescribed only by dentists where there is clear evidence for high
risk of caries and non-compliance with using other fluoridated
products; and the parents must be cooperative.
Fluoride tablets became the method of choice for fluoride
supplementation.
Supplements contain a measured amount of fluoride typically 0.25mg,
0.5mg, and 1mg usually as sodium fluoride. 2.2 mg sodiumfluoride tablet
gives 1mg ion fluoride, and 1.1 mg sodiumfluoride tablet gives 0.5mg ion
fluoride.
The American Dental Association (ADA) Recommended Fluoride
Supplementation Schedule
Age Fluoride supplement dosage according to fluoride

in the drinking water (parts per million ppm)
<0.3ppm 0.3–0.6pp >0.6ppm

Birth to 6 None none None
months
6 months to 3 0.25 mg/day none None
years
3 to 6 years 0.5 mg/day 0.25 mg/day None
6 to 16 years 1.0 mg/day 0.5 mg/day None
1
Instruction to use fluoride supplement (tablet or lozenges or drop):-
 If fluoride level is unknown, drinking water should be tested for
fluoride content before supplements are prescribed.
 Fluoride supplement indicated to children living in area with none

or low level of fluoride in water. Especially children with high risk
to dental caries, children with chronic systemic disease and
handicapped children.
 Fluoride supplement is daily used from 6months to 16 years to give

their maximum effect (To obtain the benefits from fluoride
supplements, long-term compliance on a daily basis is required).
 To maximize the topical effect of fluoride, tablets and lozenges are

intended to be chewed or sucked for 1–2 minutes before being
swallowed.
 Before considering supplementing fluoride, it is relevant to take
into account the natural sources of fluoride in food and drinking
water.
 It has also been shown that when exposure to fluoride is
discontinued, its caries-reducing effect gradually wanes. This is
entirely logical, because fluoride is affecting the dynamics of
lesion formation.
 Fluoride supplement Should not be given with milk.
Fluoride supplement during pregnancy until dental formation is
completed through pharmaceutical products, i.e. tablets or drops,
according to variable doses (0.25 and 1 mg). During pregnancy and breast
feeding, mothers should take 1 mg a day. In fact, theoretically, during
intrauterine life, the fluoride taken by the mother may work in the pre-
eruptive phase, during the amelogenesis of deciduous teeth with a
consequent beneficial effect on the newborn’s deciduous teeth. Fluoride
passes through the placenta freely, until it reaches excessively high levels
in the mother’s blood, and thus triggers this passage (barrier effect) to
protect the foetus from excessive doses. The threshold concentration that
pushes the placenta to trigger this function is 0.4 ppm of fluoride in
maternal blood . Some Authors consider the systemic administration of
fluoride as a further supplement during pregnancy, as it is identified as
the first step to caries prevention.
The children until they are old enough to swallow use Fluoride
supplement as Fluoride Drops; they are available as 0.125mg, 0.25mg,
0.50mg drops . 10 drops equal to 1mg, if 10 drops placed in a liter of
water the result concentration of 1ppm of fluoride.
2
Fluoridated salt:-
Where water fluoridation could not be initiated, some countries have
introduced salt fluoridation. Salt is usually fluoridated at 250 ppm (which
is 250 mg F/kg salt, or 0.25 mg/gm salt). Table salt in the kitchen can
contribute 1 to 4 g of the daily salt intake. Thus, a person could
potentially ingest 1 mg of fluoride a day at a salt intake of 4 grams a day.
Advantages:
1- Wide coverage
2- Need little action by the
individual 3- Low coast
4- Freedom for the consumers as both fluoridated and non-fluoridated salt
is available
5- It is safe
6- Minimum possibilities of fluorosis.
Disadvantages:
1- Salt fluoridation need community education and promotion.
2- International efforts to reduce sodium intake to help control
hypertension.
3- Consumption of fluoridated salt is lowered during early life when the
need for fluoride is the maximum.
Fluoridated milk :-
Milk fluoridation is the addition of a measured quantity of fluoride to
bottled or packaged milk to be drunk by children .both bovine and human
milk contain low level of fluoride about 0.03ppmF. Milk fluoridation is
suggested instead of water fluoridation.
Fluoridated milk promotes remineralisation of lesions in enamel in vitro
and in vivo, and inhibits demineralisation in enamel and dentine. Milk
itself has a protective effect in intra-oral caries models as well as in vitro
Disadvantages:
1- Consumption of milk varies between different socioeconomic groups .
2- Consumption decrease with age so long term benefit is less than water
fluoridation
3- Require high level of technical expertise.
– A high concentration of fluoride is needed for two reasons:
(1) the children did not drink the beverage throughout the day.
(2) calcium in the milk complexes with fluoride, which would reduce its
availability for topical benefits.

Lec 6 Prevention DR - Yamama Adnan

Uploaded by

Copyright:

Available Formats

Lec 6 Prevention DR - Yamama Adnan

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Lec 6 Prevention DR - Yamama Adnan

Uploaded by

Copyright:

Available Formats

Preventive Dentistry Dr.

Systemic Fluoridation Lec 6

Fluoride supplements were originally designed to provide the

Age Fluoride supplement dosage according to fluoride

<0.3ppm 0.3–0.6pp >0.6ppm

 Fluoride supplement indicated to children living in area with none

 Fluoride supplement is daily used from 6months to 16 years to give

 To maximize the topical effect of fluoride, tablets and lozenges are

You might also like