Who discovered the optimum concentration of fluoride in water to allow protection against caries but minimising dental fluorosis?
H. Trendley Dean - 1ppm
Who discovered Colorado brown stain and made the connection to water fluoridation?
Fredrick McKay discovered mottling on teeth without caries, H.V. Churchill discovered the link between water fluoridation in areas of the brown stain.
What is the purpose of a polishing/abrasive agent in toothpaste?
- clean and polish tooth surface without damaging enamel, prevents stain accumulation
e.g. sodium bicarbonate
What is a humectant?
- prevents evaporation of water keeping paste moist
e.g. glycerine, sorbitol
What is a binding agent?
- holds all ingredients together and assists in creating texture of toothpaste
e.g. carboxymethyl cellulose
What is the purpose of a detergent/foaming in tooth paste?
- lowers surface tension and loosens debris which assists removal with a toothbrush
e.g. sodium lauryl sulphate
What is a preservative?
- prevent contamination of bacteria and to maintain purity of product
e.g. formalin
Why do manufacturers put colour/flavouring into toothpaste?
- masks flavour of other ingredients especially SLS, promotes patient compliance
e.g. peppermint, spearmint, menthol
What is waters purpose in toothpaste?
- acts as a solvent for some ingredients and provides consistency
What therapeutic agents are used in toothpaste?
- Fluoride: anticaries, remineralisation
- Desensitising agents: reduce or eradicate dentine hypersensitivity by desensitising pulp nerve fibres e.g. strontium chloride
- Antiplaque agents: antibacterial reducing plaque formation e.g. triclosan
- Anticalculus: inhibits plaque mineralisation e.g. pyrophosphates, zinc citrate
What are the modes of action of fluoride?
- remineralisation changing structure of enamel hydroxyapatite to fluorapatite with protective effects (higher resistance to acid attack)
- inhibits bacterial growth, bacteriostatic
- interferes with ability of strep. mutans to produce acid and reduces their growth
- reduces dentine sensitivity by blocking tubules
- said to have an effect on flatter, wider cusps
What is the concentration of fluoride recommended in toothpaste in all age groups?
Standard prevention: 1000-1500ppm F
Enhanced prevention: 1350-1500ppm F
Children 10 and over at increased risk: 2800ppm F
Children/adults 16+ at increased risk consider: 5000ppm F
What is the recommended maximum intake of fluoride per day for all sources?
- 0.1mg/kg/day for children upto 8
- 10mg/day for children 9 and over regardless of weight
Fluorosis risk is omitted by around age 3 as all crowns should have developed
What is the concentration of duraphat fluoride varnish?
Which mouthwash can be recommended and its concentration?
Duraphat: 22,600ppm F
Fluoriguard Daily - 225ppm F, no alcohol
