2.1 Dental caries
Fluoride
Fluoride
Availability of adequatefluoride confers significant
resistance to dental caries. It is now considered that the
topical action offluoride on enamel and plaque is more
important than the systemic effect.
When thefluoride content of drinking water is less than
700 micrograms per litre ( 0. 7 parts per million), daily
administration offluoride tablets or drops provides suitable
supplementation. Systemicfluoride supplements should not
be prescribed without reference to thefluoride content of
the local water supply. Infants need not receivefluoride
supplements until the age of 6 months.
Dentifrices which incorporate sodiumfluoride or
monofluorophosphate are also a convenient source of
fluoride.
Individuals who are either particularly caries prone or
medically compromised may be given additional protection
by use offluoride rinses or by application offluoride gels.
Rinses may be used daily or weekly; daily use of a less
concentrated rinse is more effective than weekly use of a
more concentrated one. High-strength gels must be applied
regularly under professional supervision; extreme caution is
necessary to prevent children from swallowing any excess.
Less concentrated gels are available for home use. Varnishes
are also available and are particularly valuable for young or
disabled children since they adhere to the teeth and set in
the presence of moisture.
VITAMINS AND TRACE ELEMENTS
Sodium fluoride
lINDICATIONS AND DOSE
Prophylaxis of dental caries for water content less than
300 micrograms/litre ( 0. 3 parts per million) of fluoride
ion
▶BY MOUTH USING TABLETS
▶Child 6 months–2 years: 250 micrograms daily, doses
expressed asfluoride ion (F-)
▶Child 3–5 years: 500 micrograms daily, doses expressed
asfluoride ion (F-)
▶Child 6–17 years: 1 mg daily, doses expressed asfluoride
ion (F-)
Prophylaxis of dental caries for water content between
300 and 700 micrograms/litre ( 0. 3 – 0. 7 parts per million)
of fluoride ion
▶BY MOUTH USING TABLETS
▶Child 3–5 years: 250 micrograms daily, doses expressed
asfluoride ion (F-)
▶Child 6–17 years: 500 micrograms daily, doses expressed
asfluoride ion (F-)
Prophylaxis of dental caries for water content above
700 micrograms/litre ( 0. 7 parts per million) of fluoride
ion
▶Child 6 months–17 years:Supplements not advised
Prophylaxis of dental caries for individuals who are caries
prone or medically compromised
▶BY MOUTH USING MOUTHWASH
▶Child 6–17 years:Rinse or gargle 10 mL daily
DOSE EQUIVALENCE AND CONVERSION
▶Sodiumfluoride 2. 2 mg provides approx. 1 mgfluoride
ion.
▶These doses reflect the recommendations of the British
Dental Association, the British Society of PaediatricDentistry and the British Association for the Study of
Community Dentistry (Br Dent J 1997 ; 182 : 6 – 7 ).
COLGATE DURAPHAT®2800PPM FLUORIDE TOOTHPASTE
Prophylaxis of dental caries
▶BY MOUTH USING PASTE
▶Child 10–17 years:Apply 1 centimetre twice daily, to be
applied using a toothbrush
COLGATE DURAPHAT®5000PPM FLUORIDE TOOTHPASTE
Prophylaxis of dental caries
▶BY MOUTH USING PASTE
▶Child 16–17 years:Apply 2 centimetres 3 times a day, to
be applied after meals using a toothbrush
EN-DE-KAY®FLUORINSE
Prophylaxis of dental carries for individuals who are
caries prone or medically compromised
▶BY MOUTH USING MOUTHWASH
▶Child 8–17 years: 5 drops daily, dilute 5 drops to 10 mL
of water, alternatively 20 drops once weekly, dilute 20
drops to 10 mLlCONTRA-INDICATIONSNot for areas where drinking water
isfluoridated
lSIDE-EFFECTSDentalfluorosis
lDIRECTIONS FOR ADMINISTRATIONTablets should be
sucked or dissolved in the mouth and taken preferably in
the evening. For mouthwash, rinse mouth for 1 minute
and then spit out.
COLGATE DURAPHAT®2800PPM FLUORIDE TOOTHPASTE
Brush teeth for 1 minute before spitting out.
COLGATE DURAPHAT®5000PPM FLUORIDE TOOTHPASTE
Brush teeth for 3 minutes before spitting out.
lPRESCRIBING AND DISPENSING INFORMATIONFlavours of
oral tablet formulations may include orange.
lPATIENT AND CARER ADVICE
MouthwashAvoid eating, drinking, or rinsing mouth for
15 minutes after use.
COLGATE DURAPHAT®2800PPM FLUORIDE
TOOTHPASTEPatients or carers should be given advice on
how to administer sodiumfluoride toothpaste. Avoid
drinking or rinsing mouth for 30 minutes after use.
COLGATE DURAPHAT®5000PPM FLUORIDE
TOOTHPASTEPatients or carers should be given advice on
how to administer Sodiumfluoride toothpaste.
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Tablets may be prescribed as Sodium Fluoride Tablets.
Oral drops may be prescribed as Sodium Fluoride Oral
Drops.
Mouthwashes may be prescribed as Sodium Fluoride
Mouthwash 0. 05 % or Sodium Fluoride Mouthwash 2 %.
COLGATE DURAPHAT®2800PPM FLUORIDE TOOTHPASTE
May be prescribed as Sodium Fluoride Toothpaste 0. 619 %.
COLGATE DURAPHAT®5000PPM FLUORIDE TOOTHPASTE
May be prescribed as Sodium Fluoride Toothpaste 1. 1 %.
Dental information
Fluoride mouthwash, oral drops, tablets and toothpaste
are prescribable on form FP 10 D(GP 14 in Scotland, WP 10 D
in Wales.
There are also arrangements for health authorities to
supplyfluoride tablets in the course of pre-school dental
schemes, and they may also be supplied in school dental
schemes.
Fluoride gels are not prescribable on form FP 10 D(GP 14
in Scotland, WP 10 D in Wales).BNFC 2018 – 2019 Dental caries 705
Ear, nose and oropharynx12