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Topical Fluoride ApplicationPrevention of dental disease is a very important component ofthe overall oral health of children. Caries (dental decay) andperiodontal problems (gum disease) can be eliminated andcontrolled through effective education of the patient and/orparents or guardians. Since prevention includes good homecare, it’s important to instruct the patient in regular plaqueremoval by flossing and brushing. Topical fluoride treatmentsand pit and fissure sealants can be applied at the dental officeto afford the tooth improved resistance to decay. In addition,a prescription fluoride product can be prescribed for use athome on a daily basis for patients with a high caries risk. Thisis usually applied immediately before the patient goes to bedso that no food passes through the mouth after the rinse.Although it’s not totally understood why fluoride makes teethharder and resistant to decay, it’s known that fluoride isabsorbed into the enamel of the tooth. Fluorideaids in remineralization of teeth that have undergone initial stages ofdemineralization caused by acids produced in plaque. Thishelps keep enamel more resistant to decay. After prophylaxiswith a prophy paste or other such material to remove plaque,the teeth are well cleaned, and the patient is asked to rinse
Dental Specialties 2: Pediatric Dentistry/Orthodontics11and expectorate. Teeth are then isolated and dried with asaliva ejector, using cotton rolls as needed.Fluoride can also be applied to the patient’s teeth by meansof a fluoride tray.The trays, made of a pliable, soft plasticmaterial and usually disposable, provide an efficient meansof application. A small measured amount of fluoride gel isplaced into the troughs of the tray. The patient’s teeth aredried, and the tray is then inserted into the patient’s mouth.The fluoride in the troughs covers the teeth. Studies of fluo-ride uptake have shown that a one-minute application isgenerally effective. In the past, four-minute applications weredeemed necessary for ideal treatment. Since two differenttypes of fluoride are used (neutral sodium fluorideor acidphosphate fluoride), the manufacturer’s recommendedinstructions for the fluoride being used should be followed.Flouride can also be applied as a solution. After the teeth aredried and isolated with cotton rolls, the fluoride solution canthen be applied directly to the teeth with a cotton-tippedapplicator. When using this application method, the fluorideshould be worked into the interproximalareas (between theteeth). This method, however, doesn’t control the amount offlouride that a patient can ingest as well as using a gel.It’s important to limit the ingestion of the fluoride; therefore,suction should be applied between the trays. Suctionremoves excess saliva caused by the taste of the fluoride andthe presence of unfamiliar objects in the mouth.