This blog was created for students to interact over the material in the Predoctoral course in Pediatric Dentistry, DS443b.

Monday, January 22, 2007

Lecture 2 - Fluorides and Early Oral Care

Submit your "most important thing" recorded immediately after lecture.

Submit by clicking the comment link below. You may post comments anonymously or create a username. For credit, your student number and last name must accompany any entries.

You must post by Sunday, Jan 28, at 11:59 PM for credit.

92 comments:

Anonymous said...

Magic Minute:
A major cause of fluorosis in children from non-fluoridated areas is double supplementation of fluoride by both the physician and dentist.

Anonymous said...

Question:
Given that the fluoride content in modern tooth paste is ~1000ppm and assuming that people brush their teeth, why is it still necessary to fluoridate the water supply? Theoretically, shouldn't the amount of fluoride in toothpaste 1x/day be enough?

Anonymous said...

Liz Miltner #150

Fl varnish is a good alternative to foam tx becuase there is less risk of the child ingesting the floride.

Eric Cheung said...

We need to check how much F- in water. The children will benefit from a lower dosage of F toothpaste. One way to start a good relationship with children is doing checkups rather than extractions.

Eric Cheung 110

Anonymous said...

The earlier children see the dentist the less their total dental cost will be. Also, income and ethnicity play significant roles in caries risk.

Joshua Cardwell
#108

Anonymous said...

the younger the age kids see the dentist, the less cost dental care is during pre school years

Catherine Do #122

Anonymous said...

There is an overall decreasing incidence of caries worldwide except in areas where countries are going through economic changes. There are also differences of caries prevalence across ethnicities. Fluoridating water is one way to decrease caries but additional fluoride supplementation should be done with caution especially in children

Jun Flores #130

Anonymous said...

There is a correlation between income and caries rate. The lower the income the higher and earlier the caries rate is in children. Part of this has to do with limited access to care

Anonymous said...

Karen (Xiang) Li #146
The important message from today's lecture: There are many sources where kids can be exposed to Fl--> Dentists Rx, M.D.Rx, Drinking water, toothpaste, Fl foam, Fl varnish, etc... Hence we should investigate before Rx more Fl.

Anonymous said...

The use of flouride as a tool in the prevention of decay. The % of kid in risk for caries in California. Paradigms for dealing with caries.
Heidi Gonzalez #526

Tina said...
This comment has been removed by the author.
Tina said...

Providing parents instruction on oral health care for the infant will save the parents lots of money down the line.

Tina Duong #125

Anonymous said...

The earlier, the children come in for dental check ups. They shall have less dental expenses in the future.
And benefits of flouride varnish over gel.

Anonymous said...

The earlier, the children come in for dental check ups. They shall have less dental expenses in the future.
And benefits of flouride varnish over gel.

Abtin #524

Anonymous said...

We need to know the amount of fluoride in the water, before prescribing any systemic fluoride; because if it's at least 0.6 ppm it can cause fluorosis.

Anonymous said...

Caries is more common in population with low income; therefore as a dental professionals we need to educate this population, letting them know that the first dental visit should be 6 months after the eruption of the first tooth.
Claudia Rodriguez #531

Anonymous said...

Jonathan Do #121

The importance of the effect that Fluoride has in treating caries lies in it's topical usage as opposed to it's systemic role.

Anonymous said...

Dental disease is a progressive disease that increases as you are older/teeth present for longer.
Kim Pham 167

Unknown said...

Fluoride supplement to ALL children if water F- content is less than 0.6 ppm. Conversely, if water has more than 0.6 ppm, there is no need for Fluoride supplement. Optimum Fluoride level is 1 ppm.

#158, Naomi Nguyen

Anonymous said...

I found it interesting that we should initially see children at the dentist for the first time at 6-12 months of age or when the first tooth erupts.

- Neilesh Patel
#165

Unknown said...

I learned that infants should not be given Flourides before the age of 6 months, due to risk of fluorosis.

Anonymous said...

Shannon Lazarian #133

The dentist should see kids as early as 1 year old in order to teach them and allow them to be comfortable with dentist. Seeing kids earlier also allows you to see them in a good setting before they may need work.

Regina said...
This comment has been removed by the author.
Anonymous said...

When the teeth are developing, it is a sensitive time. So when giving fluoride, precautions should be taken just as when prescribing other medications.
Regina Espinoza #126

Unknown said...

The most magical minute:
I thought the most interesting thing from this lecture was the fact that even within the same income bracket there was a higher incidence of caries in minorities. Does this have to do with diet? Do different ethnicities place more/less importance on oral health?
Sincerly,
Paul Field #127

Anonymous said...

I learned that the earlier the child first visits the dentist, the lower the cost of dental care in the preschool years. I also learned to make sure that I do not prescribe flouride if the pediatrician has already done so.

Trish Barsanti #105

Anonymous said...

I found it interesting that current research points the finger at dentists and doctors for contributing to fluorosis in children. Knowing this, I'll be conscientious about how much fluoride I prescribe for patients, and check to make sure the doctor hasn't already prescribed it.

Anonymous said...

I found it interesting that current research points the finger at dentists and doctors for contributing to fluorosis in children with the fluoride they prescribe. Knowing this, I will be more careful in how much fluoride I prescribe and check to make sure the doctor hasn't already prescribed some.

Anonymous said...

I thought it was great to see there is an overall decline of DMF teeth around the world, however there are still a few countries where the rate is actually increasing!
Morris Poole #169

Anonymous said...

My most important thing this week was that it is very important to see children when they are very young (infant dentistry). It's important to establish a relationship with children at a young age.

Anonymous said...

I did it again, above comment by Broc Mushet #156

Anonymous said...

magical minute:The most important thing I learned is that prescribing fluoride and administering it in the clinic has so much more to it ,as many patients may be using an already fluorodinated toothpaste or may already have a prescription for it which must be taken into consideration,also that child's weight is an important thing.
poonam rai #530

Unknown said...

Magic minute:
It is becoming plainly apparent that the long time idea of the preventive approach of dental treatment is moving towards the center stage. By initiating the dental treatment of infants soon after the eruption of their first tooth, Dentists can enact early health promoting preventive measures to give the infant’s dentition a better chance of achieving long term oral health.
Jeffrey Flores #129

Anonymous said...

Fluoride supplements are a major cause of fluorosis; it is important to recognize all fluoride sources in a child's diet, including: water, toothpaste, dental and physician's prescriptions.

Anonymous said...

Fluoride supplements are a major cause of fluorosis; it is important to recognize all fluoride sources in a child's diet, including: water, toothpaste, dental and physician's prescriptions.
[Colby Smith #178]

Unknown said...

Fluoride supplementation should be considered for children after 6 months of age if fluoride levels determine in water supply is less than 0.6 ppm. Children between birth and 6 months of age are sensitive to the dosage of fluoride medication due to their weight and potential risk of fluorosis. Besides, there is no benefit for children in that age group to get fluoride supplement when they do not have teeth present in their mouth and fluoride drops work effectively as a topic agent on enamel.
-Wong, #195

Anonymous said...

i learned that

Current paradigm
• Early intervention
• Risk assessment
• Antipatory guideace
• Individualized prevention
• DS Management

Jeffrey Kim (139)

Anonymous said...

Michelle Duong #123
The earlier dental tx starts for children, the more money they will save in the long run. There exists a correlation between ethnicity and level of income with the level of caries in children.

Anonymous said...

Although fluoridation of water and fluoride supplements are principally used to promote the oral health of children, excessive intake of fluoride may have detrimental effects—increasing the risk for developing fluorosis. Hence, it is paramount significance to appropriately adjust a child’s dosage of fluoride supplementation to his/her age AND body weight.
C.Chung #112

Anonymous said...

I found it useful that we were reminded to be aware of the water fluoridation content where ever we decide to practice so that we know how much supplemental fluoride to give our patients. Other good advice was that we encourage parents to get their kids in at a young age so they save more money in the long run on dental care.

Ryan Plewe
#168

Unknown said...

Preventive measures started early in child's life will reduce dental expenses in the future.
Caries is a continous and slowly progressing process which must be monitored on regular basis.
#100

Anonymous said...

Although caries rate is decreasing in the U.S, in other parts of the world, caries rate is actually increasing. I realize that caries prevention is actually a global issue. rita 109

Unknown said...

It’s important to concentrate on infant/child oral health care in order to prevent a child/infant caries epidemic.

-Carol Kim (138)

Unknown said...

Childhood caries is an epidemic that costs a ton of money for school districts. Fluoride has a significant impact on this issue, but there are still a number of factors that continue to contribute to the problem.

Chris Claus
113

Anonymous said...

A significant relationship exists between the age a child first sees a dentist and their cost of dental care. The earlier a child sees the dentist, the less their dental expenses will be as they grow older. There is also a direct correlation between income and caries rate, as children from lower income families experience higher caries rates.

Kevin Omoto #163

Unknown said...
This comment has been removed by the author.
Anonymous said...

The earlier the child starts to see the dentist, the lesser dental care she/he need in a future

Sonia Lee (145)

Anonymous said...

Marc Thomas #182

It is important to calibrate the amount of fluoride supplemented to children with the amount that is currently in their water supple. Otherwise there is a risk of fluorosis.

Lori said...

Pumice prophylaxis is not an essential prerequisite to topical fluoride application. Also, a pea sized amount of tooth paste should be used to prevent ingestion.

Anonymous said...

Before prescribe fluoride, we need to know 1)how much is the kid's weoght? 2)Is there F in the water ?
then we can decide how much doe we can giveto that kid.

Tiffany #529

Anonymous said...

Fluoride concentration as 1pp is recommended to maximize the caries-preventing benefit and prevent fluorosis. Fluoride in the water and weight of the child are useful in calculating how much more fluoride to supplement. Remind parents to bring infants in one or six month after first tooth eruption.
- Jing Lee#144

Anonymous said...

Studies have shown that we are least effective in treating untreated decay in the youngest children and that the earlier a child has their first appointment, the lower their overall dental costs.
Joanne Kim #140

Jake said...

Jake Cragun #117

The primary cause of Fluorosis is flouride supplements. Also, with around 1000 ppm of flouride in current toothpaste formulas, kids should be good at spitting the toothpaste out before they move to fluoridated toothpaste.

Anonymous said...

When comparing caries rate in children from low income families, although minority groups have the highest percentage of their kids with caries, whites actually have more kids with caries because they comprise the bigger population.
Sanam Soroudi #180

Anonymous said...

The important factors to consider when perscribing flouride to children is the weight of the child and the percentage of water flouridation in their community. The question that comes up is how do we determine how much of flouride the patient recieves from other sources such as tooth paste before we give them a perscription?
Bozhena Fisher #128

Anonymous said...

It's good to know that children should come to the dentist for the first time at 6-12 months of age or when the first tooth erupts
#154

Anonymous said...

Magic Minute:
Optimal level of fluoride in community water supply is 1ppm.If this level is less than 0.6 ppm,only then we should consider giving additional fluoride supplements to children and that too after 6 months of age.
Amandeep Iqbal
# 527

Anonymous said...

Water flourdation, community interventions, and use of flouride toothpaste are keys to prevention of caries.

Matthew Moadel #151

Anonymous said...

Low socio-economic groups are more likely to have tooth decay due to limited access to dental care.

Hoang #135

Austin said...

Caries in children remains a major oral health problem for minorities and socio-economically disadvantaged populations. The current preventive approach relies on individualized early intervention, risk assessment, anticipatory guidance that should incorporate environmental, cultural, and general health in addition to biologic factors.
Austin Tung 187

Anonymous said...

When managing pediatric patients, the focus should be on prevention rather than restorative. One of the most important prevention methods is fluoridation which can be accomplished via a variety of different methods.

Anonymous said...

When managing pediatric patients, the focus should be on prevention rather than restorative. One of the most important prevention methods is fluoridation which can be accomplished via a variety of different methods.

#176 Rick Shamo

Unknown said...

Natalie Nguyen #159:

There's a paradigm shift in pediatric care, with the current focus on early intervention, risk assessment, anticipatory guidance, individualized prevention and disease management.

Anonymous said...

Preventive pediatric dentistry at early ages is more cost effevtive and has better prognosis than restortive at later age.
Soheil Yashari #191

Anonymous said...

It is important to suction excess flouride during flouride treatment while teeth are still calcifying to reduce the risk of dental fluorosis.

Richard Duong #124

Anonymous said...

It is important to know how much flouride a child is exposed to in order to prevent fluorosis. This is accomplished by determining their weight and how much fluoride they are consuming in their water and toothpaste. Also, make sure that their physicians are not supplementing them with fluoride.

Shelton Chow 111

Anonymous said...

It is important to gather information regarding all possible sources of fluoride intake for a child before prescribing additional systemic fluoride tablets.

Diana Craft
115

Anonymous said...

Some important things i learned this week:
The earlier children visit a dentist for the first time, the better dental experience they wil have down the road. It gives the child a chance to get to know the dentist in a non-threatening (hopefully fun) environment. This is better than waiting until the child has rampant disease and finally meeting the dentist to have multiple extractions done.
Also, the earlier visits that focus on prevention will save parents money by eliminating the need for restorative procedures.
Raquel Ulma #188

Anonymous said...

Dissanayake #119

Magic Minute: Although within the same income strata, African-American and Latino children still have more decay than their Caucasian counterparts.

Unknown said...

Magic Minute:
Before prescribing any fluoride supplements, the dentist must know the following: weight of the child, if the dhild's drinking water is fluoridated and how much, and whether the child's physician has prescribed any fluoride supplements.
Stacy Yu #193

Unknown said...

Azadeh Ahmadi-Ardakani
student 101

The overall oral hygiene in children as years pass is actually getting worse. and when prescribing oral fluoride supplements we,as dentists must pay attention to each child patient's lifestyle and the location of residency and the amount of Fluride in water of the area so we don't expose them to fluorosis.

Unknown said...

Azadeh Ahmadi-Ardakani
student 101
Minute thoughts:
The oral hygiene of children is actually getting worse as years go by and within the past years. The fluoride supplements given by pediatric dentist should be determnined based on every patient/child's requirement and the status and the amount that is added in their area's water and lifestyle.

Unknown said...
This comment has been removed by the author.
Anonymous said...

The longer fl varnish stays on the tooth the better, so it is important to let parents know not to be alarmed if their child's tooth is discolored after tx. The discoloration is temporary and should not be removed.

Niki Zarabian #194

Anonymous said...

My magic minute: Ironically, in such an affluent country, the level of childhood poverty is increasing. That means that the number of children who lack access to dental care is also rising. That sucks.

J. Oka #162

Anonymous said...

Magic minute: in more recent times, dentistry has shifted from a surgical mentality of drill and fill, to a more preventive mentality in which fluoride plays a crucial role. It's uses and properties must therefore be understood by the dentist.

Robert Busan #107

Anonymous said...

In building a house of good hygiene. Minorities (children) should start with a foundation of fluoridated drinking water, greater access to dental care/observation, and diet control (limiting of carbs).

E. Lai #141

dangerous d said...

"An ounce of prevention equals a pound of cure" - Early preventive care reduces total dental costs independent of socioeconomic status. By implication, implementation of earlier dental care for low income children both decreases their oral disease and saves Dentical money. Also, early dental preventive care establishes good habits early that carry on to the permanent dentition.

Dan Nelson #157

Anonymous said...

Magic Minute:
The earlier children are given preventive treatment, the less the overall treatment cost will be. This early treatment includes Fl- which must be carefully calculated depending on age and location of residence.

Nick Quach #170

Anonymous said...

Lei Zeng, #535 said:

Don't use fluoride toothpaste when you brush your kids's teeth. They may swallow and cause flurosis. The concentration of fluoride in the toothpaste is over 1000 RPM.

Unknown said...

It was interesting to note that for the most part, it is dentists that are responsible for fluorosis. Therefore, we must take into account that there are other sources of fluoride such as water and toothpaste, that a child may be exposed to. So we must watch with how much we prescribe.

Anonymous said...

Because caries is so much more common in minority & low-income populations, we need to target these populations regarding the importance of fluoride use in helping to reduce overall caries rate. Also, we need to be careful to not overprescribe fluoride to prevent fluorosis. (But is a little flurosis all that bad when compared to the decay we see in many low-income kids?)
Sean Young #192

William said...

Magic Minute:

I was unaware that there are topical fluoride rinses, like ACT, available over-the-counter. My brother's family live in a place where the water is not fluoridated and they pay for prescription fluoride tablets for their children, yet they are very unhappy about the cost. Those rinses would be a better option.

William said...

Supplement to William's comment:

William Traynor
#186

Anonymous said...

A toothbrush propy for plaque removal on young patients may be more valuable than a slow-speed prophy because oral hygiene can be taught at the same time.

Emmy Le
#142

Anonymous said...

There is a cprrelation between the income and caries rate in kids. Also, it would be less expensive on the overall cost if the kid starts going to the dentist earlier. Always need to think about a kid possibility of ingestion of fluoride, that's why fluoride varnish can be preferred over the fluoride foam.

Alina Tiraspolskaya (#183)

Unknown said...

The importance of knowing the different sources of fluoride a person can have access to, specially earlier on in life, will be important in determining if fluorides can be beneficial or harmful.

Unknown said...

Jared Lee #143

I was very surprised to hear that racial and ethnic minority children have more decay when compared with white counterparts of similar economic circumstances

Anonymous said...

Dentists need to consider all forms of fluoride that a child receives- including prescriptions from another doctor.

Cynthia Morford #153

Anonymous said...

It is important to concentrate on prevention when it comes to childrens dental care. An important aspect of prevention in pediatric dentistry is making sure that children are supplied with an adequate amount of flouride. Steps must be taken to ensure the amount of flouride is neither too little or too much.

Anonymous said...

Jared Martin #147:

To my surprise, different ethnicities show varying rates of caries even in equal income brackets. Fluoride can be of great preventive worth, but must be given as a supplement only after carefully considering each patients curent exposure to Fluoride in their water and toothpaste.

Anonymous said...

I learned that we don't have to do the pumice before Fl tx. Also, how much childhood caries is coorelated with economic status.
Sanaz Hamzehpour 132