Fluoride Treatment / Therapy

Fluoride therapy is the delivery of fluoride to the teeth topically or systemically in order to prevent tooth decay (dental caries) which results in cavities. Most commonly, fluoride is applied topically to the teeth using gels, varnishes, toothpaste/dentifrices or mouth rinse. Systemic delivery involves fluoride supplementation using water, salt, tablets or drops which are swallowed. Tablets or drops are rarely used where public water supplies are fluoridated.

Indications for fluoride therapy

The individual's risk factors and the reason for treatment will determine which method of fluoride delivery is used. Consult with a dentist before starting any treatment.
1) White spots
2) Moderate to high risk patients for developing decay
3) Active decay
4) Orthodontic treatment
5) Additional protection if necessary for children in areas without fluoridated drinking water
6) To reduce tooth sensitivity
7) Protect root surface
8) Decreased salivary flow

Toothpaste

Most toothpaste today contains between 0.22 percent (1000 ppm) and 0.312 percent (1450 ppm) fluoride, usually in the form of sodium fluoride or sodium monofluorophosphate (MFP); 100 g of toothpaste containing 0.76 g MFP equates to 0.1 g fluoride. Prescription strength fluoride toothpaste generally contains 1.1% (5,000 ppm) sodium fluoride toothpaste. This type of toothpaste is used in the same manner as regular toothpaste. It is well established that 1.1% sodium fluoride is safe and effective as a prevention of cavities. This prescription dental cream is used up to three times daily in place of regular toothpaste.

Mouth rinses

The most common fluoride compound used in mouth rinse is sodium fluoride. Over-the-counter solutions of 0.05% sodium fluoride (225 ppm fluoride) for daily rinsing are available for use. Fluoride at this concentration is not strong enough for people at high risk for cavities.

Prescription mouth rinses are more effective for those at high risk for caries, but are usually contraindicated for children, especially in areas with fluoridated drinking water. However, in areas without fluoridated drinking water, these rinses are sometimes prescribed for children.

Gels/foams

Gels and foams are used for individuals who are at high risk for caries, orthodontic patients, patients undergoing head and neck radiation, patients with decreased salivary flow, and children whose permanent molars should, but cannot, be sealed. The gel or foam is applied through the use of a mouth tray, which contains the product. The tray is held in the mouth by biting. Application generally takes about four minutes, and patients should not rinse, eat, smoke, or drink for at least 30 minutes after application. Some gels are made for home application, and are used in a manner similar to toothpaste. The concentration of fluoride in these gels is much lower than in professional products. An imprint of a person's teeth can be made by a dentist, who then uses that to make well fitting trays to put over their teeth. The patient can then use this to hold a fluoride treatment against their teeth overnight.

Varnish

Fluoride varnish has practical advantages over gels in ease of application, a non-offensive taste, and use of smaller amounts of fluoride than required for gel applications. Varnish is intended for the same group of patients as the gels and foams. There is also no published evidence as of yet that indicates that professionally applied fluoride varnish is a risk factor for enamel Fluorosis. The varnish is applied with a brush and sets within seconds. Topical application of fluoride has shown better result than systemic fluoride application to a greater extent.