Fluoride Guide - IneedCE.com

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Online Completion Use this page to review the questions and answers. Return to www.ineedce.com and sign in. If you have not previously purchased the program select it from the “Online Courses” listing and complete the online purchase. Once purchased the exam will be added to your Archives page where a Take Exam link will be provided. Click on the “Take Exam” link, complete all the program questions and submit your answers. An immediate grade report will be provided and upon receiving a passing grade your “Verification Form” will be provided immediately for viewing and/or printing. Verification Forms can be viewed and/or printed anytime in the future by returning to the site, sign in and return to your Archives Page. Questions 1. Fluoride has been used in the United States as an anti-caries agent since the ________. a. 1930s b. 1940s c. 1950s d. none of the above 2. _________ an intentional source of systemic fluoride. a. Fluoridated water is b. Fluoride supplements are c. Fluoridated salt is d. all of the above 3. The use of fluoride supplements by pregnant women _________. a. results in no benefit for the baby b. results in a moderate benefit for the baby c. results in a moderate benefit for the mother and the baby d. results in a great benefit for the baby and a moderate benefit for the mother 4. The Centers for Disease Control and Prevention (CDC) suggests that fluoride supplements be given to children living in areas with _________. a. suboptimal water fluoridation who are at low risk of caries b. suboptimal water fluoridation who are at moderate risk of caries c. suboptimal water fluoridation who are at high risk of caries d. all of the above 5. Current recommendations are to start fluoride supplements, if required, at _________. a. birth b. 3 months c. 6 months d. 12 months 6. The recommended fluoride supplement dose for a child age 6-16 years living in an area with 0.3 ppm – 0.6 ppm fluoride in the water is _________. a. 0.25 mg per day b. 0.5 mg per day c. 0.75 mg per day d. 1 mg per day 7. During tooth development, the cumulative ingestion of fluoride prior to pre-eruptive enamel maturation results in ________. a. fluoride ions replacing hydroxyl ions b. iodide ions replacing hydroxyl ions c. the formation of fluorapatite crystals d. a and c 8. Pre-eruptively, formed enamel is bathed in plasma that contains fluoride and contributes to the _________. a. outer fluoride-rich layer b. inner fluoride-rich layer c. inner and outer fluoride-rich layers d. none of the above 9. Fluorapatite crystals formed during tooth development are _________. a. smaller than hydroxyapatite crystals b. stronger than hydroxyapatite crystals c. more resistant to demineralization associated with the dental caries process d. all of the above 10. Systemic fluoride use during tooth development results in a concentration of fluoride of _________ in the outer layer of the enamel. a. 250 – 500 ppm b. 500 – 1,000 ppm c. 1,000 – 2,000 ppm d. none of the above 11. Inadvertent ingestion of excessive amounts of fluoride during enamel development, from all sources combined, can result in fluorosis and is dependent on ________. a. the dose of excessive fluoride b. the age of the child when excessive fluoride ingestion occurred c. the duration of excessive fluoride ingestion d. all of the above 12. Topical fluorides available in the United States include ________. a. sodium fluoride and sodium monofluorophosphate b. acidulated phosphate fluoride c. stannous fluoride d. all of the above 13. Topical fluorides act intra-orally by ________. a. providing periodic high doses of fluoride (in-office) b. providing low regular doses of fluoride (home-use) c. providing low periodic doses of fluoride (in-office) d. a and b 14. During acid attacks, subsurface dissolution occurs at ________. a. pH 1.8 - 2.8 b. pH 2.8 - 3.8 c. pH 3.8 - 4.8 d. pH 4.8 - 5.8 15. The intra-oral pH rebounds approximately________ after an acid attack. a. 15 minutes b. 30 minutes c. 45 minutes d. 60 minutes 16. Disease progression is more rapid in dentin than in enamel due to ________. a. the presence of tubules b. the presence of pulpal tissue c. the degradation of collagen fibrils d. all of the above 17. The application of high concentrations of topical fluoride results in the formation of ________ at the tooth surface. a. acid-soluble calcium phosphate-like globules b. alkali-soluble calcium phosphate-like globules c. acid-soluble calcium fluoride-like globules d. alkali-soluble calcium fluoride-like globules 18. Topical fluoride is believed to inhibit caries activity through _________. a. bacterial inhibition b. inhibition of demineralization c. promotion of remineralization d. all of the above 19. Topical fluorides result in the retention of fluoride _________. a. on the tooth surface b. in saliva and dental plaque c. on intra-oral soft tissues d. all of the above 20. Inhibition of the enzyme _________ impacts the ability of bacteria to metabolize fermentable carbohydrates. a. amelase b. enolase c. dentolase d. none of the above 21. Most of the topical effect of fluoride is due to _________. a. the presence of available fluoride b. the influence of fluoride uptake during in-office fluoride therapy c. the influence of fluoride uptake during home-use fluoride therapy d. all of the above 22. Omitting plaque removal with a professional prophylaxis prior to the use of in-office topical fluorides has been found to _________. a. result in no calcium fluoride-like globules being formed at the tooth surface b. increase fluoride retention and the efficacy of fluoride therapy c. decrease the efficacy of fluoride therapy d. a and c 23. Available in-office topical fluorides range from _________. a. 2,500 ppm – 20,000 ppm fluoride b. 3,300 ppm – 21,600 ppm fluoride c. 3,300 ppm – 22,600 ppm fluoride d. 9,500 ppm – 22,600 ppm fluoride 24. The vast majority of clinical trials, evidence-based studies and the major use worldwide of fluoride varnish are as an in-office topical fluoride for _________. a. the prevention of dental caries b. the relief of hypersensitivity c. cavity linings d. none of the above 25. Five percent sodium fluoride varnish has been found to be effective in reducing caries in _________. a. the primary dentition b. the permanent dentition c. patients with root caries d. all of the above 26. Clinicians have found the use of fluoride varnish unit doses _________. a. simplifies application b. results in the use of a defined amount of varnish c. reduces any risk of cross-contamination d. all of the above 22 www.ineedce.com
Questions (continued) 27. One meta-analysis by Marinho et al. found an overall caries reduction in the primary dentition of _________ and _________ in the permanent dentition. a. 23%; 26% b. 28%; 36% c. 33%; 46% d. 38%; 56% 28. Acidulated phosphate fluoride (APF) gels and foams contain _________ ppm fluoride,and neutral sodium fluoride gels contain approximately _________ ppm fluoride. a. 9,000; 12,300 b. 9,000; 22,600 c. 12,300; 9,000 d. 12,300; 22,600 29. In a meta-analysis of fluoride gels, a caries reduction average of _________ was found across 14 placebo-controlled studies. a. 15% b. 21% c. 25% d. 31% 30. The ADA recommends the use of _________. a. one-minute gels b. four-minute gels c. fluoride varnish d. b and c 31. In addition to the ADA recommendations for professional fluorides, _________ contributes to the selection of in-office and home-use fluorides. a. professional judgment b. product efficacy and safety c. other considerations d. all of the above 32. A patient 6 years of age or older with one/two incipient/cavitated lesions in the previous 3 years and/or at least one risk factor would be defined as _________. a. low risk b. moderate risk c. high risk d. none of the above 33. _________ is a protective factor against caries. a. Use of xylitol b. Use of antimicrobials c. Optimal fluoride exposure d. all of the above 34. Alcohol-containing rinses _________. a. can result in irritation in some patients b. can result in a drying sensation in patients with xerostomia c. should not be used by alcoholics d. all of the above 35. It is recommended to commence use of a fluoride dentifrice in children at _________. a. 6 months of age b. 1 year of age c. 18 months of age d. 2 years of age 36. In one meta-analysis of 70 dentifrice trials conducted in children age 16 and under, an average reduction of _________ in DMFS was found. a. 19% b. 24% c. 29% d. 34% 37. One study of 5,000 ppm fluoride prescription paste/gel found a _________ of root caries. a. 37% remineralization b. 47% remineralization c. 57% remineralization d. none of the above 38. A 24-hour study by _________ et al. found that nighttime fluoride use resulted in extended fluoride retention in whole saliva. a. Hero b. Nero c. Pero d. Zero 39. In a study by Driscoll et al., a caries reduction of up to _________was demonstrated in schoolchildren rinsing once weekly at school during a 30-month period with 0.2% sodium fluoride. a. 35% b. 45% c. 55% d. 65% 40. A study on the arrestment of smoothsurface carious lesions in 11 – 15-year olds, with use of 0.05% sodium fluoride rinse once daily, found an arrestment rate of _________. a. 74.4% b. 78.4% c. 84.4% d. 88.4% 41. Sodium fluoride rinses are available at 0.02% concentrations in the United States and Canada, and these rinses _________. a. should be used twice daily given the lower concentration of fluoride b. have published clinical trials c. as with 0.05% fluoride rinse, are recommended for use in children age 6 and over d. a and c 42. A study on daily use of 0.05% sodium fluoride rinse in older adults found a root caries reduction of up to _________. a. 51% b. 61% c. 71% d. 81% 43. A study on daily use of 0.05% sodium fluoride rinse in children found a coronal caries reduction of up to _________. a. 30% b. 35% c. 40% d. 45% 44. A study on daily use of 0.044% acidulated phosphate fluoride rinse in orthodontic patients found a _________ reduction in the development of white spots. a. 38% b. 48% c. 58% d. 68% 45. The presence of moderate amounts of biofilm _________. a. deters fluoride from reaching the tooth surface b. repels fluoride from the biofilm c. increases the retention of intra-oral fluoride d. none of the above 46. Post-brushing rinsing _________. a. reduces the level of intra-oral bioavailable fluoride b. removes fluoride that was just delivered by the dentifrice c. is standard practice for most patients d. all of the above 47. Increasing the flow rate of fluoride rinse has been suggested as a possible mechanism to _________. a. increase the amount of fluoride penetrating biofilm b. increase the amount of fluoride penetrating the teeth c. decrease the amount of fluoride ingested d. all of the above 48. Adjunctive use of fluoride rinses has been advocated for _________ patients, together with routine oral hygiene procedures, to increase the amount of available fluoride and increase protection against caries. a. low risk b. moderate risk c. high risk d. b and c 49. Successful fluoride preventive interventions include the use of_________. a. fluoridated water and fluoride dentifrices b. professional topical fluorides c. home use over-the-counter rinses, prescription pastes, gel and rinses d. all of the above 50. _________must be considered when determining the appropriate combination of preventives. a. The individual patient’s risk level and age b. A product’s efficacy and clinical support c. A product’s safety d. all of the above www.ineedce.com 23
Page 1 and 2: Fluoride Guide Earn 3 CE credits Th
Page 3 and 4: Educational Objectives The overall
Page 5 and 6: Fluoride-enriched salt Fluoridated
Page 7 and 8: Topical fluorides Topical fluorides
Page 9 and 10: acid attacks occur, the globules st
Page 11 and 12: The American Dental Association rec
Page 13 and 14: Risk levels and ADA recommendations
Page 15 and 16: Considerations for in-office and ho
Page 17 and 18: fluoridated and non-fluoridated are
Page 19 and 20: 0.05% sodium fluoride mouth rinse a
Page 21 and 22: just delivered by the dentifrice an
Page 23: increment in primary teeth: 24-mont

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