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• Probable Toxic dose (PTD) based on weight<br />
• 5mg F/kg of body weight<br />
• if less than PTD consumed, give Ca, Al, Mg products in office<br />
• over PTD - same as above plus hospital observation<br />
• over 15mg F/kg - same as above, but call 911<br />
• Signs and symptoms<br />
• Nausea, vomiting, diarrhea, abdominal cramps<br />
• Increased salivation, dehydration<br />
• Treatment<br />
• time is everything, blood levels reach max 30 to 60 min from ingestion<br />
• Milk and eggs or other Ca, Mg, Al<br />
• binds Fl<br />
• Coats membranes of GI preventing burns<br />
• Fluids also help to dissolve<br />
• Do not induce vomiting, but patient will often vomit anyway<br />
Application<br />
• Ribbon into tray - DO NOT OVERFILL (may ingest)<br />
• Pt - upright; dry teeth<br />
• place tray then saliva ejector<br />
• instruct pt to chew slightly<br />
• 4 minute application regardless of which used<br />
• do not leave unattended<br />
• After: expectorate excess Fl, no eat or drink for 30 minutes<br />
Fluoride Varnish<br />
• 5% NaF (26,000ppm)<br />
• FDA: use for dentin hypersensitivity, not reducing caries (ADA does endorse this)<br />
• Can by applied every 6 months to prevent caries in high risk population<br />
• Application<br />
• apply thin layer (.5 mm)<br />
• Post op - forego brushing soft diet that evening<br />
• may discolor teeth and restorations, but not permanent<br />
Fluoride prophy paste: does not replace fluoride application<br />
• prophy removes about .1-1.0 micron of Fl-rich enamel<br />
• At best, Fl in prophy replaces what it removed<br />
• not approved as a Fl treatment<br />
Fl in Dentifrice (toothpaste)<br />
• 1000ppm<br />
• NaF with compatible abrasive is most effective<br />
• Fluorosis/toxicity risk if swallowed
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