CLASSIFICATION AND DIFFERENCES BETWEEN SYSTEMIC AND TOPICAL FLOURIDES

PRESENTED BY: DR. TABISH ZIA KHATTAK

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OBJECTIVEAt the end of my presentation, my fellows would able to know about:• Systemic Fluorides• Topical Fluorides• Classification

&•Differences B/w them

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CONTENTS• Introduction• Definition• Classification of Systemic Fluorides• Classification of Topical fluorides• Differences• Summary• References

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INTRODUCTION

• Fluorine is member of halogen family and is the most electronegative and reactive of all the elements.• The compounds of fluorine are called FLUORIDE.• Its selective action on the hard tissues of the body

attributes significantly to prevention and control of dental carries.

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CLASSIFICATION

On the basis of delivery method fluorine is classified into two main categories.1. Systemic Fluorides2. Topical Fluorides

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SYSTEMIC FLUORIDES•Definition:-

“Systemic fluoride is a phrase used to describe fluoride that is ingested by mouth usually through a community's drinking water or supplements”.

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TOPICAL FLUORIDES•Definition:-

“The term Topical Fluorides is used to describe those delivery system which provide Fluorine for a local chemical reaction to the exposed surface of erupted dentition”.

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CLASSIFICATION OF SYSTEMIC FLUORIDESCommunity Water FluoridationSchool Water FluoridationSalt FluoridationMilk FluoridationFluoride Supplement

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COMMUNITY WATER FLUORIDATION

• The controlled addition of fluoride compounds to a water supply, in order to bring to its concentration up to an optimal, to prevent carries.• Level of F concentration depend on climate, ranges from

0.7 to 1.2 PPM• Water Fluoridation studies showed reduction of dental

carries in Children by 40% to 70% &

Root Carries in Adults 20% to 40%.9

HISTORYGrand Rapids, Michigan

In 1945, the first to have F added to water supply and after 15 years study , result were so impressive that other city joined.

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SCHOOL WATER FLUORIDATION

• It is suitable alternative where water fluoridation is not feasible.• The amount of fluoride added in school drinking

water should be greater than normal addition (about 4.5 times more FLUORIDE).• There has around 25% to 40% decrease in dental

carries.

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HISTORYThe procedure was first started in 1954 in Saint Thomas U.S Virgin Islands by US Public Health Service Division .

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SALT FLUORIDATION• Salt Fluoridation is the control addition of F

usually NaF or KF during the manufacture of salt for human consumption.• The reduction in dental carries was found to be

parallel to that found with Water Fluoridation.• The WHO found to Be appropriate for developing

countries.

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HISTORY

First Fluoride Salt was introduced by WESPI in Switzerland in 1948. It has been on sale in Switzerland in 1955.

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MILK FLUORIDATION

• Addition of a measured quantity of F to bottled or packaged milk to be drunk by children.• Fluoridated milk keeps a permanently low level of ionized F with in the oral cavity, promoting remineralization.• This topical mechanism contributes to the carries preventive effect of fluoridated milk.

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HISTORYIt was first introduced by Ziegler,

a Pediatrician, who started his first project of Fluoridated milk in Swiss City of Winterthur in 1953.

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FLUORIDE SUPPLEMENT

• Fluoride Supplements are available in different form such as Fluoride Tablets, Drops, Lozenges.• Mostly given to children.• More costly than water or other fluoridation

methods.

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CLASSIFICATION OF TOPICAL FLUORIDES• Professionally Applied:-

It was introduced by Bibby in 1942.Involve the use of high F concentration products

ranging from 5000 to 19,000ppm, equivalent to 5-19mg F/ml.

Sodium Fluoride, Stannous Fluoride, Acidulated Phosphate F.

• Self-Applied:-Include fluoride dentifrices, mouth rinses & gels.Are low fluoride concentration product ranging

from 200-1000ppm or 0.2-1mg F/ml.22

PROFESSIONALLY APPLIED:-

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SELF-APPLIED:-

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DIFFERENCES SYSTEMIC FLUORIDEApplied through

systemic route during development of dentition (pre-eruptively).

Usually lower concentrations of F are used.

Effect are there throughout the life.

It can lead to dental fluorosis.

Patient's co-operation and compliance are not required.

TOPICAL FLUORIDEApplied topically after

eruption of teeth (post-eruptively).

Normally high concentration of F is used.

Effect are seen only for shorter durations.

It does not lead to fluorosis.

Patient’s co-operation and compliance are absolutely necessary.

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DIFFERENCESRecommended in

general for whole population.

Cost effective and cheaper.

Self application (generally).

Fluoride is incorporated in the tooth structure during developing stage.

Recommended for special group and high-risk children.

Not cost effective and expensive.

Normally applied professionally. Some time patient can use themselves at home, e.g. dentifrices, mouth rinses.

Fluoride is lost after sometime. Hence required repeated application.

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SUMMARY• Fluorine Introduction• Systemic FluorideCommunity Water FluoridationSchool Water FluoridationSalt FluoridationMilk FluoridationFluoride Supplement• Topically FluorideSelf appliedProfessionally applied• Differences 2

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