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Clinical Application of Topical Fluoride Products- Risks, Benefits, and Recommendations

University of Florida, College of Dentistry, Department of Orthodontics, J. Hillis Miller Health Center, Gainesville, Florida 32610

This portion of the symposium discusses the various methods of professionally applying high-concentration topical fluoride products and their risks and benefits. Numerous recent investigations in this area of research are reviewed and discussed. Data from these research investigations point to the need for care when high-potency F products are used, especially in young children. Oral-retained F doses following four-minute topical application procedures ranged from 10 to 31 mg when no suction devices or patient expectoration was utilized. Following the use of suctioning devices, oral-retained F doses ranged from 6 to 12 mg, a clinically unacceptable level. Following the use of suctioning devices plus patient expectoration, the oral-retained F doses were reduced to from 2 to 7.5 mg, depending on type of F product and application system.

The following recommendations for topical application of high-potency F products are made:

(I) No more than 2 g of gel per tray or approximately 40% of tray capacity should be dispensed. Even more conservative amounts should be considered for small children.

(2) Because patients may have the need to swallow during a four-minute topical application procedure, the use of a saliva ejector during the procedure is recommended.

(3) Following the four-minute application procedure, the patient should be instructed to expectorate thoroughly for from 30 sec to one min, regardless of whether high-speed suction is utilized. Expectoration is probably the single most effective way of reducing orally retained fluoride.

(4) When utilizing custom individually fitted trays for patients requiring daily or weekly application of a high-F-concentration product, utilize only 5 to 10 drops of product per tray.

REFERENCES

• Allison, N.B.; Pashley, D.H.; Whitford, G.M.; and McKinney, R.V. (1982): Rate of Recovery of Rat Gastric Mucosa Following Single Fluoride Dosing, IADR Progr & Abst 61: No. 1016.
• Angmar-Mansson, B.; Ericsson, Y.; and Ekberg. D. (1976): Plasma Fluoride and Enamel Fluorosis, Calcif Tissue Res 22:48-77.
• Ångmar-Månsson, B. and Whitford, G.M. (1981): Plasma Fluoride and Enamel Fluorosis in the Rat, Caries Res 15:194.
• Ångmar-Månsson, B. and Whitford, G.M. (1983): Single Fluoride Doses and Enamel Fluorosis in the Rat, Caries Res 17:172.
• Doyle, T.E. and LeCompte, E.J. (1982): Amounts of Fluoride Dispensed by Operators Using Various Tray Techniques. IADR Progr & Abst 61: No. 1284.
• Easmann. R.P. Allison, N.B.; Pashley, D.H.; Whitford, G.M.; and McKinney, R.V. (1981): Histologic and Scanning Study of Gastric Mucosa Following Fluoride Application, IADR Progr & Abst 60: No. 769.
• Easmann, R.P.; Pashley. D.H.; and McKinney, R.V. (1982): Histology of Early Gastric Mucosal Reaction to Fluoride Containing Compounds, IADR Progr & Abst 61: No. 1015.
• Eisen. J. and LeCompte, E.J. (19851: A Comparison of Oral Fluoride Retention Following Topical Treatments with APF Gels of Varying Viscosities. Pediatric Dent 7:175-179.
• Ekstrand, J.; Ehrnebø, M.; and Boreus, L. (1978): Fluoride Bio-availability After Intravenous and Oral Administration, Clin Pharmacol Ther 23:329-337.[Medline] [Order article via Infotrieve]
• Ekstrand, J.; Koch, G.; Lindgren. L.E.; and Peterson, L.G. (1981): Pharmacokinetics of Fluoride Gels in Children and Adults, Caries Res 15:213-220.[Medline] [Order article via Infotrieve]
• Ekstrand, J. and Koch, G. (1980): Systemic Fluoride Absorption Following Fluoride Gel Application, J Dent Res 59:1067.[Free Full Text]
• Englander. H.R.; Keyes, P.H.; Gestwicki. M.; and Sultz, H.A. (1967): Clinical Anticaries Effect of Repeated Topical Sodium Fluoride Applications by Mouthpieces, J Am Dent Assoc 75:638-644.[Medline] [Order article via Infotrieve]
• Hagan, P.P.; Rozier, R.G.; and Bawden, J.W. (1985): The Caries Preventive Effects of Full- and Half-strength Topical Acidulated Phosphate Fluoride, Pediatric Dent 7:185-191.
• LeCompte, E.J. and Doyle T.E. ( 1982): Oral Fluoride Retention Following Various Topical Application Techniques in Children, J Dent Res 61:1397-1400.[Abstract/Free Full Text]
• LeCompte. E.J. and Doyle, T.E. (1985): The Effects of Suctioning Devices on Oral Fluoride Retention, J Am Dent Assoc 10:357-360.
• LeCompte. E.J. and Whitford, G.M. (1982): Pharmacokinetics of Fluoride from APF Gel and Fluoride Tablets in Children. J Dent Res 61:469-472.[Abstract/Free Full Text]
• LeCompte. E.J. and Whitford, G.M. (1981): The Biologic Availability of Fluoride from Alginate Impressions and APF Gel Application in Children, J Dent Res 60:776-780.[Abstract/Free Full Text]
• More, F.; Grimaldo, J.; Corpron. R.; and Loesche, W. (1983): Ingestion of Fluoride During a Topical Application, AADR Progr & Abst 62: No. 837.
• Owen, D.; Morris, M.; Adir, J.; and Bakker, U. (1979): Monitoring Ingestion and Urinary Excretion of Topical Fluoride, IADR Progr & Abst 58: No. 1256.
• Whitford. G.M.; Allmann. D.W.; and Shahed. A.R. (1987): Topical Fluorides: Effects on Physiologic and Biochemical Processes, J Dent Res 66:1072-1078.[Abstract/Free Full Text]

Journal of Dental Research, Vol. 66, No. 5, 1066-1071 (1987)
DOI: 10.1177/00220345870660051701


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