FLUORIDE VARNISH

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GUIDED BY : Dr. PRASHANT CHOUDHARY PREPARED BY : PATEL BRIJESH ROLL NO. 44 4 th YEAR BDS DEPARTMENT OF PEDODONTICS AND PREVENTIVE DENTISTRY

FLUORIDE VARNISH: 

FLUORIDE VARNISH

CONTENTS:: 

CONTENTS: Introduction Composition Factor affecting topical fluoride application Indication and contraindication Advantages and disadvantages Mechanism of action Application procedure Available varnish preparation

INTRODUCTION : 

INTRODUCTION Defination:(VARNISH) It is solution of one or more resins which when applied onto the surface, evaporates leaving a thin resin film, that serves as a barrier. (2-400um) Function: Reduce micro leakage Reduce passage of irritants Act as surface(electrical) insulator Release fluoride on tooth surface

COMPOSITION : 

COMPOSITION Fluoride varnish is composed of a high concentration of fluoride as a salt or silane preparation in a fast drying, alcohol and resin based solution. The concentration, form of fluoride, and dispensing method may vary depending on the manufacturer. While most fluoride varnishes contain 5% sodium fluoride at least one brand of fluoride varnish contains 1% difluorsilane in a polyurethane base . Bifluoride 12(2.71%NaF ,2.92%CaF 2 )

FACTOR AFFECTING TOPICAL FLUORIDE APPLICATION : 

FACTOR AFFECTING TOPICAL FLUORIDE APPLICATION TOOTH CONDITION FORMULATION OF AGENT APPLICATION PROCEDURE

1.TOOTH CONDITION : 

1.TOOTH CONDITION Tooth age Natural fluoride concentration Enamel defects Dentin/ Cementum Tooth surface

2.FORMULATION OF AGENT : 

2.FORMULATION OF AGENT Fluoride agent Ph Fluoride concentration Formulation components

3.APPLICATION PROCEDURE : 

3.APPLICATION PROCEDURE Pre-application prophylaxis Effect of time Temperature Number of application Enamel pre treatment (etching &polyvalent metal ions) Imprevious coating

INDICATION: 

INDICATION Use as a topical fluoride agent on moderate and high-risk patients , especially children 5 year and younger. Desensitizing agent for exposed root surfaces. Fluoridated cavity varnish . Fluoride treatment for institutionalized patients or in other situations where setting, equipment and patient management might preclude the use of other fluoride delivery methods.

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Caries prevention on exposed root surfaces . Fluoride application around orthodontic bands and brackets. Fluoride treatment on patients when there is a concern that a fluoride rinse, gel or foam might be swallowed. Those receiving radiation of head and neck. In pt wit reduce salivary flow due to medication.

CONTRAINDICATIONS: 

CONTRAINDICATIONS Areas with open cavities .(fluoride bomb) Patients that are at low-risk or are decay-free and live in an area where the water is fluoridated. Treatment of areas where discoloration after treatment may be an aesthetic concern .

ADVANTAGES: 

ADVANTAGES They are easily and quickly applied Fluoride varnishes are available in different flavours which can be advantageous when treating younger patients They do not have the bitter taste of some fluoride gels, but in some patients the taste of the varnish can cause nausea especially when consuming food within the 24 hours post treatment. They dry rapidly and will set even in the presence of saliva.

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Because they do not require the use of fluoride trays they are suitable for use in patients with a strong gag reflex. Due to the small amounts used and the rapid setting time there is only a small or negligible amount of fluoride ingested. Application requires very little equipment and so it can be applied in settings where a dental operatory is not available .

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It has a sticky consistency which helps it to adhere to the tooth’s surface thereby allowing the fluoride to stay in contact with the tooth for several hours. Based on published findings, professionally applied fluoride varnish does not appear to be a risk factor for dental fluorosis , even in children under the age of 6. This is due to the reduction in the amount of fluoride which may potentially be swallowed during the fluoride treatment because of the small quantities used and the adherence of the varnish to the teeth.

DISADVANTAGES : 

DISADVANTAGES Due to the colour and adherence of most fluoride varnishes they may cause a temporary change in the surface colour of teeth as well as some filling materials. As the varnish is worn away by eating and brushing the yellowish colour fades . Patient compliance is required.

MECHANISM OF ACTION : 

MECHANISM OF ACTION 10Ca 5 (PO 4 ) 3 OH + 6Ca 5 (PO 4 ) 3 F +2CaF 2 10F - + 6Ca 3 (PO 4 ) 2 +10OH - 2Ca 5 (PO 4 ) 3 OH + 2Ca 5 (PO 4 ) 3 F + CaF 2 Ca(OH) 2

APPLICATION PROCEDURE: 

APPLICATION PROCEDURE Although it is not necessary to do a professional prophylaxis prior to the application of a fluoride varnish, it is recommended that the teeth be cleaned with a toothbrush. Wiping with a cotton gauze is adequate in cases where there is no heavy plaque or debris. The teeth should be lightly dried with air or a cotton gauze. The varnish will adhere even if the teeth are moist. Isolate the teeth to prevent recontamination with saliva (not by cotton roll) A small amount of varnish ( eg . 0.5ml) is dispensed. The entire dentition may be treated with as little as 0.3-0.6 ml. (1 st paint on lower arch)

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A small brush or applicator is then used to apply the varnish The varnish will set on contact with the slightly moist teeth. As a result of the time needed for frequent reloading of the brush/applicator, Hodgson (2005) has suggested an alternative technique utilizing a 5 ml plastic syringe . This method allows a more efficient application of the varnish which can be particularly useful in cases where speed is important , such as with a difficult pediatric patient. In order to be effective in decay prevention the varnish should be reapplied at least twice yearly.

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INSTRUCT THE PATIENT: Not rinse or drink anything at all for that day. Not to eat solid for that day. Take a liquid and semisolid till next morning. Not to brush that day.

WHY FLUORIDE IS USE AS CARIES PREVENTION?: 

WHY FLUORIDE IS USE AS CARIES PREVENTION? It inhibit plaque formation Inhibit bacterial growth Facilate remineralization process Form a large and acid resistant crystal

WHY GIVEN SEMIANNUALLY?: 

WHY GIVEN SEMIANNUALLY? To increase the fluoride content in enamel to as high as possible in a short time. Prevent the formation of CaF and other fluoride precipitates that are more soluble.

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10Ca 5 (PO 4 ) 3 OH + 6Ca 5 (PO 4 ) 3 F + 2CaF 2 10F - + 6Ca 3 (PO 4 ) 2 +10OH - 2Ca 5 (PO 4 ) 3 OH + 2Ca 5 (PO 4 ) 3 F + CaF 2 Ca(OH) 2

AVAILABLE VARNISH PREPARATION : 

AVAILABLE VARNISH PREPARATION Duraphat: First fluoride varnish developed in Germany. Contain 22,600 ppm fluoride as NaF in a neutral colophonium base 30% -40% caries reduction in permanent dentition 7% - 44% caries reduction in primary dentition Carex : Another fluoride varnish that contains a lower fluoride concentration than Duraphat(1.8%F). Efficacy equivalent to duraphat. Fluoritop (INDIA)

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Fluorprotector: Clear polyurethane base product containing 7000 ppm fluoride from an organic compound,difluorosilane .(silane F with 0.7%F in a polyurethane base). It contain polyurethane lacquer dissolved in chloroform and difluorosilane at a conc. Of 2% by weight ,equivalent to o.32% fluoride in the liquid. It is dispensed in 1 ml ampule(6.21mg F)

REFERENCE: 

REFERENCE Textbook of Pedodontics by Shobha Tandon 2 nd edition ch.26:fluorides (pg no.:279-284) Textbook of Preventive and Community Dentistry by Soben Peter 4 th Edition ch.11 Fluorides in Preventive Dentistry(pg no.:255-256) Textbook of Dental Material by Manappallil 2 nd Edition Ch no.14 liners and varnish(pg no.:264) Fluoride varnish Wikipedia(internet)

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THANK YOU