PREVENTIVE DENTAL MATERIALS
Shan Lal, DDS
Pediatric Dentistry

Preventive Dental Materials
Tooth Paste
Mouth Washes
Fluorides
Sealants
Mouth guards

Tooth Paste
Components/composition
Colloidal binding agents - Na Alginate, methy cellulose
      Function: prevent separation of the components in the tube during storage.
Humectants (moistens or dilutes) - glycerin
      Function: reduces water loss by evaporation.
Preservatives - used to inhibit bacterial growth.
Flavoring agents

Tooth Paste
5. Abrasives - Ca carbonate, hydrated silica
    Ca pyrophosphate, Na bicarbonate
    Function: removal of plaque, stains, calculus.
6. Detergents - Na laurylsulphate
    Function: used to reduce surface tension and enhance the removal of debris from the tooth surface.
7. Therapeutic agents - Stannous Fl
    Function: increased uptake of Fl ion leading to increased resistance of Fluorapatite to acid demin

Mouth Washes
Active agent - anti-caries, antimicrobial
Solution - water, alcohol - preservative
Surfactant - Na laurylsulphate
 ph - 3.4 - 6.6
Ethanol 0-27%
carcinogenic effects
staining

Preventive Materials
Fluoride gels, foam and varnish:
Used for remineralisation of decalcified enamel and incipient caries.
Sealants:
Indicated for preventing and arresting incipient lesions.
Available as clear or white, filled or unfilled, containing Fluoride or not.

Fluorides
 Gels, Foams, Rinses, Varnishes
APF gel - 2% NaF, 0.34%HF, 0.98% Phos acid
4 min application is optimal
No eating or drinking for 1hr post application
Applied twice a year

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Question
   A 5 yr old pt lives in an area with .75   ppm flouride. What is the recommended Fl supplement in this case? NDB-87

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Fluoride Varnishes
5% NaF
Long History in Europe
Excellent Clinical Effectiveness
0.1% Difluorosilane
Durafluor, Omnifluor, etc.
Easy to Use: Paint THIN Layer on Dry Teeth
24 Hour Slight Yellowing

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Question
-  A child spends his first seven years in a community in a temperate zone, water supply contains 3 ppm flouride, mottling will develop in which teeth?  NDB’87

NDB  Excerpts
F inhibits glucosyltransferase. Strep mutans uses this to produce dextrans to attach to teeth.
 Fl prevents smooth surface caries NOT pit and fissure caries….Sealants prevent pit and fissure C.
Toxic flouride dose =5mg/kg.
Lethal dose=20mg/kg.
Antidote-milk and antacids containing calcium.

NDB  Excerpts
Flourides affect the tooth in the following manner-Chemically reacts with hydroxyapatite crystals to replace the hydroxyl ions,
Only effects the outer layers of enamel…makes the apatite crystals more resistant to acid,…Increases remineralization.
Total reduction of smooth surface caries by flouride –
    75-90%,   (systemic 30%, topical30%, occlusal sealants-30%).

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Glass Ionomer cements
Fluorosilicate glass powder(base) combined with a water soluble polymer(acid)
    e.g. - Ketac cement
Resin-modified glass ionomer cements:
   are glass ionomers  with a light polymerised resin component.
   e.g.- Vitrebond and Vitremer

Resin-modified glass ionomers
Advantages:
Increased mechanical properties
Physiochemically bonds to tooth structure
Biocompatible, moisture forgiving
Similar coefficient of thermal expansion as dentin therefore a good dentin replacement material. (sandwich technique)
Ion lechability - Fluoride release(anticariogenic action)
Minimal polymerization shrinkage

Mouthguards
Stock,  custom made
Technique - Place a polyvinyl polyethylene thermoplastic sheet  over the model on a vacuform. Trim to fit.

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Thank you !
Recommended reading…
“Craig”
Dental Decks