Fluorides
Kelas obat: Agen Antineoplastik
Panganggone Fluorides
Nyegah Karies Gigi
Digunakake kanthi lisan utawa topikal kanggo nyegah utawa nyuda kedadeyan karies dental lan kemajuan alon utawa mbalikke lesi dental sing ana.
Efek saka fluoride biasane posteruptive; njaga jumlah fluoride cilik sing konsisten ing saliva lan plak dental. (Deleng Tindakan.)
Digunakake minangka suplemen diet kanggo nyegah karies dental ing bocah-bocah ing wilayah sing konsentrasi ion fluorida ing banyu ngombe kurang optimal. Nalika American Dental Association (ADA), American Academy of Pediatric Dentistry (AAPD), lan CDC nyaranake nimbang suplemen diet fluoride mung kanggo bocah-bocah ing wilayah sing duwe risiko dhuwur kanggo karies dental, AAP nyatakake yen digunakake ing bocah-bocah sing duwe risiko luwih murah. uga bisa dianggep. Sumber paparan fluoride liyane saka sumber ngombe utama uga kudu dianggep.
CDC nyaranake supaya wong diwasa lan bocah-bocah kanthi resiko kurang kanggo karies dental ngombe banyu fluoridasi sing cukup lan nggunakake dentifrice fluoridated kaping pindho saben dina. Wong sing duwe risiko luwih dhuwur kanggo karies dental mbutuhake paparan tambahan fluoride (contone, mbilas tutuk, suplemen diet, preparat sing ditrapake dening personel dental).
Kanggo keuntungan antikaries tambahan ing wong diwasa lan pasien pediatrik ≥6 taun. , gel perawatan fluoride utawa solusi mbilas bisa digunakake: natrium fluorida 1,1% gel (ngandhut 0,5% ion fluoride); natrium fluorida 0,02, 0,05, utawa 0,2% larutan mbilas (sing ngemot 0,009, 0,02, utawa 0,09% ion fluoride); gel fluoride fosfat acidulated utawa mbilas lisan (sing ngemot 0,5 utawa 0,02% ion fluoride); lan stannous fluoride 0,4% gel utawa 0,63% solusi rinsing (diencerke lan digunakake minangka solusi 0,1%).
Sodium fluoride 2% gel, umpluk, utawa larutan mbilas lisan kanthi profesional (ngandhut ion fluoride 0,9%); sodium fluoride 5% varnish† [off-label] (ngandhut 2,26% ion fluoride); utawa gel utawa umpluk fluorida fosfat acidulated (ngandhut 1,23% ion fluoride) uga digunakake kanggo keuntungan antikaries tambahan. Ing pasien kanthi risiko tambah karies, para ahli nyaranake aplikasi fluorida topikal dening personel dental paling sethithik saben 3-6 sasi.
Kanggo wong diwasa, remaja, lan bocah-bocah ≥6 taun kanthi risiko tambah karies dental, ADA nyaranake fluorida topikal kanthi resep-resep ing ngisor iki: aplikasi varnis profesional sing ngemot ion fluorida 2,26% utawa asam. gel fosfat fluoride ngemot 1,23% ion fluoride paling sethithik saben 3-6 sasi utawa ing omah nggunakake gel kekuatan resep utawa tempel sing ngemot 0,5% ion fluoride kaping pindho saben dina utawa solusi bilas sing ngemot 0,09% ion fluoride paling sethithik saben minggu (utawa saben dina kanggo nyegah karies akar ing wong diwasa). Kanggo bocah sing beresiko <6 taun, varnish fluoride 2,26% dianjurake.
AAP lan US Preventive Services Task Force (USPSTF) nyaranake varnish fluoride ing setelan perawatan utama kanggo kabeh bayi lan bocah cilik wiwit erupsi untu lan terus nganti perawatan dental ditetepake. Sanajan ahli dental nyaranake mbatesi panggunaan varnish fluoride kanggo bocah-bocah kanthi risiko tambah karies, USPSTF nyatakake yen alat kanggo netepake risiko karies durung divalidasi ing setelan perawatan primer lan ora dingerteni manawa nggunakake alat kasebut dening dokter perawatan primer bakal akurat. lan terus-terusan ngenali bocah-bocah sing bakal ngalami karies gigi.
Kanggo bocah-bocah kanthi resiko kurang kanggo karies gigi, AAP nyaranake nggunakake dentifrice fluoridated lan varnish fluoride (ditrapake sacara profesional saben 3-6 sasi) wiwit erupsi untu; yen sumber banyu ora fluoridated, netepke kabeh sumber fluoride potensial lan nimbang tambahan dietary fluoride. Kanggo bocah-bocah sing beresiko dhuwur kanggo karies dental, AAP nyaranake nggunakake mbilas tutuk tanpa resep sing ngemot fluoride wiwit umur 6 taun (yen bocah bisa andal swish lan expectorate mbilas) bebarengan karo rekomendasi sing digawe kanggo bocah-bocah berisiko rendah.
Faktor risiko karies gigi kalebu status sosial ekonomi sing kurang utawa tingkat pendhidhikan wong tuwa sing kurang, kurang perawatan gigi sing rutin, kurang asuransi dental utawa akses menyang layanan dental, insiden karies gigi sing dhuwur ing sedulur tuwa utawa pengasuh, akar. lumahing sing kapapar dening resesi gingiva, tingkat dhuwur saka infèksi karo bakteri kariogenik, gangguan kemampuan kanggo njaga kebersihan lisan, lapisan untu kang atos utawa dentin malformed, suda aliran salivary (saka obat-obatan, radiation, utawa penyakit), kurang kapasitas buffering salivary, lan nyandhang papan maintainers, piranti ortodontik, utawa prostesis dental, utamane yen digabungake karo konsumsi karbohidrat olahan sing kerep.
Fluoridasi pasokan banyu umum minangka cara paling efektif kanggo nyedhiyakake tingkat fluoride sing optimal kanggo bagean gedhe saka populasi. Bukti sing apik ndhukung fluoridasi pasokan banyu umum kanggo nyegah lan ngontrol karies gigi. Layanan Kesehatan Umum AS (PHS) nyaranake konsentrasi fluorida optimal 0,7 ppm (mg/L) ing sumber banyu umum kanggo menehi perlindungan saka karies dental nalika mbatesi risiko fluorosis dental.
Ing komunitas sing konsentrasi fluoride ing sumber banyu punika> 2 ppm, nggunakake sumber alternatif banyu ngombe kanggo anak ≤8 taun.
Amarga konsumsi omben-omben sing kasedhiya kanthi komersial (kalebu banyu botol) ing AS lan Kanada ngganti konsumsi banyu tap utawa sumur, pentinge fluoridasi banyu komunitas lokal ing asupan fluoride bisa uga kena pengaruh. Nanging, rekomendasi saiki kanggo suplemen fluoride ing bocah-bocah terus adhedhasar konsentrasi fluoride ing banyu ngombe lokal.
ADA, AAPD, lan AAP nyaranake yen ing wilayah sing mbutuhake suplemen fluoride oral, bocah-bocah umur 6 sasi nganti 16 taun nampa suplemen fluoride saben dina kanggo menehi manfaat maksimal kanggo untu sulung lan permanen.
Efikasi fluorida sing ditrapake sacara topikal beda-beda gumantung saka konsentrasi ion fluorida ing persiapan, cara lan frekuensi aplikasi, lan suwene panggunaan.
Fluorida topikal (contone, gel, mbilas tutuk, varnish) digunakake kanggo nyegah tahap awal karies dental (yaiku, lesi putih decalcified) watara piranti orthodontic tetep; dentifrice fluoridated piyambak ora cukup ing akeh patients orthodontic. Pasinaon tambahan dibutuhake kanggo nemtokake cara optimal kanggo ngirim fluoride topikal kanggo pasien ortodontik; data winates nuduhake yen varnish fluoride bisa nyuda resiko lesi putih decalcified.
Gel fluoride fosfat asam (piyambak utawa ing kombinasi karo substitusi saliva) wis digunakake kanggo ngontrol bosok dental sawise xerostomia-producing radiation therapy. tumor ing sirah lan gulu.
Gel fluoride stannous wis digunakake kanggo nglindhungi saka karies postirradiation.
Desensitizing Dentin
Digunakake topikal kanggo desensitize lumahing ROOT kapapar untu.
Hipersensitivitas bisa disebabake dening paparan dentin lan gerakan cairan liwat tubulus dentin sing mbukak, sing ngaktifake serat saraf ing pulp. Perawatan bisa uga kalebu terapi sing nyumbang kanggo oklusi tubulus sing mbukak (contone, fluoride, oxalates, sealant utawa agen ikatan, terapi laser) lan / utawa nyandhet transmisi saraf (contone, kalium nitrat).
Terapi fluoride bisa uga kalebu nggunakake dentifrices fluoride lan gel fluoride utawa bilas ditambah kaya sing dibutuhake karo pernis fluoride, gel, utawa bilas kanthi profesional.
Penyakit Balung
Sodium fluoride wis digunakake sacara lisan kanggo nambah kepadatan balung lan nyuda nyeri balung ing perawatan macem-macem metabolisme† [off-label] (osteoporosis† [off-label], kortikosteroid-induced osteoporosis† [off-label]) lan penyakit balung neoplastik† [off-label] (lesi balung ing pirang-pirang myeloma†, nyeri balung sing gegandhèngan karo karsinoma prostat metastatik†). Kualitas massa balung anyar ora mesthi, lan bukti yen fluoride nyuda resiko patah tulang dadi konflik lan kontroversial. Terapi liyane (umpamane, kalsium, vitamin D, inhibitor resorpsi balung, gumantung saka penyakit tartamtu) saiki luwih disenengi.
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Carane nggunakake Fluorides
Administrasi
Diwenehake kanthi lisan minangka solusi utawa tablet sing bisa dikunyah utawa topikal ing untu minangka dentifrice, busa, gel, larutan mbilas, utawa pernis.
Administrasi Oral
Atur natrium fluorida kanthi lisan minangka tablet sing bisa dikunyah utawa minangka solusi sing ora diencerake utawa dicampur karo banyu utawa cairan non dairy liyane. Bubarake tablet sing bisa dikunyah ing tutuk utawa ngunyah sadurunge ngulu, luwih becik sadurunge turu sawise nyikat untu.
Aja nyampur solusi fluoride karo susu utawa susu formula utawa ngonsumsi produk susu sajrone 1 jam administrasi oral suplemen fluoride amarga panyerepan fluoride bisa diganggu.
Administrasi suplemen fluoride oral mung nalika program fluoridasi komunitas ora kasedhiya utawa layak lan nalika konsentrasi ion fluoride ing banyu ngombe ≤0,6 ppm (mg/L).
Administrasi Topikal Oral
Ora kanggo perawatan sistemik; aja nguntal.
Solusi mbilas bisa ditelan mung yen diarahake dening dokter kanggo nyedhiyakake suplemen fluoride sistemik.
Kanggo nyilikake jumlah fluoride sing ditelan lan diserap sacara sistemik lan risiko fluorosis, instruksi lan/utawa ngawasi bocah-bocah <12 taun babagan teknik sing tepat kanggo nggunakake preparat topikal. (Deleng Fluorosis Gigi ing Cautions.)
AAP nyatakake bocah-bocah cilik ora kudu mbilas nganggo banyu sawise nyikat untu nganggo dentifrice berfluorida amarga naluri dheweke ngulu; expectorating tanpa rinsing nyuda jumlah fluoride ditelan lan ninggalake sawetara fluoride ing saliva kanggo uptake menyang plak.
Oral Topical Administration (Sodium Fluoride)
1,1% gel (ngemot 0,5% ion fluoride. ): Sawise nyikat lan flossing untu, aplikasi pita lancip saka gel kanggo untu nganggo sikat untu utawa tutuk tray kanggo ≥1 menit; ekspektoran. Kanggo entuk manfaat maksimal, aja mangan utawa ngombe sajrone 30 menit sawise administrasi. Wong diwasa, aja mbilas tutuk sajrone 30 menit sawise administrasi; anak, mbilas tutuk sak tenane.
0,02, 0,05, lan 0,2% larutan mbilas (masing-masing ngemot 0,009, 0,02, utawa 0,09% ion fluoride): Sawise gosok untu kanthi sak tenane, mbilas larutan kanthi kuat ing sakubenge lan ing antarane untu sajrone 1 menit. Ekspektoran. Kanggo entuk manfaat maksimal, aja mangan, ngombe, utawa mbilas nganti 30 menit sawise administrasi.
2% umpluk utawa gel (ngandhut 0,9% ion fluoride): Bisa ditrapake dening personel dental. Isi tray karo gel (sepertelon kebak) utawa nganggo umpluk banjur lebokake tray menyang tutuk pasien. Kanggo entuk manfaat maksimal, pasien cokotan entheng ing tray tutuk sajrone 4 menit. Copot tray (s) lan duwe keluwihan expectorate pasien. Pasien ora kudu mangan, ngombe, utawa mbilas ≥30 menit sawise aplikasi.
5% varnish (ngandhut 2,26% ion fluoride): Bisa ditrapake dening personel dental utawa medis. Aplikasi lapisan tipis (biasane 0.2-0.5 ml) menyang untu nganggo sikat aplikator. Preparation hardens ing kontak karo saliva; lapisan ageman mati liwat periode jam. Pasien kudu mangan mung panganan sing lembut lan ngindhari omben-omben panas sajrone sawetara jam sawise aplikasi; uga kudu ngempet saka floss utawa sikat untu kanggo ≥4 jam lan luwih kanggo 24 jam. Ngindhari preparat fluorida topikal kanthi resep liyane sajrone 24 jam sawise aplikasi. Nundha panggunaan suplemen diet fluoride sawetara dina sawise perawatan.
Oral Topical Administration (Acidulated Phosphate Fluoride)
Aja diselehake ing wadhah porselin utawa kaca. (Deleng Permukaan Gigi lan Pewarnaan Restorasi ing Cautions lan uga ndeleng Panyimpenan ing Stabilitas.)
Gel 1,1% (ngandhut 0,5% ion fluoride): Sawise nyikat untu kanthi normal, mbilas kanthi sak tenane. Aplikasi pita lancip saka gel kanggo untu nganggo sikat untu utawa tutuk tray kanggo ≥1 menit; ekspektoran. Kanggo entuk manfaat maksimal, aja mangan utawa ngombe sajrone 30 menit sawise administrasi. Wong diwasa, aja mbilas tutuk sajrone 30 menit sawise administrasi; bocah-bocah, mbilas tutuk kanthi sak tenane.
Solusi mbilas sing ngandhut ion fluorida 0,02%: Gunakake sawise gosok untu kanthi sak tenane. Cuci solusi ing sakubenge lan ing antarane untu kanggo 1 menit, banjur expectorate. Aja mangan utawa ngombe suwene 30 menit sawise administrasi.
Bump utawa gel sing ngandhut 1,23% ion fluoride: Bisa ditrapake dening personel dental. Isi tray karo gel (sepertelon kebak) utawa nganggo umpluk banjur lebokake tray menyang tutuk pasien. Kanggo entuk manfaat maksimal, pasien cokotan entheng ing tray tutuk sajrone 4 menit. Copot tray (s) lan duwe keluwihan expectorate pasien. Pasien ora kudu mangan, ngombe, utawa mbilas ≥30 menit sawise aplikasi.
Kanggo desensitizing lumahing oyod sing katon, gunakake gel sawise nyikat lan flossing sadurunge turu.
Oral Topical Administration (Stannous Fluoride)
0,4% gel kanggo nyegah karies dental : Sawise nyikat untu biasane, aplikasiake ing untu nganggo sikat untu. Sikat untu sak tenane; ngidini gel kanggo tetep ing untu kanggo 1 menit, banjur expectorate. Aja mangan utawa ngombe sajrone 30 menit sawise administrasi.
Gel 0,4% kanggo nyuda sensitivitas: Sawise nyikat lan floss untu biasane, goyangake sikat untu kanggo mbusak keluwihan banyu; aplikasi gel kanggo nutupi bristles. Sikat untu sak tenane; ngidini gel kanggo tetep ing untu kanggo 1 menit, banjur expectorate. Gunakake sikat untu utawa swab katun kanggo mesthekake yen kabeh wilayah sensitif ditutupi karo gel. Aja mangan, ngombe, utawa mbilas nganti 30 menit sawise administrasi.
Solusi mbilas 0,1%: Konsentrasi 0,63% diencerake kanggo nyiyapake solusi 0,1% sadurunge digunakake. Gunakake sawise sikat biasa. Swish swish watara lan antarane untu kanggo 1 menit; ekspektoran. Baleni. Aja mangan utawa ngombe 30 menit sawise administrasi.
RekonstitusiReconstitute bubuk fluoride kaya sing diarahake dening pabrikan.
PengenceranSiapkan 0,1% larutan bilas saka 0,63% konsentrasi sadurunge digunakake. Tambah 3,75 ml mbilas klempakan menyang vial nyawiji (utawa isi kanggo 1/8 oz tandha); nambah 26,25 ml banyu (utawa isi kanggo 1 tandha ons) lan nyampur kanggo nyedhiyani 0,1% solusi rinsing. Gunakake langsung; solusi bisa decompose ing sawetara jam kanggo stannous hydroxides, mbentuk endapan putih.
Dosis
Kasedhiya minangka sodium fluoride, acidulated fosfat fluoride, sodium monofluorophosphate, utawa stannous fluoride; dosis ditulis ing syarat-syarat ion fluoride.
Dosis suplemen fluoride oral beda-beda miturut umur bocah lan konsentrasi fluoride ing banyu ngombe. Setel dosis kanthi proporsi karo jumlah fluoride sing diwenehake saka kabeh sumber sing bisa (contone, setelan perawatan bocah, sekolah, banyu botol, omben-omben, susu formula bayi, panganan sing wis disiapake, dentifrice, multivitamin, mbilas tutuk). Aja ngluwihi dosis sing disaranake. (Deleng Fluorosis Gigi lan uga pirsani Panganggone Pediatrik ing Ati-ati.)
Gigi resep utawa nonresep umume ngemot ion fluoride 0,5 utawa 0,1–0,15%.
Pasien Pediatrik
Nyegah Karies Gigi Obat Gigi sing ngandung fluoride Topikal OralBayi lan bocah cilik (saka erupsi untu sepisanan nganti umur 3 taun): Aplikasi mung smear (kira-kira 0,1). g; kira-kira ukuran wiji beras) menyang sikat untu kaping pindho saben dina.
Bocah umur 3-6 taun: Gunakake mung sacukupe kacang polong (kira-kira 0,25 g) ing sikat untu kaping pindho saben dina.
Intake Diet sing Nyukupi OralKanggo tingkat intake ndhuwur sing bisa ditolerir, deleng Watesan Preskripsi miturut Dosis lan Administrasi.
Tabel 1. Asupan Fluorida Saben Dina sing Nyukupi ing Bayi, Anak, lan Remaja107Umur
Kecukupan Asupan Fluoride Saben Dina
0-6 sasi
0,01 mg
7-12 sasi
0,5 mg
1-3 taun
>0,7 mg
4-8 taun
1,1 mg
9-13 taun
2 mg
14-18 taun
2.9-3.2 mg
Suplementasi Fluoride ing Area sing Kurang Fluoride ing Banyu Ngombe Tabel Oral 2. Dosis Saben Oral Fluoride Tambahan (minangka Tablet Chewable utawa Solusi) kanggo Bocah-bocah sing manggon ing wilayah sing ora nyukupi fluoride ing banyu ngombe (ditulis ing syarat-syarat ion fluoride)107109131134135Konsentrasi Ion Fluoride ing banyu ngombe
Umur
<0,3 ppm
0,3–0,6 ppm
>0,6 ppm
0 nganti <6 sasi
Ora ana
Ora ana
Ora ana
6 sasi nganti <3 taun
0,25 mg
Ora ana
Ora ana
3 nganti <6 taun
0,5 mg
0,25 mg
Ora ana
6-16 taun
1 mg
0,5 mg
Ora ana
Sodium Fluoride Oral Topikal1,1% gel (ngandhut 0,5% ion fluoride) ing bocah-bocah ≥6 taun : Produsen nyaranake nggunakake sapisan dina, luwih apik ing wayah turu, kajaba diwenehake dening dokter. Nalika digunakake kaping pindho saben dina, salah siji saka sawetara perawatan fluoride topikal sing diresepake utawa ditrapake sacara profesional sing disaranake dening ADA kanggo bocah-bocah umur ≥6 taun kanthi risiko tambah karies dental.
Solusi mbilas 0,02% (ngandhut 0,009% fluoride. ion) ing bocah-bocah ≥6 taun: 10 mL kaping pindho saben dina.
Solusi mbilas 0,05% (ngandhut ion fluoride 0,02%) ing bocah-bocah ≥6 taun: 10 mL sapisan dina.
0,2% larutan bilas (ngandhut 0,09% ion fluoride) ing bocah-bocah ≥6 taun: 10 mL sapisan saben minggu, luwih becik sadurunge turu. Yen digunakake paling ora sapisan saben minggu, salah siji saka sawetara perawatan fluoride topikal sing diresepake utawa ditrapake sacara profesional sing dianjurake dening ADA kanggo bocah-bocah umur ≥6 taun kanthi risiko tambah karies dental.
5% varnish† (ngemot 2.26 % ion fluoride): Aplikasi liwat aplikator ing lapisan tipis (biasane 0,2–0,5 mL) menyang untu. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi. Yen digunakake ing frekuensi iki, salah siji saka sawetara perawatan fluoride topikal sing ditrapake kanthi profesional utawa kanthi resep-resep sing dianjurake dening ADA kanggo bocah-bocah umur ≥6 taun kanthi risiko tambah karies dental. Siji-sijine perawatan fluoride topikal sing ditrapake kanthi profesional utawa kanthi resep sing disaranake dening para ahli kanggo bayi (wiwit erupsi untu) lan bocah-bocah <6 taun.
2% gel utawa umpluk (ngandhut 0,9% ion fluoride): Aplikasi liwat trays. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi.
Acidulated Phosphate Fluoride Oral Topikal1,1% gel (ngandhut 0,5% ion fluoride) ing bocah-bocah umur ≥6 taun: Sapisan saben dina, luwih becik nalika turu, kajaba diwenehake dening dokter.
Larutan mbilas sing ngandhut ion fluorida 0,02% ing bocah-bocah ≥6 taun: 10 mL sapisan dina, luwih becik sadurunge turu.
Gel sing ngandhut 1,23% ion fluoride ing bocah-bocah ≥6 taun: Aplikasi liwat tray. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi. Nalika digunakake ing frekuensi iki, salah siji saka sawetara perawatan fluoride topikal sing ditrapake sacara profesional utawa kanthi resep-resep sing disaranake dening ADA kanggo bocah-bocah umur ≥6 taun kanthi risiko tambah karies dental.
Bump sing ngemot 1,23% ion fluoride: Aplikasiake liwat nampan. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi.
Stannous Fluoride Oral Topikal0,4% gel ing bocah-bocah ≥6 taun: Sapisan dina.
0,1% larutan bilas ing bocah-bocah ≥6 taun: Encer 0,63% konsentrasi sadurunge digunakake menyang solusi 0,1%. (Deleng Dilution ing Dosis lan Administrasi.) Gunakake sapisan dina utawa kaya sing diarahake dening dokter. Gunakake 15 ml, banjur baleni karo tambahan 15 ml.
Desensitizing Dentin Sodium Fluoride Oral Topikal5% varnish (ngandhut 2,26% ion fluoride): Aplikasi liwat aplikator ing lapisan tipis kanggo untu saben 6 sasi; yen perlu, bisa digunakake kanthi aman kaping 4 saben taun ing pasien ≥6 taun.
Stannous Fluoride Oral Topikal0,4% gel ing bocah-bocah ≥12 taun: Kaping pindho saben dina (esuk lan sore) utawa kaya sing diarahake dening dokter.
0,1% larutan bilas ing bocah ≥6 taun: Dilute 0,63% konsentrasi sadurunge digunakake kanggo solusi 0,1%. (Deleng Dilution ing Dosis lan Administrasi.) Gunakake sapisan dina utawa kaya sing diarahake dening dokter. Gunakake 15 mL, banjur baleni karo tambahan 15 mL.
Dewasa
Nyegah Karies Gigi Asupan Fluoride Oral Saben Dina sing NyukupiDewasa ≥19 taun: 3.1–3.8 mg saben dina.
Sodium Fluoride Oral Topikal1,1% gel (ngandhut 0,5% ion fluoride): Produsen nyaranake nggunakake sapisan saben dina, luwih becik nalika turu, kajaba diwenehake dening dokter. Yen digunakake kaping pindho saben dina, salah siji saka sawetara perawatan fluoride topikal sing bisa diresepake utawa ditrapake kanthi profesional sing disaranake dening ADA kanggo wong diwasa kanthi risiko tambah karies gigi.
0,02% larutan bilas (ngandhut 0,009% ion fluoride): 10 mL kaping pindho saben dina.
0,05% larutan bilas (ngandhut 0,02% ion fluoride): 10 mL sapisan dina.
0,2% larutan mbilas (ngandhut 0,09% ion fluoride): 10 mL sapisan saben minggu, luwih becik nalika turu. Yen digunakake paling ora sepisan saben minggu (utawa saben dina kanggo nyegah karies oyod), salah siji saka sawetara perawatan fluoride topikal sing diresepake utawa ditrapake sacara profesional sing dianjurake dening ADA kanggo wong diwasa kanthi risiko tambah karies gigi.
5% varnish† (ngandhut 2,26% ion fluoride): Aplikasi liwat aplikator ing lapisan tipis (biasane 0,2-0,5 ml) kanggo untu. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi. Nalika digunakake ing frekuensi iki, salah siji saka sawetara perawatan fluoride topikal sing ditrapake kanthi profesional utawa kanthi resep sing disaranake dening ADA kanggo wong diwasa kanthi risiko tambah karies gigi.
2% gel utawa busa (ngandhut 0,9% ion fluoride): Aplikasi liwat trays. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi.
Acidulated Phosphate Fluoride Oral Topikal1,1% gel (ngandhut 0,5% ion fluoride): Sapisan saben dina, luwih becik sadurunge turu, kajaba diwenehake dening dokter.
Larutan mbilas sing ngemot ion fluoride 0,02% : 10 ml sapisan dina, luwih becik sadurunge turu.
Gel ngemot 1,23% ion fluoride: Aplikasi liwat trays. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi. Yen digunakake ing frekuensi iki, salah siji saka sawetara perawatan fluoride topikal sing ditrapake sacara profesional utawa kanthi resep-resep sing dianjurake dening ADA kanggo wong diwasa kanthi risiko tambah karies gigi.
Bump sing ngemot 1,23% ion fluoride: Aplikasi liwat tray. Frekuensi biasa aplikasi fluoride profesional paling sethithik saben 3-6 sasi.
Stannous Fluoride Oral Topikal0,4% gel: Sapisan saben dina.
Solusi mbilas 0,1%: Encerake konsentrat 0,63% sadurunge digunakake dadi larutan 0,1%. (Deleng Dilution ing Dosis lan Administrasi.) Gunakake sapisan dina utawa kaya sing diarahake dening dokter. Gunakake 15 ml, banjur baleni karo tambahan 15 ml.
Desensitizing Dentin Sodium Fluoride Oral Topikal5% varnish (ngandhut 2,26% ion fluoride): Aplikasi liwat aplikator ing lapisan tipis kanggo untu saben 6 sasi; yen perlu, bisa ditrapake kaping 4 saben taun.
Stannous Fluoride Oral Topikal0,4% gel: Gunakake kaping pindho saben dina (esuk lan sore) utawa kaya sing diarahake dening dokter.
0,1% larutan bilas: Encer 0,63% konsentrasi sadurunge digunakake kanggo 0,1 % solusi. (Deleng Dilution ing Dosis lan Administrasi.) Gunakake sapisan dina utawa kaya sing diarahake dening dokter. Gunakake 15 mL, banjur baleni kanthi tambahan 15 mL.
Watesan Resep
Pasien Anak
Tingkat Intake Ndhuwur Saben Dina sing Bisa Ditoleransi Fluoride ing Bayi lan Anak107 Tabel 3.Umur
Tingkat Asupan Fluorida Ndhuwur Saben Dina sing Ditoleransi
Umur 0–6 sasi
0,7 mg
umur 7–12 sasi
0,9 mg
1-3 taun
1,3 mg
4-8 taun
2,2 mg
9-18 taun
10 mg
Desensitizing Dentin Oral TopikalStannous fluoride 0,4% gel (perawatan diri) ing bocah ≥12 taun: Maksimal kaping pindho saben dina kanggo 4 minggu kanggo untu sensitif .
Stannous fluoride 0,1% larutan bilas (disiapake saka 0,63% konsentrasi) ing bocah-bocah ≥6 taun (ngrawat dhewe): Maksimal sapisan saben dina kanggo 4 minggu kanggo untu sensitif.
Wong diwasa
Tingkat Intake Ndhuwur Saben Dina sing DitoleransiMaksimal 10 mg saben dina.
Wanita sing ngandhut: Maksimal 10 mg saben dina.
Wanita sing nyusoni: Maksimal 10 mg saben dina.
Desensitizing Dentin Oral TopikalStannous fluoride 0,4% gel (perawatan diri): Maksimal kaping pindho saben dina kanggo 4 minggu kanggo untu sensitif.
Larutan mbilas stannous fluoride 0,1% (disiapake saka 0,63% konsentrat) (ngrawat diri): Maksimal sapisan saben dina suwene 4 minggu kanggo untu sensitif.
Populasi Khusus
Gangguan Hepatik
Ora ana rekomendasi dosis khusus ing wektu iki.
Gagal ginjal
Ora ana rekomendasi dosis khusus ing wektu iki; nanging, ndeleng Gagal ginjel ing Cautions.
Pasien Geriatrik
Pilih dosis kanthi ati-ati amarga nyuda fungsi ginjel sing gegandhengan karo umur.
Pènget
Contraindications
Pènget / PancegahanFluorosis Gigi
Jumlah sing berlebihan bisa nyebabake fluorosis dental sing gegandhengan karo dosis (hypocalcification lan hypoplasia) lan owah-owahan osseous ing bocah-bocah <8 taun, utamane yen konsentrasi ion fluoride ing banyu ngombe > 0,6 ppm. Anak umur 15 sasi nganti 3 taun paling rentan kanggo fluorosis saka untu permanen.
Sebagéan gedhé kasus ing AS arang banget utawa entheng; Nanging, prevalensi mundhak wiwit taun 1980-an nganti awal taun 2000-an, bisa uga amarga paparan fluorida sing luwih gedhe.
Tindakake teknik sing tepat kanggo ngetrapake preparat topikal kanggo nyuda jumlah sing dicerna lan diserap sacara sistemik.
Fluorosis entheng ora mengaruhi fungsi waos; bisa nggawe enamel luwih tahan kanggo karies. Bisa nyebabake bintik-bintik buram putih ing pinggir insisal untu anterior utawa ujung cusp untu posterior ("snow capping").
Risiko untu stained lan pitted ing fluorosis moderat nganti abot; efek umume wis dianggep utamané kosmetik. Sawetara ahli saiki takon apa pitting sing ana hubungane karo fluorosis abot, sing nyebabake mundhut enamel, mung kosmetik amarga enamel untu nglindhungi dentin lan pulp saka bosok lan infeksi.
Fluorosis Skeletal
Konsentrasi ion fluorida sing dhuwur (yaiku, 4-8 ppm [mg/L]) ing banyu ngombe bisa nyebabake peningkatan kepadatan mineral balung lan osteosclerosis fluoride sing katon. Risiko ngembangake fluorosis langsung ana hubungane karo ombone lan durasi paparan fluoride; fluorosis skeletal sing lumpuh arang banget ing AS.
Pewarnaan Permukaan Gigi lan Restorasi
Pewarnaan utawa pigmentasi (umpamane, kuning, coklat, coklat-ireng) saka untu bisa uga amarga aplikasi topikal saka larutan pekat utawa gel saka fluoride stannous, utamane ing pasien karo kebersihan oral sing ora apik. Kebersihan lisan sing apik (contone, sikat sing cukup) nyuda resiko pewarnaan; pewarnaan ora mbebayani utawa permanen lan bisa dibusak dening dentist.
Persediaan fluoride fosfat asam bisa nyebabake porselen lan restorasi keramik dadi kusam kajaba dilindhungi saka kontak. Preparat sodium fluoride netral bisa disaranake kanggo pasien sing ngalami restorasi kasebut.
Reaksi Sensitivitas
Reaksi AlergiRuam alergi lan reaksi idiosinkratik liyane arang dilapurake.
Urticaria, dermatitis exfoliative, dermatitis atopik, eksim, sirah, kekirangan, gangguan lambung, stomatitis, lan GI lan reaksi alergi ambegan bisa kedadeyan arang banget.
Pasien kanthi mucositis utawa jaringan gingiva sing abraded utawa sensitif bisa uga hipersensitif marang alkohol utawa bahan liyane sing ana ing sawetara preparat fluoride lisan utawa topikal.
Dyspnea jarang kedadeyan ing bocah asma sing nampa pernis fluoride. Pembengkakan edema sing kacarita arang sawise aplikasi, utamane nalika ditrapake ing permukaan sing amba. Yen ana intoleransi, copot lapisan kanthi sikat lan mbilas.
Panganggone Kombinasi Tetep
Yen fluoride digunakake ing kombinasi tetep karo preparat liyane, nimbang ati-ati, pancegahan, lan kontraindikasi sing ana gandhengane karo agen sing bebarengan. (Deleng Panganggone Pediatrik ing Caution.)
Populasi Tertentu
KandhutanKategori B.
Suplemen fluoride sing diwenehake kanthi lisan kanggo wanita ngandhut ora nyegah karies gigi ing anak-anake.
LaktasiDisebarake menyang susu kanthi jumlah cilik. Suplemen fluoride ing wanita sing nyusoni ora samesthine bakal mengaruhi asupan fluorida bayi. Nanging, gunakake kanthi ati-ati ing wanita sing nyusoni.
Panggunaan PediatrikAja ngluwihi dosis suplemen fluoride oral sing disaranake. (Deleng Contraindications lan uga Dental Fluorosis ing Cautions, lan ndeleng Dosis ing Dosis lan Administrasi.) Suplemen fluoride lisan ora dianjurake kanggo bayi <6 sasi.
Risiko potensial kanggo bocah cilik saka ngulu preparat fluoride topikal kalebu mual lan muntah lan, kanthi ingestion bola-bali, fluorosis dental. Bocah-bocah cilik biasane ora bisa nindakake proses mbilas sing perlu karo solusi mbilas lisan, lan luwih cenderung ngulu preparat dental fluoridated topikal (contone, pasta gigi).
Awasi kanthi ati-ati lan/utawa ngawasi bocah-bocah <6 taun babagan panggunaan sing tepat saka dentifrices fluoridated kanggo mesthekake jumlah sing bener digunakake (ndeleng Dosis ing Dosis lan Administrasi) lan kanggo nyilikake ngulu dentifrices. Uga menehi instruksi lan ngawasi sing umur 6-12 taun yen perlu babagan teknik sing tepat kanggo nggunakake preparat fluoride topikal (contone, larutan mbilas, gel, dentifrices).
Pernis sodium fluoride sing ngemot 2,26% ion fluoride yaiku mung preparasi fluoride topikal sing ditrapake kanthi profesional sing dianjurake dening ADA utawa AAPD kanggo digunakake ing bocah-bocah <6 taun kanggo nyegah karies dental†; paparan fluoride sistemik dianggep luwih murah karo varnish tinimbang karo preparat profesional liyane.
Aja nggunakake gel perawatan fluoride lan solusi mbilas kanggo nyegah karies dental ing bocah-bocah <6 taun kajaba diwenehake dening dokter gigi utawa profesional medis. Panggunaan preparat fluorida topikal kanthi resep-resep ing omah (contone, gel, pasta, solusi bilas) ora dianjurake dening ADA utawa AAPD kanggo digunakake ing bocah-bocah <6 taun.
Mungkin angel nyetel jumlah fluoride sing dibutuhake saka preparat multivitamin utawa multivitamin/wesi kombinasi tetep sing digunakake minangka suplemen fluoride oral. (Deleng Dosis ing Dosis lan Administrasi.)
Panggunaan GeriatrikOra ana beda sakabèhé ing safety lan khasiat fluorida topikal lisan relatif marang wong diwasa sing luwih enom, nanging sensitivitas tambah ora bisa ditolak. Secara substansial diilangi dening ginjel; pasien geriatrik luwih cenderung ngalami penurunan fungsi ginjel; ngawasi fungsi ginjel lan nyetel dosis sing cocog.
Tablet sing bisa dikunyah lisan ora dituduhake kanggo wong diwasa, kalebu wong diwasa geriatrik.
Gagal GinjalDiekskresi dening ginjel; mulane, risiko reaksi beracun bisa uga luwih gedhe ing pasien sing duwe fungsi ginjel cacat.
Apa obatan liyane bakal mengaruhi Fluorides
Obat Spesifik
Obat
Interaksi
Komentar
Aluminium hidroksida
Konsumsi bebarengan bisa nyuda penyerapan fluoride oral
Kalsium
Bisa nyebabake pembentukan kalsium fluorida lan bisa nyuda panyerepan fluoride nganti 10-25%
Konsumsi produk susu sing ngemot kalsium kanthi simultan bisa uga ora duwe pengaruh kanggo penyerapan konsentrasi rendah kalsium. fluoride ana ing banyu ngombe
Singkirake produk susu sajrone 1 jam sawise administrasi sistemik fluoride oral
Magnesium hidroksida
Konsumsi bebarengan bisa nyuda penyerapan fluoride oral
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