exogenous prophylaxis

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Exogenous Prophylaxis

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fluorine containing facilities for local application

remineralization solutionsencapsulants

1. The concentration of fluorides not must exceed for a local prophylaxis1-2% (calculating on a fluorine), as with the increase of concentration efficiency does not grow.

2. Efficiency of influencing is conditioned by their concentration in the free ionized kind.

 3. It is necessary to take into account in this connection fastening possibility fluoride ions with the ions of calcium.

4. Fluorides is appointed taking into account maintenance of fluorine in a drinking-water and climatic factors.

Presently became obviously, that the decline of morbidity by caries is explained to the wide uses of fluorine containing of tooth-pastes.

Pastes are given recommended to the use from 3-4 years. Cleaning is necessary 2 times per a day for 3 minutes, consistently clearing all surfaces of tooth.

One of widespread facilities of local prophylaxis there are varnishes which use for the prolonged period of influencing of fluoride on enamel. They form tape adjoining to the enamel, and which remains on teeth during a few hours and in fissures a few days and even weeks.

A fluorine – varnish shows itself composition of natural resins of vegetable origin. At the market presented: „Ftorlac” (Kharkiv), varnish „Duraphat”, „Belac” (Vladmiva).

A method is given recommended at the moderate or high level of intensity of caries of teeth, to the children and young people with the high risk of origin of caries. Frequency of causing of varnish is 2-4 times per a year, depending on activity of caries.

 

Method: the surface of teeth is purged from the deposit and is dried out. Then by the special brush varnish is inflicted by a skim on the surface of tooth. At the same time it is possible to cover all teeth on one jaw or 3-5 teeth. For getting dry of varnish it is needed about 2-3 minutes. It is possible to dry the varnish by the compressed air. After coverage of teeth by fluorine varnish it is impossible to use the meal of 1-3 hours and in future the desired only spoon-meat. It is not recommended to clean teeth 24 hours. Varnish is contained on-the-spot tooth not less 12 hours and for this time his ions penetrate on a depth to 100 mcm of healthy enamel.

To cover teeth by varnish it follows depending on activity of cariosity: at a 1 degree — 2 times per a year, at 2 — 4 times per a year, at 3 — from 6 to 12 times per a year. Triple coverage of teeth is recommended with an interval 1-2 days.

It is set that in a year after application of fluorine containing varnish second caries of teeth goes down on the average on 50%.

Gels and solutions of fluoride of sodium 1% and 2% are used for appliques and electrophoresis. A doctor-dentist conducts procedure in the conditions of policlinic. Remineralization action of gels is based on diffusion of matters from gel in saliva and from her in the enamel of tooth.

Method: teeth preliminary clear, dry out and impose the wadding tampon well moistened by solution of fluoride of sodium on 3- 5 minutes. At first assess the masticatory surfaces of teeth, and then – labial and cheeks on both jaws. If gel is used, he is inflicted by heated by a brush and give to dry out. After procedure does not recommend eat and drink during 2 hours.

As a rule conduct 3-5 appliques by solution twice on a year and 2-6 appliques by gel on a year.

Causing of fluorides by a spoon: 1. To choose the spoon of the proper size It must be the covered is all dental row, including the areas of retraction and it follows to

provide access of gel to the contact with the structure of teeth. The ends of spoon (peripheral areas) must be closed in order that gel did not flow down in the cavity of mouth sick. Ideally spoons befit with coverage from the made foam material, as they fit snugly dental row of patient and allow to gel to achieve all surfaces 

2. To place gel in a stretcher. 3. To insert a spoon in the mouth of patient. 4. To insert between the spoons of saliva ejector, making sure, that to the patient

comfortably (at this method for balance of bite from opposite sides necessary wadding rollers)

5. To bring a spoon out of mouth sick. 6. To ask a patient to spit out immediately after the delete of spoon. After procedure, at a necessity the delete of superfluous fluoride, to apply the intensive

sucking 7. To warn a patient that during 30 minutes after procedure it is impossible to eat or

drink

The wide use in the prophylaxis of caries was found by solutions with the low concentrations of fluoride.

The rinses begin to use, when the first second teeth cut through at children. The method of prophylaxis is given does not need considerable expenses of time and financial resources, and that time is effective enough.

Amount of rinses makes: - by a 0,05% solution -1 once on a day - by a 0,1% solution -1 once in a week - by a 0,2% solution – 1 one time in two weeks For the improvement of co-operation of fluorine with an

enamel preliminary it follows well to clean teeth and rinse a mouth by alkaline water for the change of рН environment. In addition it is necessary to teach a child to rinse a mouth by ordinary water by energetic motions by cheeks.

depending on age of child give to rinse the mouth of 5-10 ml solution. The rinse lasts 1-3 minutes, and for the children of junior age more expedient double rinse on 1 minute. After it a mouth is rinsed by clean water.

Application by the children of rinses by solution of fluorine sodium gives reduction to the caries 30%, upon termination of rinses an effect lasts yet in 2-3.

At casual swallowing of fluoride of sodium it is necessary to give to the child to take an a swig at the soupspoon of solution of chloride of calcium, which, linking a fluorine will not give him to be sucked in.

Fluorine containing disks (paper and paraffins) are produced in packing for 10 things. The expense of material is a 1 disk on procedure. The disk of «Ftorglicofoskal’» contains the followings ingredients:

- neurosin — 8-16 g - fluoride of sodium — 0,5-2 g - superficial matters — 0,5-2,0 g - beeswax — 4,5-6,5 g - paraffin. A disk is fixed in an angular tip by a mandrel. A fluorine is rubbed in hard

fabrics of tooth on minimum speed with the use of three types of motions: recurrently-forward, up-down, circles.

As usual, before treatment by fluorine containing disks the professional hygiene of cavity of mouth is conducted, whereupon by disks at first the vestibular surfaces of all teeth of maxilla are processed from left to right, then lower — from right to left. After it the palatal surfaces of teeth of maxilla and languages surfaces of teeth of lower jaw are processed, farther are masticatory surfaces of teeth of overhead and lower jaws with the use of only circular motions clockwise. At a variable bite process by fluorine containing disk only the second teeth. It is recommended 2-3 multiple treatment of teeth with an interval 1-2 days, in a year 2-4 courses.

In practice of therapeutic dentistry fluorine containing disks found large popularity not only at the prophylaxis of teeth decay but also at treatment of hyperesthesia of hard fabrics of teeth.

At application of remineralization matters it is expedient to heat them to 40-450C, taking into account that the increase of temperature of solution on 10 strengthens precipitation of ions on-the-spot enamel on 1 %.

Choosing the concentration of remineralization solution, it should be remembered that the high concentration of calcium conduces only to mіneralіzation of superficial layer of enamel, while the low concentrated solutions are instrumental in remineralization on all depth of enamel.

In behalf of the combined application of remineralization solutions and solutions of fluorine the fact of assistance of ions to the fluorine testifies to the acceleration of plugging in the net of enamel of calcium and phosphorus.

"Remodent"  is the preparation synthesized from natural materials consists of complex of ions macro- and micrtoelements necessary for activating of process of remіneralіzation and prophylaxis of caries. Unlike fluorine preparation is instrumental in substituting for the ions of calcium and phosphorus in the crystalline grate of enamel of teeth.

On preliminary cleared (by a tooth brush and tooth-paste) and dried up teeth inflict the wadding tampon saturated by solution of "Remodent"    on 15—20 minutes. During this time a tampon is changed twice. After an applique it is not recommended to rinse a mouth and adopt a meal during 2 hours. Next appliques conduct twice for a week after the same method. The course of treatment is 20—30 appliques.

In addition, with the purpose of prophylaxis of teeth decay it is possible to recommend the rinse of mouth by a 3% solution of "Remodent" by duration of 3—4 of minutes (1—2 times per a week) during 10 months on a year. On one rinse goes to 15—25 ml solution.

Borovskij’s – Leus’s method Teeth carefully purge from the dental raid by ordinary pastes,

dry out. Consistently conduct appliques by a 10% solution of glucoside

of calcium during 15 minutes(3 times for 5 minutes) and 2% by water solution of fluoride of sodium during 3 minutes. Duration of course on the average 10-15 procedures every day or in a day.

 Borovskij’s – Leus’s method (with electrophoresis) This chart foresees electrophoresis of a 10% solution of

glucoside of calcium (3—5 minutes) and applique of a 2% soluble- fluoride of sodium (1—2 minutes) 3 times in a week.

  Borovskij’s – Volkov’s method Two-component solution which consists of a 10% solution of

nitrate of calcium and 10% solution of hydrophosphate to the ammonium is used. Prepare teeth and consistently conduct appliques by each of these solutions for 3-5 minutes. Through 5-7 procedures on-the-spot enamel and in mіcro spaces under superficial layer the matter appear which is an ionogen phosphorus and calcium. This method is used for treatment of hyperesthesia.

THE END