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Preparations for the prevention and treatment of primary caries
03-09-2009
It is known that regular and thorough removal of plaque is important in the prevention of caries. For an objective assessment of oral hygiene produce display (stained) plaque with special diagnostic dyes (indicators), which recorded organic component of dental plaque.
2.1.1. Indicators plaque
In the dental practice as a diagnostic dye used plaque 0,75% and 6% solution of basic fuchsin, 4.5% alcohol solution of erythrosine, erythrosine tablets (from 6 - 10 mg), solution Schiller - Pisarev, 2% aqueous methylene blue.
Magenta (Fuchsini) - basic fuchsin solution. Stain dental plaque in crimson. The drug is used for rinsing.
Rp.: Fuchsini bas. 1.5
Spiritus aethylici 75% 25 ml D.S. 15 drops to l / i cup of water (for rinsing the mouth for 20 s)
Erythrosine (Erythrosin) - a red dye of low toxicity. Contains iodine in its composition. Available in a 4.5% alcohol and pills (Mentadent C-Plague, Og] In Einfarb Plagueindika -
tor, Plague-Farbetabletten, etc.).
Rp.: Sol. Erythrosini 5% 15 ml
D.S. Apply with a cotton swab on the surface of teeth
Rp.: Tab. Erythrosini 0,006 N. 30
D.S. Chew 1 tablet for 1 min
Fluorescein (Fluorescein) - dye plaque does not contain iodine, so it can be used in patients with sensitization to iodine. Painted fluorescein plaque visible only under ultraviolet light. Issued under the names «Plak-Lite» ( «Blendax»), «Fluorescein» 0,75%.
Solution Schiller - Pisarev dental plaque stain yellow-brown color. The drug is applied to the tooth surface using a cotton swab.
Rp.: Lodi 1,0
Kalii iodidi 2,0
Aq. destill. 40 ml
M.D.S. Solution Schiller - Pisarev. Apply with a cotton swab on the surface of teeth
Metilenovyi sinni (Methylenum coeruleum) is used to detect dental plaque: 1-2% aqueous solution of methylene blue applied to the tooth surface using a cotton swab.
Rp.: Methyleni coerulei 2,0 Aq. dcstiil. 100 ml M.D.S. For lubricating the surface of teeth
2.1.2. Fluorine compounds
Prevention and treatment of early stage of caries carried out with fluorine. Fluorine compounds normalize the mineral and protein metabolism, which creates favorable conditions for mineralization of dental hard tissues and bones of the skeleton. Appointment of fluoride preparations during the mineralization of hard tissues contributes to their kariesre resistance of that used in carrying out preventive measures in childhood.
Fluorine compounds enter the body with food and water. The optimal amount of fluoride introduced into the body of an adult, is in the range 1.2-2,6 mg / day, and introduced into the body of the child - 1,2-1,6 mg.
For the prevention of dental caries used organic and inorganic compounds of fluorine. The most frequent are sodium fluoride, potassium fluoride, tin fluoride, aminoftorid, titanium fluoride. Fluoride appointed local and inward.
Local use 0,05-0,2% aqueous solution of sodium fluoride (to rinse, applications, electro-and phonophoresis), as well as ftorlak, ftorsoderzhashie gels and toothpastes.
Sodium fluoride (Natrium fluoratum) in the local application enters into chemical combination with one of the main mineral component of enamel - hydroxyapatite, transforming it into gidroksiftorapa fluorapatite-anorthite, and more resistant to acid. Education fluorapatite in the enamel and reduces its permeability.
Sodium fluoride (0.05% and 0,2%) prescribed as local facilities for children from 6 years and adults in the form of gargles. Mouth cavity with solutions of sodium fluoride is carried out after eating and brushing your teeth in a passage (3 rinse for 1 min): 0.05% solution daily for one passage, 0,2% solution - one passage in 1-2 weeks. Children 6 to 9 years of age take for rinsing of 7,5 ml (teaspoon), aged 10 years and older - 15 ml (tablespoon). Rinsing with solutions of sodium fluoride is carried out in 9 months, repeating the treatment every year. Perhaps the simultaneous use of tablets, solutions of sodium fluoride and ftorlaka.
Rp.: Sol. Natrii fluorati 0,05% 50 ml D.S. To rinse the mouth
For applications using 0.2% solution or 1 - 2% sodium fluoride gel. Before the procedure the surface of your teeth thoroughly cleaned to remove plaque, isolated from saliva and dried. Then, on the surface of the teeth for 4-5 min impose loose cotton swabs moistened with a solution of sodium fluoride. In the course of treatment 4.7 applications (2 times a year).
Rp.: Sol. Natrii fluorati 0,2% 50 mf
D.S. For applications to the surface of the tooth enamel or electrophoresis (enter from the cathode for 2-3 min); rate 4.7 Procedures
Ftorlak (Phthorlacum) - composition of natural resins, viscous consistency, dark-yellow color, containing 2.9% fluorine. The structure consists ftorlaka (per 100 g): sodium fluoride (5 g), balsam fir (40 g), shellac (19 g), chloroform (12 g) and ethyl alcohol (24 g). Not dissolve in water, pH 5.25.
Film ftorlaka long retained on the tooth surface, saturating the surface layer of enamel with fluorine ions, which promotes the formation of more stable and less soluble in acids fluorapatite.
For the prevention of dental caries ftorlak use in children aged 7 to 14 years. Drug of treated teeth 3 times with an interval of 6 months.
As a therapeutic tool for caries in the stage of spots and hyperesthesia of hard tissues of teeth ftorlak applied to the individual affected teeth 1-2 times a week. The course of treatment - up to 4 applications. If you want to spend 6-12 months after re-treatment drug.
Rp.: Phthorlacum 25 ml
D.S. Apply to the tooth surface for 3 - 5 minutes
For the prevention of caries ftorlak used as follows. The surface of the tooth is carefully cleaned of plaque, rubbed with a cotton swab (thorough drying is not required). With a brush or plastic (wooden) sticks lopatkoobraznoy preparation with a thin layer is deposited on the surface of teeth from the teeth of the mandible (to avoid the accumulation of saliva). Within 4-5 min after application ftorlaka (yet not varnish dries), patient should not close his mouth. Within 12-22 h should be used only fluid writing and brush your teeth. Recommend triple coverage dental fluoride varnish with an interval of 1-2 days. At 6 months, repeat the procedure.
For applications use 0.2% solution of sodium fluoride or 1.2% fluorine-containing gel. Before applique tooth surface thoroughly cleaned to remove plaque, isolated from saliva swabs and dried or air. Then, on the surface of the teeth for 4-5 min impose a loose cotton swabs impregnated with drug. In the course of treatment - for 3.7 applications, 2 times a year.
For applications recommended 1-2% sodium fluoride gel on 3% agar. As hot as the gel is applied to thoroughly cleaned and dried the surface of teeth with a brush. In case of contact with the surface of the tooth gel solidifies as a thin film. Not allowed to eat for 3 hours on the course - 3-5 applications.
Fluorine-containing gels and varnishes are gradually replacing the use of local solutions of fluorides, since they are solutions to a number of advantages. First, because of its viscous consistency, they are better
keep fluorides on the surface of the tooth. In addition, gels can be applied using Impression spoons, simultaneously on all the teeth in a single procedure, which saves time dentist and patient.
When you use fluoride gels should comply with the measures that allow patients to minimize swallowing of the gel:
• During the application to use saliva ejector;
• limit the amount of gel placed in each custom tailored impression spoon, 5-10 drops;
• During the procedure the patient must sit up straight, his head bent forward.
Fluorine-containing gels are best cast with Impression spoons coated foam rubber. The duration of application should not exceed 4 min. After the procedure, patients are advised to refrain from eating, drinking and rinsing for 30 min. Applications fluoride gels are recommended once every 6 months or more frequently if necessary.
When working with acid ftorfosfatnymi gels should take protective measures in the event of the oral cavity in patients porcelain dentures, which can break down acid solutions and gels (before the applique is recommended to lubricate them with petroleum jelly).
Currently, many companies manufacture a variety of name and composition kariesprofilak-cal fluoride solutions: Pro Fluoride M ( «VOCO»), Fluocal Solute ( «Septodont»), gels: Fluocal Gel ( «Septodont»), Fluoridin Gel N 5 ( « VOCO »), Pro Fluorid Gelex (« VOCO »), Fluor-Gel (« Blend-a-med »), Oral At Fluor-gel (« Cooper »), Elmex-gele (« Wypert »), etc.; fluoride lacquers: Fluoridine ( «VOCO»), Bifiuorid 12 ( «VOCO»), Controcar ( «Hammacher»), Duraphat ( «Woelm»), Belagel Ca, P, F, et al Belagel
We prove the high efficiency protivokarioznaya ftorfosfatnogo acid gel, comprising 12 300 ppm * fluorides, and rinse «Fluor» (230 ppm fluoride), «Forte» (910 ppm fluoride) gels containing fluoride, tin (970 and 19400 ppm fluoride), and ammonium fluoride ( «Elmex fluid», etc.).
In order to prevent dental caries are also special polishing paste containing fluoride: «Detartrine Fluoree» ( «Septodont»), «Proxyt» ( «Vi-vadent») etc. They are used for polishing the surface of teeth 1-2 times a year as kariesprofilakticheskogo funds.
Fluoride gels, containing in their composition of neutral sodium gel (5000 ppm) and tin fluoride (1000 ppm), can be used by patients themselves as a caries preventive measure. They are recommended as a means of preventing tooth decay for weekly use over the age of 8 years (Elmex gelee, Blend-a-med gel, etc.).
For the prevention of dental caries using a broad arsenal of fluoride toothpaste (with fluoride concentrations of 0,01 - 1%): «Zodiak», «Karimed», «Komilfo», «Ftorodent», «Cheburashka», «Remodent», «Blend-a - med »,« Crest »,« Blendax »,« Elmex »,« Signal »,« Lacalut »,« Binaca »,« Pepsodent »,« Chlorodent-fluor-forte »,« Fluorodent »,« Polana »,« Copadent » , «Colgate», «Elgy-fluor», «Macleans», «Aquafresh», etc.
Endogenous ftorprofilaktika caries involves the introduction into the body of fluoride to drinking water, table salt, milk, fluoride tablets. For mass prophylaxis appropriate to fluoridation of drinking water containing fluoride at concentrations of less than 0.5 mg / liter. With fluorine ratornyh installations on city water supply fluoride concentration adjusted to 0,8-1,2 mg / liter.
For younger and middle age as a means kariesprofilakticheskogo gives the effect of the use of fluoridated milk.
Proved kariesprofilakticheskoe effect fluoride salt. The normal concentration of fluoride should be considered 200 mg / kg of salt, when several types of fluoridated salt (for household cooking purposes and for bakeries, restaurants and other catering). This concentration can be increased by a factor of 2 only if only fluoridated salt for household cooking needs.
The effectiveness of caries prevention using ftorsoderzhashih tablets largely depends on the regularity of their admission.
The use of tablets of sodium fluoride helps prevent the formation of cavities not only in those teeth that erupted after the dose, but also to have carved the incomplete process of mineralization. These tablets contain 0.0011 and 0.0022 g sodium fluoride. They are used in age from 2 to 14 years. Necessary daily dose set depending on the child's age and the fluoride in the water a particular source. Sodium fluoride tablets are inside after eating and brushing. Tablets should be chewed and held in mouth until dissolved, then swallow. It is not recommended while taking preparations containing calcium.
Children aged 2 to 6 years are designated by sodium fluoride 0.0011 g, 6 years or older - at 0,0022 g 1 per day. The drug is taken daily, at least 250 days a year, annually until the age of 14.
Contraindicated use of tablets of sodium fluoride in areas where the fluorine content in drinking water exceeds 0.8 mg / liter. For information about the content of fluorine in drinking water are in the sanitary-epidemiological station.
Sodium fluoride release tablets of 0.0011 and 0.0022 g, as well as in powder, which is prepared from 0,05% and 0,2% solutions.
To avoid the risk of acute fluoride poisoning medicinal packaging, containing, as a rule, 200-250 tablets should be stored in places inaccessible to children.
Rp.: Tab. Natrii fluoridi 0,0011 N. 50
D.S. 1 tablet per day (for children 2-6 years)
Rp.: Tab. Natrii fluoridi 0,0022 N. 50
DS 1 tablet per day (children 7-14 years old)
In Poland, issued a similar pills «On-trium fluoratum», containing 0,001 grams of sodium fluoride. This drug is given to children from 3 to 6 years to 1 Cr tablets per day, from 6 to 14 years - 2 tablets per day.
Vitaftor (Vitaphthorum) - combined preparation comprising a complex of vitamins A, C, D2, and sodium fluoride. In 1 ml contains sodium fluoride, 0.22 mg, retinol palmitate (vitamin A) 0.36 mg, ergocalciferol (vitamin D2) 0,002 mg of ascorbic acid (vitamin C) 12 mg with the addition of sorbitol and other substances.
Vitaftor used in combination protivokarioznyh therapeutic and preventive measures. Its advisable to assign children living in areas with inadequate fluoride (less than 1 mg / l) in drinking water, and children with signs of A-and D-hypovitaminosis.
Pharmacological properties vitaftora due to a combination of its vitamins A, D2, C and sodium fluoride. Vitamins A and D2 regulate the exchange of ions of phosphorus and calcium in the body, contribute to their absorption in the intestine and the normal development of tissues of the teeth and skeleton. Sodium fluoride has protivokarioznoe action, is well absorbed and accumulates in the tissues of the teeth, bones and to a lesser extent in cartilage. Ascorbic acid limits the deposition of fluoride salts in the tissues and thereby prevents its side effects.
Accepts vitaftor inside 10-15 minutes after eating or while eating 1 time a day every day. Children from 1 year to 6 years are for 1 / 2 teaspoon, from 7 to 14 years - 1 teaspoonful. The drug is used within 1 month, after a 2-week break, repeat the course. Repeated courses are recommended 4-6 times per year with a break for the summer months.
The drug is contraindicated if the content of fluorine in drinking water of more than 1,5 mg / l and at the phenomena of A-and D-hypervitaminosis.
Product: in bottles of dark glass of 115 ml.
Rp.: Vitaphthori 115 ml
D.S. At 1 ^ 2-1 teaspoon 1 times per day during meals for 3 months.
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