Hygiene Atlas

Atlas · Plate XV · Caries and Preventive Agents · 05

Topical fluorides

Know the strengths: 5% sodium fluoride varnish holds 22,600 ppm, 1.23% APF gel 12,300 ppm, 2% neutral sodium fluoride about 9,000 ppm and prescription 1.1% paste 5,000 ppm. Varnish is safest for young children and is repeated every 3-6 months for elevated risk. APF is acidic, so keep it off porcelain, composite, glass ionomer and titanium.

High-yield facts · 12

  1. 5% sodium fluoride varnish = 22,600 ppm F; about 0.25 mL for a primary dentition, 0.4 mL mixed, 0.5 mL permanent.S3
  2. Varnish sets on contact with saliva, can be placed on moist teeth, and is safest for young children because little is swallowed.S3
  3. Varnish frequency for elevated risk: at least every 3-6 months.S3
  4. 1.23% APF gel or foam = 12,300 ppm, pH about 3.5; applied 4 minutes in trays; avoid on porcelain, composite, glass ionomer and titanium.S3
  5. 2% neutral sodium fluoride gel = about 9,000 ppm; safe on restorations and implants.S3
  6. 0.4% stannous fluoride gel (about 1,000 ppm) and 0.454% SnF2 toothpaste (about 1,100 ppm) are antimicrobial and can stain.T2
  7. Prescription 1.1% NaF toothpaste = 5,000 ppm, for high-risk patients 6 and older.S3
  8. OTC toothpastes: 0.243% NaF (1,100 ppm) or 0.76% sodium monofluorophosphate (1,000 ppm), about 1,000-1,500 ppm.S3
  9. Fluoride rinses: 0.05% NaF daily (about 230 ppm) and 0.2% NaF weekly (about 900 ppm, used in school programs).S33
  10. Rinses are not recommended for children under 6 because they may swallow them.S33
  11. Toothpaste amounts: a rice-grain smear under age 3 and a pea-size amount ages 3-6.S3
  12. Patients should not eat or drink for 30 minutes after gel/foam; after varnish, soft foods are fine but avoid brushing and hot or hard foods for about 4-6 hours.T2

Facts are written in our own words; each tag links to its source. Values marked "sources vary" differ between references, so check the one your program uses.