Journal of Dental Research, Vol 66, 1066-1071, Copyright © 1987 by International & American Associations for Dental Research Online Journals
Clinical application of topical fluoride products--risks, benefits, and recommendations
E. J. Lecompte
This portion of the symposium discusses the various methods of
professionally applying high-concentration topical fluoride products and
their risks and benefits. Numerous recent investigations in this area of
research are reviewed and discussed. Data from these research
investigations point to the need for care when high-potency F products are
used, especially in young children. Oral-retained F doses following
four-minute topical application procedures ranged from 10 to 31 mg when no
suction devices or patient expectoration was utilized. Following the use of
suctioning devices, oral-retained F doses ranged from 6 to 12 mg, a
clinically unacceptable level. Following the use of suctioning devices plus
patient expectoration, the oral-retained F doses were reduced to from 2 to
7.5 mg, depending on type of F product and application system. The
following recommendation for topical application of high-potency F products
are made: (1) No more than 2 g of gel per tray or approximately 40% of tray
capacity should be dispensed. Even more conservative amounts should be
considered for small children. (2) Because patients may have the need to
swallow during a four-minute topical application procedure, the use of a
saliva ejector during the procedure is recommended. (3) Following the
four-minute application procedure, the patient should be instructed to
expectorate thoroughly for from 30 sec to one min, regardless of whether
high-speed suction is utilized. Expectoration is probably the single most
effective way of reducing orally retained fluoride. (4) When utilizing
custom individually fitted trays for patients requiring daily or weekly
application of a high-F-concentration product, utilize only 5 to 10 drops
of product per tray.
