Fluoride Therapy - 2
Carious lesions associated with xerostomia are often found along the gingival margin on exposed buccal and lingual root surfaces, at and underneath crown margins, and in root furcations. Initially, these surfaces may appear as incipient areas of decalcification along the cervical margin; later, areas of decalcification are evident on posterior cusp tips and incisal edges of anterior teeth. Eventually, carious lesions become circumferential, and invade all surfaces of the enamel.13,14 Increased enamel erosion and abrasion are also evident in xerostomic clients, which facilitates plaque accumulation, dental caries formation, gingival inflammation and recession.9 Root caries are often found in areas that are difficult to access with daily oral hygiene procedures, leading to extensive destruction of the teeth and possible tooth loss. For teeth that serve as anchors for fixed partial dentures, dental caries destruction is of great significance, as restoration of these areas can be costly for the client, and restorative options may be limited.
Clients experiencing drug-induced xerostomia must be placed on a topical supplemental fluoride, used daily in conjunction with an effective oral hygiene regimen. Fluoride ions become incorporated into the enamel or dentin by replacing hydroxyapatite crystals with fluorapatite crystals, which are more resistant to acid erosion. The resultant acid resistance of the tooth structure decreases the rate of demineralization. Fluoride has also been shown to increase both the size and rate of growth of enamel crystals formed during remineralization, and enhances the natural remineralizing actions of saliva.9 ,15 ,16 ,17
