Public Health · single question
A patient with bulimia presents with significant dental erosion. Which of the following advice should NOT be given?
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Correct answer: C. Apply acidulated phosphate fluoride (APF) gel in the office
C) Apply acidulated (APF) fluoride gel — CORRECT (should NOT be used).
Acidulated phosphate fluoride (APF) has a low pH (~3.5) and can further ETCH already softened and eroded enamel in bulimic patients. Neutral sodium fluoride (NaF) gels or varnishes should be used instead for fluoride therapy in these patients. APF is contraindicated when enamel is thin, compromised, or etched.
A) Rinse with water: Recommended — dilutes and removes acid from the mouth after purging. Appropriate advice.
B) Fluoride toothpaste: Appropriate — helps remineralize eroded enamel. Patients should wait 30–60 minutes after vomiting before brushing though.
D) Avoid immediate brushing: Correct advice — brushing on acid-softened enamel causes additional abrasion.
Acidulated phosphate fluoride (APF) has a low pH (~3.5) and can further ETCH already softened and eroded enamel in bulimic patients. Neutral sodium fluoride (NaF) gels or varnishes should be used instead for fluoride therapy in these patients. APF is contraindicated when enamel is thin, compromised, or etched.
A) Rinse with water: Recommended — dilutes and removes acid from the mouth after purging. Appropriate advice.
B) Fluoride toothpaste: Appropriate — helps remineralize eroded enamel. Patients should wait 30–60 minutes after vomiting before brushing though.
D) Avoid immediate brushing: Correct advice — brushing on acid-softened enamel causes additional abrasion.