Restorative & Materials · patient case question
What is the most relevant property of a topical fluoride agent for sustained caries prevention?
Patient case: Wear, erosion and a burning mouth
demo: 31-year-old female
chief: Sensitive front teeth that look increasingly thin, and occasional pain that comes and goes.
history: She drinks four cans of soda daily and has a history she is reluctant to discuss regarding eating patterns. She is otherwise well.
meds: None.
findings: Marked erosion of the lingual surfaces of the maxillary teeth with intact buccal surfaces. Smooth, shiny, saucer-shaped cervical lesions on the buccal aspects of several premolars. Parotid regions appear full bilaterally.
Show answer and explanation
Correct answer: A. Substantivity, the ability to be retained and released over time
- A. Correct. Substantivity means the agent binds to oral surfaces and continues releasing fluoride long after application. Calcium fluoride-like deposits act as a reservoir, releasing fluoride when pH drops. This is why fluoride varnish outperforms a rinse that is cleared in minutes, and it is the same property that makes chlorhexidine effective.
- B. Fluoride does inhibit bacterial enolase at high concentration, but its principal action is on the mineral phase rather than antibacterial.
- C. Bioavailability at the moment of application matters for uptake, but a high concentration cleared quickly gives little sustained protection.
- D. Viscosity affects handling and retention time somewhat, but it is not the underlying property being tested.
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