Drug reference

Sodium fluoride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1299, 1300, 1301

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Prophylaxis of dental caries for water content less than 300micrograms/litre (0.3 parts per million) of fluoride ion ▶BY MOUTH USING TABLETS ▶Child 6 months–2 years: 250 micrograms daily, doses expressed as ﬂuoride ion (F-) ▶Child 3–5 years: 500 micrograms daily, doses expressed as ﬂuoride ion (F-) ▶Child 6–17 years: 1 mg daily, doses expressed as ﬂuoride ion (F-) ▶Adult: 1 mg daily, doses expressed as ﬂuoride ion (F-) Prophylaxis of dental caries for water content between 300 and 700micrograms/litre (0.3–0.7 parts per million) of fluoride ion ▶BY MOUTH USING TABLETS ▶Child 3–5 years: 250 micrograms daily, doses expressed as ﬂuoride ion (F-) ▶Child 6–17 years: 500 micrograms daily, doses expressed as ﬂuoride ion (F-) ▶Adult: 500 micrograms daily, doses expressed as ﬂuoride ion (F-) Prophylaxis of dental caries ▶BY MOUTH USING MOUTHWASH ▶Adult: Rinse or gargle 5–10 mL daily DOSE EQUIVALENCE AND CONVERSION ▶Sodium ﬂuoride 2.2 mg provides approx. 1 mg ﬂuoride ion. COLGATE DURAPHAT ® 2800PPM FLUORIDE TOOTHPASTE Prophylaxis of dental caries ▶BY MOUTH USING PASTE ▶Child 10–17 years: Apply 1 centimetre twice daily, to be applied using a toothbrush ▶Adult: Apply 1 centimetre twice daily, to be applied using a toothbrush COLGATE DURAPHAT ® 5000PPM FLUORIDE TOOTHPASTE Prophylaxis of dental caries ▶BY MOUTH USING PASTE ▶Child 16–17 years: Apply 2 centimetres 3 times a day, to be applied after meals using a toothbrush ▶Adult: Apply 2 centimetres 3 times a day, to be applied continued → after meals using a toothbrush EN-DE-KAY ® FLUORINSE Prophylaxis of dental caries ▶BY MOUTH USING MOUTHWASH ▶Adult: 5 drops daily, dilute 5 drops to 10 mL of water, alternatively 20 drops once weekly, dilute 20 drops to 10 mL

PDF pages 1299, 1300

Prescribing And Dispensing Information

Flavours of oral tablet formulations may include orange.

PDF page 1300

Safety

Side Effects

Dental ﬂuorosis

PDF page 1300

Dose and formulations

Directions For Administration

▶With oral use Tablets should be sucked or dissolved in the mouth and taken preferably in the evening. ▶With oral (topical) use For mouthwash, rinse mouth for 1 minute and then spit out. COLGATE DURAPHAT ® 5000PPM FLUORIDE TOOTHPASTE Brush teeth for 3 minutes before spitting out. COLGATE DURAPHAT ® 2800PPM FLUORIDE TOOTHPASTE Brush teeth for 1 minute before spitting out. Ear, nose and oropharynx

PDF page 1300

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Endekay (Manx Healthcare Ltd) Sodium fluoride 1.1 mg Endekay Fluotabs 3-6 Years 1.1mg tablets | 200 tablet p £2.38 DT = £2.38 Sodium fluoride 2.2 mg Endekay Fluotabs 6+ Years 2.2mg tablets | 200 tablet p £2.38 DT = £2.38 Paste ▶Sodium fluoride (Non-proprietary) Fluoride (as Sodium fluoride) 2.8 mg per 1 gram Sodium fluoride 0.619% dental paste sugar free sugar-free | 75 ml P £4.17 DT = £3.81 Fluoride (as Sodium fluoride) 5 mg per 1 gram Sodium fluoride 1.1% dental paste sugar free sugar-free | 51 gram P £7.88 DT = £6.88 ▶Colgate Duraphat (Colgate-Palmolive (UK) Ltd) Fluoride (as Sodium fluoride) 2.8 mg per 1 gram Colgate Duraphat 2800ppm fluoride toothpaste sugar-free | 75 ml P £3.26 DT = £3.81 Fluoride (as Sodium fluoride) 5 mg per 1 gram Colgate Duraphat 5000ppm fluoride toothpaste sugar-free | 51 gram P £6.50 DT = £6.88 Chewable tablet ▶Fluor-a-day (DHP Healthcare Ltd) Sodium fluoride 1.1 mg Fluor-a-day 1.1mg chewable tablets sugar- free | 200 tablet p £3.38 DT = £3.38 Sodium fluoride 2.2 mg Fluor-a-day 2.2mg chewable tablets sugar- free | 200 tablet p £3.38 DT = £3.38 Mouthwash ▶Sodium fluoride (Non-proprietary) Sodium fluoride 500 microgram per 1 ml Sodium fluoride 0.05% mouthwash sugar free sugar-free | 250 ml G s DT = £1.51 ▶Colgate FluoriGard (Colgate-Palmolive (UK) Ltd) Sodium fluoride 500 microgram per 1 ml Colgate FluoriGard 0.05% daily dental rinse alcohol free sugar-free | 400 ml £2.99 Colgate FluoriGard 0.05% daily dental rinse sugar-free | 400 ml G £2.99 ▶Endekay (Manx Healthcare Ltd) Sodium fluoride 500 microgram per 1 ml Endekay 0.05% daily fluoride mouthrinse sugar-free | 250 ml G £1.51 DT = £1.51 sugar-free | 500 ml G £2.45 Oral ulceration and inﬂammation Oral ulceration and inflammation Ulceration and inflammation Ulceration of the oral mucosa may be caused by trauma (physical or chemical), recurrent aphthae, infections, carcinoma, dermatological disorders, nutritional deﬁciencies, gastro-intestinal disease, haematopoietic disorders, and drug therapy (see also Chemotherapy induced mucositis and myelosuppression under Cytotoxic drugs p. 938). It is important to establish the diagnosis in each case as the majority of these lesions require speciﬁc management in addition to local treatment. Local treatment aims to protect the ulcerated area, to relieve pain, to reduce inﬂammation, or to control secondary infection. Patients with an unexplained mouth ulcer of more than 3 weeks’ duration require urgent referral to hospital to exclude oral cancer. Simple mouthwashes A saline mouthwash may relieve the pain of traumatic ulceration. The mouthwash is made up with warm water and used at frequent intervals until the discomfort and swelling subsides. Antiseptic mouthwashes Secondary bacterial infection may be a feature of any mucosal ulceration; it can increase discomfort and delay healing. Use of a chlorhexidine mouthwash p. 1275 is often beneﬁcial and may accelerate healing of recurrent aphthae. Corticosteroids Topical corticosteroid therapy may be used for some forms of oral ulceration. In the case of aphthous ulcers it is most effective if applied in the ‘prodromal’ phase. Thrush or other types of candidiasis are recognised complications of corticosteroid treatment. Hydrocortisone oromucosal tablets p. 1281 are allowed to dissolve next to an ulcer and are useful in recurrent aphthae and erosive lichenoid lesions. Beclometasone dipropionate inhaler p. 1280 sprayed on the oral mucosa is used to manage oral ulceration [unlicensed indication]. Alternatively, betamethasone soluble tablets p. 1281 dissolved in water can be used as a mouthwash to treat oral ulceration [unlicensed indication]. Systemic corticosteroid therapy (see under Corticosteroids, inﬂammatory disorders p. 1216), is reserved for severe conditions such as pemphigus vulgaris. Local analgesics Local analgesics have a limited role in the management of oral ulceration. When applied topically their action is of a relatively short duration so that analgesia cannot be maintained continuously throughout the day. The main indication for a topical local analgesic is to relieve the pain of otherwise intractable oral ulceration particularly when it is due to major aphthae. For this purpose lidocaine hydrochloride 5% ointment below or lozenges containing a local anaesthetic are applied to the ulcer. Lidocaine hydrochloride 10% solution as spray can be applied thinly to the ulcer [unlicensed indication] using a cotton bud. When local anaesthetics are used in the mouth care must be taken not to produce anaesthesia of the pharynx before meals as this might lead to choking. Preparations on sale to the public: many mouth ulcer preparations, throat lozenges, and throat sprays on sale to the public contain a local anaesthetic. To identify the active ingredients in such preparations, consult the product literature of the manufacturer— the correct proprietary name should be ascertained as many products have very similar names but different active ingredients. Benzydamine hydrochloride p. 1280 and ﬂurbiprofen p. 1280 are non-steroidal anti-inﬂammatory drugs (NSAIDs). Benzydamine hydrochloride mouthwash or spray may be useful in reducing the discomfort associated with a variety of ulcerative conditions. It has also been found to be effective in reducing the discomfort of tonsillectomy and post- irradiation mucositis. Some patients ﬁnd the full-strength mouthwash causes some stinging and, for them, it should be diluted with an equal volume of water. Flurbiprofen lozenges are licensed for the relief of sore throat. Choline salicylate p. 1281 is a derivative of salicylic acid and has some analgesic action. The dental gel may provide relief for recurrent aphthae, but excessive application or conﬁnement under a denture irritates the mucosa and can itself cause ulceration. Other preparations Doxycycline p. 1282 rinsed in the mouth may be of value for recurrent aphthous ulceration. Periodontitis Low-dose doxycycline (Periostat ®) is licensed as an adjunct to scaling and root planing for the treatment of periodontitis; a low dose of doxycycline reduces collagenase activity without inhibiting bacteria associated with periodontitis. For anti-infectives used in the treatment of destructive (refractory) forms of periodontal disease, see under Oropharyngeal infections, antibacterial therapy p. 1282. See also Mouthwashes and other preparations for oropharyngeal use p. 1275 for mouthwashes used for oral hygiene and plaque inhibition. ANAESTHETICS, LOCAL

PDF pages 1300, 1301

Clinical care

Patient And Carer Advice

Mouthwash Avoid eating, drinking, or rinsing mouth for 15 minutes after use. COLGATE DURAPHAT ® 5000PPM FLUORIDE TOOTHPASTE Patients or carers should be given advice on how to administer Sodium ﬂuoride toothpaste. COLGATE DURAPHAT ® 2800PPM FLUORIDE TOOTHPASTE Patients or carers should be given advice on how to administer sodium ﬂuoride toothpaste. Avoid drinking or rinsing mouth for 30 minutes after use. l PROFESSION SPECIFIC INFORMATION Dental practitioners’ formulary Tablets may be prescribed as Sodium Fluoride Tablets. Oral drops may be prescribed as Sodium Fluoride Oral Drops. Mouthwashes may be prescribed as Sodium Fluoride Mouthwash 0.05% or Sodium Fluoride Mouthwash 2%. COLGATE DURAPHAT ® 5000PPM FLUORIDE TOOTHPASTE May be prescribed as Sodium Fluoride Toothpaste 1.1%. COLGATE DURAPHAT ® 2800PPM FLUORIDE TOOTHPASTE May be prescribed as Sodium Fluoride Toothpaste 0.619%. Dental information Fluoride mouthwash, oral drops, tablets and toothpaste are prescribable on form FP10D (GP14 in Scotland, WP10D in Wales. There are also arrangements for health authorities to supply ﬂuoride tablets in the course of pre-school dental schemes, and they may also be supplied in school dental schemes. Fluoride gels are not prescribable on form FP10D (GP14 in Scotland, WP10D in Wales).

PDF page 1300

Dose text by age group

Child 6 months–2 years

250 micrograms daily, doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 3–5 years

500 micrograms daily, doses expressed

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 6–17 years

1 mg daily, doses expressed as ﬂuoride

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

1 mg daily, doses expressed as ﬂuoride ion (F-)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 3–5 years

250 micrograms daily, doses expressed

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 6–17 years

500 micrograms daily, doses expressed

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

500 micrograms daily, doses expressed as

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

Rinse or gargle 5–10 mL daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 10–17 years

Apply 1 centimetre twice daily, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

Apply 1 centimetre twice daily, to be applied

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 16–17 years

Apply 2 centimetres 3 times a day, to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

Apply 2 centimetres 3 times a day, to be applied

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

5 drops daily, dilute 5 drops to 10 mL of water,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1300

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Sodium fluoride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1299, 1300, 1301

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 1299, 1300

Prescribing And Dispensing Information

Flavours of oral tablet formulations may include orange.

PDF page 1300

Safety

Side Effects

Dental ﬂuorosis

PDF page 1300

Dose and formulations

Directions For Administration

PDF page 1300

Medicinal Forms

PDF pages 1300, 1301

Clinical care

Patient And Carer Advice

PDF page 1300

Dose text by age group

Child 6 months–2 years

250 micrograms daily, doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 3–5 years

500 micrograms daily, doses expressed

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 6–17 years

1 mg daily, doses expressed as ﬂuoride

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

1 mg daily, doses expressed as ﬂuoride ion (F-)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 3–5 years

250 micrograms daily, doses expressed

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 6–17 years

500 micrograms daily, doses expressed

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

500 micrograms daily, doses expressed as

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

Rinse or gargle 5–10 mL daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 10–17 years

Apply 1 centimetre twice daily, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

Apply 1 centimetre twice daily, to be applied

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Child 16–17 years

Apply 2 centimetres 3 times a day, to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

Apply 2 centimetres 3 times a day, to be applied

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1299

Adult

5 drops daily, dilute 5 drops to 10 mL of water,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1300

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.