2012 Fluoride Therapy Guide
Transcription
2012 Fluoride Therapy Guide
YOUR PARTNER IN ORAL HEALTH 2012 Fluoride Therapy Guide AT-HOME FLUORIDE Neutral Sodium Fluorides Colgate® PreviDent® 5000 BOOSTER (Rx Only) Colgate® PreviDent® 5000 SENSITIVE (Rx Only) Prescription Strength Toothpaste Prescription Strength Toothpaste for Sensitive Teeth Active Ingredient 1.1% sodium fluoride (5000 ppm F-) • 1.1% sodium fluoride (5000 ppm F-) • 5% potassium nitrate Patient Condition • Medium to high caries risk • Orthodontic decalcification • Dentin hypersensitivity • Medium to high caries risk • Root exposure Mode of Action • Fluoride inhibits demineralization of dental enamel, stimulates remineralization and reduces acid production in plaque • Liquid gel formula enables faster fluoride dispersion than pasteform Rx toothpaste1 • Fluoride inhibits demineralization of dental enamel, stimulates remineralization and reduces acid production in plaque • Potassium nitrate desensitizes the pulpal nerve endings to provide clinically proven sensitivity relief3 • Liquid gel formula enables faster fluoride dispersion than pasteform Rx toothpaste1 • Strengthens teeth2 • Reverses early caries2 • Technology shown to significantly remineralize root caries2 • Sensitivity relief and prescription fluoride in one convenient product • Strengthens teeth2 • Reverses early caries2 • Technology shown to significantly remineralize root caries2 a) by 38% in three months2 Dental Professional and patient Benefits a) by 38% in three months2 b) by 57% in six months2 • Mild cleaning system with low abrasion See page 7 for brief summary of information. To Order: 1.800.372.4346 1 b) by 57% in six months2 • Contains 5% potassium nitrate, clinically proven for sensitivity relief3 • Gentle cleaning system Colgate® PreviDent® 5000 ENAMEL PROTECT (Rx Only) Prescription Strength Toothpaste Prescription Strength Toothpaste for Sensitive Teeth 1.1% sodium fluoride (5000 ppm F-) • 1.1% sodium fluoride (5000 ppm F-) • 5% potassium nitrate • Medium to high caries risk • Patient requires gentle toothpaste formulation • Hypersensitivity resulting from enamel wear • Medium to high caries risk • Fluoride inhibits demineralization of dental enamel, stimulates remineralization and reduces acid production in plaque • Liquid gel formula enables faster fluoride dispersion than pasteform Rx toothpaste1 • Fluoride strengthens enamel and makes teeth more resistant to acid attacks • Potassium nitrate desensitizes the pulpal nerve endings to provide clinically proven sensitivity relief3 • Liquid gel formula enables faster fluoride dispersion than pasteform Rx toothpaste1 • Strengthens teeth2 • Reverses early caries2 • Technology shown to significantly remineralize root caries2 a) by 38% in three months2 • Strengthens teeth and helps protect against acid wear5 • Clinically proven technology to increase resistance to enamel erosion by over 50% vs Sensodyne® ProNamel™5 • Technology shown to significantly remineralize root caries2 b) by 57% in six months2 a) by 38% in three months2 b) by 57% in six months2 • SLS free formula • Gentle cleaning system • Soothing mint flavor formulated to appeal to dry mouth sufferers4 • Contains 5% potassium nitrate, clinically proven for sensitivity relief3 • Mild cleaning system with low abrasion * Formulated for dry mouth sufferers Sensodyne® is a registered trademark of GlaxoSmithKline CAVITY PROTECTION / SENSITIVITY RELIEF Colgate® PreviDent® 5000 DRY MOUTH* (Rx Only) www.colgateprofessional.com 2 AT-HOME FLUORIDE Neutral Sodium Fluorides Colgate® PreviDent® 5000 PLUS (Rx Only) Colgate® PreviDent® GEL (Rx Only) Prescription Strength Toothpaste Prescription Strength Toothpaste Active Ingredient 1.1% sodium fluoride (5,000 ppm F-) 1.1% sodium fluoride (5,000 ppm F-) Patient Condition • Medium to high caries risk • Root exposure • Medium to high caries risk • Root exposure Mode of Action Fluoride inhibits demineralization of dental enamel, stimulates remineralization and reduces acid production in plaque Fluoride inhibits demineralization of dental enamel, stimulates remineralization, and reduces acid production in plaque • Strengthens teeth2 • Reverses early root caries2 • Technology shown to significantly remineralize root caries2 • Provides an effective second fluoride treatment after brushing with a fluoride toothpaste • Up to 91% arrestment of early root caries6 • Can be delivered via custom mouth tray, for patients who have difficulty brushing • Pleasant flavor improves patient compliance • Safe for porcelain crowns & composite restorations Dental Professional and patient Benefits a) by 38% in three months2 b) by 57% in six months2 • Mild cleaning system with low abrasion • Safe for restorations and ceramic crowns See page 7 for brief summary of information. To Order: 1.800.372.4346 3 ® When should you recommend a Colgate® PreviDent® 5000 Rx product? Reduces caries up to 55% 0.2% sodium fluoride (900 ppm F-) • Medium to high caries risk • Difficulty brushing Fluoride inhibits demineralization of dental enamel, stimulates remineralization, and reduces acid production in plaque GINGIVAL RECESSION with exposure of root surfaces. ORTHODONTIC TREATMENT increases the number of sites where plaque can accumulate. RESTORATIONS might harbor bacteria at their margin, putting them at risk for recurrent decay. PERIODONTAL TREATMENT might leave dentin exposed with a increased risk of dentin hypersensitivity and root caries. DRY MOUTH significantly increases the risk of rampant caries. ACID EROSION might expose dentin, leading to hypersensitivity. Liquid gel formula enables faster fluoride dispersion vs. paste form toothpaste8 • • • • • • Provides 4 times the fluoride of an OTC rinse Up to 55% caries reduction with weekly use7 Once weekly regimen helps to improve patient compliance Pleasant cool mint flavor Once weekly regimen for ease of use Safe for all types of restorations ppm Fluoride Release 4500 4000 +26% 3500 PreviDent® 5000 Liquid Gel Dentifrice 5,000 ppm Toothpaste 3000 2500 2000 1500 1000 500 0 0 5 10 15 20 Time (Seconds) 25 30 CAVITY PROTECTION / SENSITIVITY RELIEF Colgate PreviDent RINSE (Rx Only) ® www.colgateprofessional.com 4 OVER THE COUNTER Stannous Fluorides Colgate® Gel-Kam® GEL Colgate® Phos-Flur® RINSE Preventative Treatment Gel for Cavity Protection & Sensitive Teeth Anticavity Dental Rinse Active Ingredient 0.4% stannous fluoride (970 ppm F-) 0.044% sodium fluoride in an acidulated phosphate solution (200 ppm F-) Patient Condition • Medium to high caries risk • Hypersensitivity due to exposed dentin • Prevention of decay • Orthodontic decalcification • Caries risk Mode of Action • The anti-bacterial effect of stannous ions helps prevent plaque formation and the fluoride helps to control caries9 • Stannous fluoride helps form a tin-rich surface deposit to occlude open dentin tubules9 Acidulated phosphate fluoride solution creates microscopic calcium fluoride reservoirs; lowered pH allows for enhanced uptake and retention of fluoride in enamel Dental Professional and patient Benefits • 0.4% stannous fluoride strengthens and remineralizes the enamel • Provides an effective second fluoride treatment after brushing with a fluoride toothpaste • Enhanced protection against caries versus toothpaste alone10 • Clinically proven to help prevent caries11 • Reduces white spots by up to 58%12 • Remineralizes teeth by forming microscopic reservoirs of fluoride on the tooth’s enamel13 • ADA Seal • Choice of pleasant flavors See page 7 for brief summary of information. To Order: 1.800.372.4346 5 Acidulated Phosphate Fluorides Colgate® PreviDent® VARNISH (Rx Only) Braces may lead to white spots. Help to reduce the appearance of white spots with Colgate® Phos-Flur® Rinse.12 5% sodium fluoride (22,600 ppm F-) • Dentin hypersensitivity • Post periodontal surgery • Medium to high caries risk* • Post scaling / root planing • Root exposure Deposition of significant amounts of calcium fluoride that inhibit dentin fluid flow and provide a reservoir of fluoride ions • Ready-to-use unit dose treatment • Highest fluoride concentration available (22,600 ppm F-) as compared to n on-varnish fluorides • Provides high concentration of fluoride at the enamel and exposed dentin surface • Dries transparent on teeth • Contains xylitol, a natural sweetener * Use of fluoride varnish for caries prevention has been endorsed by the ADA Council of Scientific Affairs. Although FDA has cleared fluoride varnishes to be used as cavity varnishes/liners and for the treatment of hypersensitive teeth, caries prevention is an “off-label” use because FDA has not cleared it for this purpose.15 Available in: Colgate® Phos-Flur® Rinse provides a unique acidulated phosphate fluoride solution: Shown in a clinical study to provide greater fluoride uptake & deeper fluoride penetration14 Clinically proven to help prevent caries11 Contains phosphate to help build strong teeth CAVITY PROTECTION / SENSITIVITY RELIEF IN-OFFICE FLUORIDE Neutral Sodium Fluorides www.colgateprofessional.com 6 This is a brief summary of the prescribing information, for full prescribing information please visit www.colgateprofessional.com ® ® DESCRIPTION: Self-topical neutral fluoride toothpaste containing 1.1% (w/w) sodium fluoride®for use ® as a dental caries preventive in adults and pediatric patients. ® 1.1% Sodium Fluoride ® DESCRIPTION: Self-topical neutral fluoride toothpaste containing 1.1% (w/w) sodium ® fluoride and 5% potassium nitrate. ® ® Active Ingredient: Sodium fluoride (NaF) PRESCRIPTION 1.1% (w/w) STRENGTH TOOTHPASTE ® ® ® Active Ingredients: Sodium fluoride 1.1% (w/w),Potassium nitrate 5% INDICATIONS AND USAGE: A dental caries preventive and sensitive teeth toothpaste; for twice daily self-applied topical use, followed by rinsing. Helps reduce the painful sensitivity of the teeth cold, heat, acids, sweets or contact in adult patients and children 12 yearsFluoride 1.1% to Sodium Fluoride 1.1% Sodium *Formulated Mouth established Sufferers of age and older.forItDry is well that 1.1% sodium fluoride is safe and extraordinarily PRESCRIPTION 1-4STRENGTH TOOTHPAS effective as a caries preventive when applied frequently with mouthpiece applicators. PRESCRIPTION STRENGTH TOOTHPASTE PRESCRIPTION STRENGTH TOOTHPASTE FOR SENSITIVE TEETH PreviDent® 5000 Sensitive brand of 1.1% sodium fluoride toothpaste with 5% potassium nitrate in a squeeze bottle is easily applied onto a toothbrush. This prescription toothpaste should be used twice daily in place of your regular toothpaste unless otherwise instructed 0.2% Neutral Sodium Fluo % used Sodium Fluoride % Sodium by your dental professional. May1.1be in areas where drinking water is fluoridated1.1 since topical Fluoride fluoride cannot produce fluorosis. (See WARNINGS for exception.) PRESCRIPTION STRENGTH TOOTHPASTE Non-abrasive formula is gentle SENSITIVE DRY MOUTH 1.1% Sodium Fluoride 5% Potassium Nitrate INDICATIONS AND USAGE: A dental caries preventive; for once daily self-applied topical use. It is well established that 1.1% sodium fluoride is safe and extraordinarily effective as a caries preventive when applied frequently with mouthpiece applicators.1-4 PreviDent® 5000 Booster brand of 1.1% 1.1% Sodium Fluoride 1.1% Sodium Fluoride 1.1% Sodium Fluoride sodium fluoride toothpaste in a squeeze bottle is easily applied onto a toothbrush. This *Formulated for Dryprescription Mouth Sufferers 5% Potassium Nitrate PRESCRIPTION STRENGTH TOOTHPASTE toothpaste should be used once daily in place of your regular toothpaste unless otherwise instructed PRESCRIPTION STRENGTH TOOTHPASTE on teeth and gums PRESCRIPTION STRENGTH by your dental professional. May be used in areas where drinking water is fluoridated since topical TOOTHPASTE FOR SENSITIVE TEETH CONTRAINDICATIONS: Do not use in pediatric patients under age 12 years unless recommended by a dentist or physician. fluoride cannot produce fluorosis. (See WARNINGS for exception.) WARNINGS: Not for systemic treatment - DO NOT SWALLOW. Keep out of reach of infants and children. Children under 12 years of age, consult a dentist CONTRAINDICATIONS: Do not use in pediatric patients under age 6 years unless recommended by a dentist or physician. or physician. Note: Sensitive teeth may indicate a serious problem that may need prompt care by a dentist. See your dentist if the problem persists or worsens. Do not WARNINGS: Prolonged daily ingestion may result in various degrees of dental fluorosis in pediatric patients under age 6 years, especially if the water use this product longer than 4 weeks unless recommended by a dentist or physician. fluoridation exceeds 0.6 ppm, since younger pediatric patients frequently cannot perform the brushing process without significant swallowing. Use in pediatric patients under age 6 years requires special supervision to prevent repeated swallowing of toothpaste which could cause dental fluorosis. Pediatric patients under PRECAUTIONS: age 12 should be supervised in the use of this product. Read directions carefully before using. Keep out of reach of infants and children. General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in male and female mice and PRECAUTIONS: female rats treated with fluoride at dose levels ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in General: Not for systemic treatment. DO NOT SWALLOW. male rats treated with 2.5 and 4.1 mg/kg of body weight. In a second study, no carcinogenesis was observed in rats, males or females, treated with Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in male and female mice and female rats fluoride up to 11.3 mg/kg of body weight. Epidemiological data provide no credible evidence for an association between fluoride, either naturally treated with fluoride at dose levels ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in male rats treated with 2.5 occurring or added to drinking water, and risk of human cancer. and 4.1 mg/kg of body weight. In a second study, no carcinogenesis was observed in rats, males or females, treated with fluoride up to 11.3 mg/kg of body weight. Fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion has potential to induce chromosome aberrations in Epidemiological data provide no credible evidence for an association between fluoride, either naturally occurring or added to drinking water, and risk of human cancer. cultured human and rodent cells at doses much higher than those to which humans are exposed. In vivo data are conflicting. Some studies report Fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion has potential to induce chromosome aberrations in cultured human chromosome damage in rodents, while other studies using similar protocols report negative results. and rodent cells at doses much higher than those to which humans are exposed. In vivo data are conflicting. Some studies report chromosome damage in rodents, Potential adverse reproductive effects of fluoride exposure in humans has not been adequately evaluated. Adverse effects on reproduction were reported while other studies using similar protocols report negative results. for rats, mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats Potential adverse reproductive effects of fluoride exposure in humans has not been adequately evaluated. Adverse effects on reproduction were reported for rats, demonstrated that lower concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities. mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats demonstrated that lower Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities. administered is incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount administered is 12.2 mg fluoride/kg of body weight (rats) or 13.1 mg/kg of body weight (rabbits) did not affect the litter size or fetal weight and did not increase the incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to 12.2 mg fluoride/kg of body weight frequency of skeletal or visceral malformations. There are no adequate and well-controlled studies in pregnant women. However, epidemiological (rats) or 13.1 mg/kg of body weight (rabbits) did not affect the litter size or fetal weight and did not increase the frequency of skeletal or visceral malformations. There studies conducted in areas with high levels of naturally fluoridated water showed no increase in birth defects. Heavy exposure to fluoride during in utero are no adequate and well-controlled studies in pregnant women. However, epidemiological studies conducted in areas with high levels of naturally fluoridated water development may result in skeletal fluorosis which becomes evident in childhood. showed no increase in birth defects. Heavy exposure to fluoride during in utero development may result in skeletal fluorosis which becomes evident in childhood. Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised when products when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to were seen in rats administered fluoride up to 5 mg/kg of body weight. 5 mg/kg of body weight. Pediatric Use: Safety and effectiveness in pediatric patients below the age of 12 years have not been established. Please refer to the Pediatric Use: The use of PreviDent® 5000 Booster in pediatric age groups 6 to 16 years as a caries preventive is supported by pioneering clinical studies with 1.1% CONTRAINDICATIONS and WARNINGS sections. sodium fluoride gels in mouth trays in students age 11 to 14 years conducted by Englander et al.2-4 Safety and effectiveness in pediatric patients below the age of 6 Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/v) sodium fluoride, 15 percent were 65 and over, while 1 percent were years have not been established. Please refer to the CONTRAINDICATIONS and WARNINGS sections. 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/w) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are useful to monitor renal function.5 more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.5 SENSITIVE ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies have been rarely reported. ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies have been rarely reported. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) have been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) have been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (a thin ribbon) of PreviDent® 5000 Booster contains approximately 2.5 mg fluoride. A 3.4 FL OZ (100 mL) bottle contains approximately 608 mg fluoride. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion. (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) have been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) have been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (a thin ribbon) of PreviDent® 5000 Sensitive contains approximately 2.5 mg fluoride. A 3.4 FL OZ (100 mL) bottle contains approximately 575 mg fluoride. DOSAGE AND ADMINISTRATION: Follow these instructions unless otherwise instructed by your dental professional: 1.Adults and pediatric patients 6 years of age or older, apply a thin ribbon of PreviDent® 5000 Booster to a toothbrush. Brush thoroughly once daily for two minutes, preferably at bedtime, in place of your regular toothpaste. 2.After use, adults expectorate. For best results, do not eat, drink, or rinse for 30 minutes. Pediatric patients, ages 6-16 years of age, expectorate after use and rinse mouth thoroughly. DOSAGE AND ADMINISTRATION: Follow these instructions unless otherwise instructed by your dental professional: Adults and children 12 years of age and older: Apply at least a 1 inch strip of PreviDent® 5000 Sensitive onto a soft bristle toothbrush. Brush teeth thoroughly for at least 1 minute, expectorate, and rinse mouth thoroughly. Use twice a day (morning and evening) or as recommended by a dentist or physician. Make sure to brush all sensitive areas of the teeth. Children under 12 years of age: Consult a dentist or physician. Rev. 11/08 To Order: 1.800.372.4346 7 DRY MOUTH Rev. 11/08 ® DESCRIPTION: Self-topical neutral fluoride toothpaste containing 1.1% (w/w) sodium fluoride for use as a dental caries preventative in adults and pediatric patients. ® ® DRY MOUTH 1.1% Sodium Fluoride *Formulated for Dry Mouth Sufferers PRESCRIPTION STRENGTH TOOTHPASTE Active Ingredient: Sodium fluoride 1.1% (w/w) INDICATIONS AND USAGE: A dental caries preventive; for once daily self-applied topical use. It is well established that 1.1% sodium fluoride is safe and extraordinarily effective as a caries 1-4 ® preventive when applied frequently with mouthpiece applicators. PreviDent 5000 Dry Mouth 1.1% Sodium Fluoride 1.1% Sodium Fluoride 1.1% Sodium Fluoride brand of 1.1% sodium fluoride toothpastePRESCRIPTION in a squeezeSTRENGTH bottle is TOOTHPASTE easily applied onto a toothbrush. PRESCRIPTION STRENGTH TOOTHPASTE Non-abrasive formula is gentle This prescription toothpaste should be used once daily in place of your regular toothpaste unless on teeth and gums otherwise instructed by your dental professional. May be used in areas where drinking water is fluoridated since topical fluoride cannot produce fluorosis. (See WARNINGS for exception.) CONTRAINDICATIONS: Do not use in pediatric patients under age 6 years unless recommended by a dentist or physician. WARNINGS: Prolonged daily ingestion may result in various degrees of dental fluorosis in pediatric patients under age 6 years, especially if the water fluoridation exceeds 0.6 ppm, since younger pediatric patients frequently cannot perform the brushing process without significant swallowing. Use in pediatric patients under age 6 years requires special supervision to prevent repeated swallowing of toothpaste which could cause dental fluorosis. Pediatric patients under age 12 should be supervised in the use of this product. Read directions carefully before using. Keep out of reach of infants and children. PRECAUTIONS: General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in male and female mice and female rats treated with fluoride at dose levels ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in male rats treated with 2.5 and 4.1 mg/kg of body weight. In a second study, no carcinogenesis was observed in rats, males or females, treated with fluoride up to 11.3 mg/kg of body weight. Epidemiological data provide no credible evidence for an association between fluoride, either naturally occurring or added to drinking water, and risk of human cancer. Fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion has potential to induce chromosome aberrations in cultured human and rodent cells at doses much higher than those to which humans are exposed. In vivo data are conflicting. Some studies report chromosome damage in rodents, while other studies using similar protocols report negative results. Potential adverse reproductive effects of fluoride exposure in humans has not been adequately evaluated. Adverse effects on reproduction were reported for rats, mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats demonstrated that lower concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities. Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount administered is incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to 12.2 mg fluoride/kg of body weight (rats) or 13.1 mg/kg of body weight (rabbits) did not affect the litter size or fetal weight and did not increase the frequency of skeletal or visceral malformations. There are no adequate and well-controlled studies in pregnant women. However, epidemiological studies conducted in areas with high levels of naturally fluoridated water showed no increase in birth defects. Heavy exposure to fluoride during in utero development may result in skeletal fluorosis which becomes evident in childhood. Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to 5 mg/kg of body weight. Pediatric Use: The use of PreviDent® 5000 Dry Mouth in pediatric age groups 6 to 16 years as a caries preventive is supported by pioneering clinical studies with 1.1% sodium fluoride gels in mouth trays in students age 11 to 14 years conducted by Englander et al.2-4 Safety and effectiveness in pediatric patients below the age of 6 years have not been established. Please refer to the CONTRAINDICATIONS and WARNINGS sections. Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/v) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.5 ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies have been rarely reported. DESCRIPTION: Self-topical®neutral fluoride toothpaste containing 1.1% (w/w) sodium fluoride and 5% potassium nitrate. ® ® ® ENAMEL PROTECT 0.2% Neutral Sodium Fluoride 1.1% Sodium Fluoride 5% Potassium Nitrate PRESCRIPTION STRENGTH TOOTHPASTE FOR SENSITIVE TEETH ® Active Ingredients: Sodium fluoride 1.1%(w/w), Potassium nitrate 5% Inactive Ingredients: water, hydrated silica, sorbitol, PEG-12, sodium lauryl sulfate, DRY MOUTH carrageenan, dioxide, sodium 0.63% Stannousflavor, poloxamer 407, cocamidopropyl 0.4%betaine, Stable titanium Stannous Fluoride Fluoride Concentrate saccharin, mica, sodium hydroxide PREVENTATIVE TREATMENT GEL 1.1% Sodium Fluoride 1.1% Sodium Fluoride Acidulat ORAL CARE RINSE *Formulated for Dry Mouth Sufferers CLINICAL PHARMACOLOGY: Frequent topical applications to the teeth with preparations PRESCRIPTION STRENGTH TOOTHP STRENGTH TOOTHPASTE havingPRESCRIPTION a relatively high fluoride content increase tooth resistance to acid dissolution and enhance penetration of the fluoride ion into tooth enamel. INDICATIONS AND USAGE: A dental caries preventive and sensitive teeth toothpaste; for twice daily self-applied topical use, followed by rinsing. Helps reduce the painful sensitivity of the teeth to cold, heat, acids, sweets or contact in adult patients and children 12 years of age and older. It is well established that 1.1% sodium fluoride is safe and extraordinarily effective as a caries preventive when applied frequently with mouthpiece applicators.1-4 PreviDent® Sensitive brand of 1.1% sodium fluoride toothpaste with 5% potassium nitrate in a squeeze bottle is easily applied onto a toothbrush. This prescription toothpaste should be used twice daily in place of your regular toothpaste unless otherwise instructed by your dental professional. May be used in areas where drinking water is fluoridated since topical fluoride cannot produce fluorosis. (See WARNINGS for exception.) CONTRAINDICATIONS: Do not use in pediatric patients under age 12 years unless recommended by a dentist or physician. WARNINGS: Not for systemic treatment - DO NOT SWALLOW. Keep out of reach of infants and children. Children under 12 years of age, consult a dentist or physician. Note: Sensitive teeth may indicate a serious problem that may need prompt care by a dentist. See your dentist if the problem persists or worsens. Do not use this product longer than 4 weeks unless recommended by a dentist or physician. PRECAUTIONS: General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in male and female mice and female thers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to 5 mg/kg of body weight. Pediatric Use: Safety and effectiveness in pediatric patients below the age of 12 years have not been established. Please refer to the CONTRAINDICATIONS and WARNINGS sections. Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/v) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.5 ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies have been rarely reported. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) have been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) have been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (a thin ribbon) of PreviDent® 5000 Enamel Protect contains approximately 2.5 mg fluoride. A 3.4 FL OZ (100 mL) bottle contains approximately 591 mg fluoride. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) have been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) have been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (a thin ribbon) of PreviDent® 5000 Dry Mouth contains approximately 2.5 mg fluoride. A 3.4 FL OZ (100 mL) bottle contains approximately 608 mg fluoride. DOSAGE AND ADMINISTRATION: Follow these instructions unless otherwise instructed by your dental professional: 1. Adults and children 12 years of age and older: Apply at least a 1 inch strip of PreviDent® 5000 Enamel Protect onto a soft bristle toothbrush. Brush teeth thoroughly for at least 1 minute, expectorate, and rinse mouth thoroughly. 2. Use twice a day (morning and evening) or as recommended by a dentist or physician. Make sure to brush all sensitive areas of the teeth. Children under 12 years of age: Consult a dentist or physician. DOSAGE AND ADMINISTRATION: Follow these instructions unless otherwise instructed by your dental professional: 1. Adults and pediatric patients 6 years of age or older, apply a thin ribbon of PreviDent® 5000 Dry Mouth to a toothbrush. Brush thoroughly once daily for two minutes, preferably at bedtime, in place of your regular toothpaste. 2. After use, adults expectorate. For best results, do not eat, drink, or rinse for 30 minutes. Pediatric patients, ages 6-16 years of age, expectorate after use and rinse mouth thoroughly. STORAGE: Store at Controlled Room Temperature, 68-77°F (20-25°C) Rev. 11/08 HOW SUPPLIED: 3.4 FL OZ (100 mL) in plastic bottles. Mint: NDC 0126-0022-92 REFERENCES: 1. American Dental Association, Accepted Dental Therapeutics Ed. 40 (Chicago, 1984): 405-407. 2. H.R. Englander et al., JADA 75 (1967): 638-644. 3. H.R. Englander et al., JADA 78 (1969): 783-787. 4. H.R. Englander et al., JADA 83 (1971): 354-358. 5. Data on file, Colgate Oral Pharmaceuticals. Rev. 12/10 www.colgateprofessional.com 8 ® DESCRIPTION: Self-topical neutral fluoride dentifrice containing 1.1% (w/w) sodium fluoride for use as a dental caries preventive in adults and pediatric patients. ® ® NSITIVE 1.1% Sodium Fluoride Sodium Fluoride Potassium Nitrate PRESCRIPTION STRENGTH TOOTHPASTE RIPTION STRENGTH HPASTE FOR SENSITIVE TEETH for exception.) ® ACTIVE INGREDIENT: Sodium Fluoride 1.1% (w/w). ACTIVE INGREDIENTS: Sodium Fluoride (NaF) 1.1% (w/v). INDICATIONS AND USAGE: A dental caries preventive; for once daily self-applied topical use. It is well established that 1.1% sodium fluoride is safe and extraordinarily effective as a caries preventive when ® ® Neutral Sodium Fluoride applied frequently withFluoride mouthpiece applicators.1-4 PreviDent0.2% 50001.1 Plus brand ofFluoride 1.1% sodium fluoride in 1.1% Sodium 1.1% Sodium Fluoride % Sodium for Dry Mouth Sufferers a*Formulated squeeze-tube is easily applied onto a toothbrush. This prescription dental cream should be used once daily Non-abrasive formula is gentle PRESCRIPTION STRENGTH TOOTHPASTE in place of regular toothpaste unless otherwise instructed by your dental professional. May be used in on your teeth and gumsTOOTHPASTE PRESCRIPTION STRENGTH areas where drinking water is fluoridated since topical fluoride cannot produce fluorosis. (See WARNINGS INDICATIONS USAGE: A dental caries preventive, for once daily self-applied topical use. It is well 0.4% StableAND Stannous Fluoride 0.63% Stannous established that 1.1% sodium fluoride is safe and extraordinarily effective as a caries preventive when Fluoride Concentrate PREVENTATIVE ® 0.2%TREATMENT Neutral Sodium Fluoride 5% Sodium Fluoride applied frequently with GEL mouthpiece applicators.1-4 PreviDent Gel in aFluoride squeeze-tube is easily applied onto a Acidulated Phosphate ORAL CARE RINSE Solution toothbrush as well as a mouthpiece tray. This prescription dental gel should be used once daily following use of a regular toothpaste unless otherwise instructed by your dental professional. DRY MOUTH CONTRAINDICATIONS: Do not use in pediatric patients under age 6 years unless recommended by a dentist or physician. WARNINGS: Prolonged daily ingestion may result in various degrees of dental fluorosis in pediatric patients under age 6 years, especially if the water fluoridation exceeds 0.6 ppm, since younger pediatric patients frequently cannot perform the brushing process without significant swallowing. Use in pediatric patients under age 6 years requires special supervision to prevent repeated swallowing of dental cream which could cause dental fluorosis. Read directions carefully before using. Keep out of reach of infants and children. PRECAUTIONS: General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in male and female mice and female rats treated with fluoride at dose levels ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in male rats treated with 2.5 and 4.1 mg/kg of body weight. In a second study, no carcinogenesis was observed in rats, males or females, treated with fluoride up to 11.3 mg/kg of body weight. Epidemiological data provide no credible evidence for an association between fluoride, either naturally occurring or added to drinking water, and risk of human cancer. Fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion has potential to induce chromosome aberrations in cultured human and rodent cells at doses much higher than those to which humans are exposed. In vivo data are conflicting. Some studies report chromosome damage in rodents, while other studies using similar protocols report negative results. Potential adverse reproductive effects of fluoride exposure in humans has not been adequately evaluated. Adverse effects on reproduction were reported for rats, mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats demonstrated that lower concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities. Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount administered is incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to 12.2 mg fluoride/kg of body weight (rats) or 13.1 mg/kg of body weight (rabbits) did not affect the litter size or fetal weight and did not increase the frequency of skeletal or visceral malformations. There are no adequate and well-controlled studies in pregnant women. However, epidemiological studies conducted in areas with high levels of naturally fluoridated water showed no increase in birth defects. Heavy exposure to fluoride during in utero development may result in skeletal fluorosis which becomes evident in childhood. Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to 5 mg/kg of body weight. Pediatric Use: The use of PreviDent® 5000 Plus® in pediatric age groups 6 to 16 years as a caries preventive is supported by pioneering clinical studies with 1.1% sodium fluoride gels in mouth trays in students age 11-14 years conducted by Englander, et al.2,3,4 Safety and effectiveness in pediatric patients below the age of 6 years have not been established. Please refer to the Contraindications and Warnings sections. Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/w) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.5 ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies have been rarely reported. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) have been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) have been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (a thin ribbon) of PreviDent® 5000 Plus® contains 2.5 mg fluoride. A 1.8 oz. tube contains 255 mg fluoride. DOSAGE AND ADMINISTRATION: Follow these instructions unless otherwise instructed by your dental professional: 1. Adults and pediatric patients 6 years of age or older, apply a thin ribbon of PreviDent® 5000 Plus® to a toothbrush. Brush thoroughly once daily for two minutes, preferably at bedtime. 2.After use, adults expectorate. For best results, do not eat, drink, or rinse for 30 minutes. Pediatric patients, age 6-16, expectorate after use and rinse mouth thoroughly. REV 05/03 To Order: 1.800.372.4346 9 DESCRIPTION: Self-topical neutral fluoride gel containing 1.1% sodium fluoride for use as a dental caries preventive in pediatric patients and adults. This prescription product is not a dentifrice. 0.63% Stannous Fluoride Concentrate 1.1% Sodium Fluoride ORAL CARE RINSE Non-abrasive formula is gentle on teeth and gums or physician. CONTRAINDICATIONS: Do not use in pediatric patients under age 6 years unless recommended by a dentist WARNINGS: Prolonged daily ingestion may result in various degrees of dental fluorosis in pediatric patients under age 6 years, especially in the areas with high fluoride concentration in drinking water. Use in pediatric patients under age 6 years requires special supervision to prevent repeated swallowing of gel. Read directions carefully before using. Keep out of reach of infants and children. PRECAUTIONS: General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in male and female mice and female rats treated with fluoride at dose levels ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in male rats treated with 2.5 and 4.1 mg/kg of body weight. In a second study, no carcinogenesis was observed in rats, males or females, treated with fluoride up to 11.3 mg/kg of body weight. Epidemiological data provide no credible evidence for an association between fluoride, either naturally occurring or added to drinking water, and risk of human cancer. Fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion has potential to induce chromosome aberrations in cultured human and rodent cells at doses much higher than those to which humans are exposed. In vivo data are conflicting. Some studies report chromosome damage in rodents, while other studies using similar protocols report negative results. Potential adverse reproductive effects of fluoride exposure in humans has not been adequately evaluated. Adverse effects on reproduction were reported for rats, mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats demonstrated that lower concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities. Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount administered is incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to 12.2 mg fluoride/kg of body weight (rats) or 13.1 mg/kg of body weight (rabbits) did not affect the litter size or fetal weight and did not increase the frequency of skeletal or visceral malformations. There are no adequate and well-controlled studies in pregnant women. However, epidemiological studies conducted in areas with high levels of naturally fluoridated water showed no increase in birth defects. Heavy exposure to fluoride during in utero development may result in skeletal fluorosis which becomes evident in childhood. Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to 5 mg/kg of body weight. Pediatric Use: The use of PreviDent® Brush-On Gel in pediatric age groups 6 to 16 years as a caries preventive is supported by pioneering clinical studies with 1.1% sodium fluoride gels in mouth trays in students age 11-14 years conducted by Englander, et al.2,3,4 Safety and effectiveness in pediatric patients below the age of 6 years have not been established. Please refer to the Contraindications and Warnings sections. Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/v) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies have been rarely reported. Overdosage: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) have been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) have been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (a thin ribbon) of PreviDent® Gel contains approximately 2 mg fluoride. A 0.8 oz. tube contains approximately 104 mg fluoride. A 2 oz. tube contains approximately 266 mg fluoride. DOSAGE AND ADMINISTRATION: Follow these instructions unless otherwise instructed by your dental professional: 1. After brushing thoroughly with toothpaste, rinse as usual. Adults and pediatric patients 6 years of age or older, apply a thin ribbon of gel to the teeth with a toothbrush or mouth trays once daily for at least one minute, preferably at bedtime. 2. After use, adults expectorate gel. For best results, do not eat, drink, or rinse for 30 minutes. Pediatric patients, age 6-16, expectorate gel after use and rinse mouth thoroughly. REV 05/03 0.4% Sta PREVENTATIV DESCRIPTION: PreviDent® Rinse brand of 0.2% neutral sodium fluoride is a mint-flavored, neutral, aqueous solution containing 6% alcohol. DESCRIPTION: Gel-Kam® brand of stannous fluoride Oral Care Rinse is a stable, water-free concentrate containing 0.63% stannous fluoride for dilution to 0.1% stannous fluoride. This is a treatment rinse, not a mouthwash. Active Ingredient: Sodium Fluoride 0.2% (w/v). INDICATIONS AND USAGE: A dental caries preventive, for weekly self-applied topical use. Weekly rinsing 0.63% Stannous Stannous with a neutral 0.2% sodium fluoride solution protects against0.4% dentalStable caries in pediatricFluoride patients. PreviDent® Fluoride Concentrate PREVENTATIVE TREATMENT GEL compliance. 0.2% Neutral Sodium Fluoride Rinse provides a ready-to-use preparation and favorable May 0.2% Neutral 1.1% Sodium Sodium Fluoride Fluoride 1.1% Sodium Fluoridefor convenient administration ORAL CARE RINSE be used in areas where drinking water is fluoridated since topical fluoride cannot produce fluorosis. (See PRESCRIPTION STRENGTH TOOTHPASTE Non-abrasive formula is gentle WARNINGS for exception.) on teeth and gums Active Ingredient: Stannous fluoride 0.63% (w/w) (provides 0.1% (w/v) stannous fluoride). 0.63% Stannous Fluoride Concentrate Acidulated Phosphate Solution ORALFluoride CARE RINSE CONTRAINDIACTIONS: Do not use in patients with dysphagia. Do not use in pediatric patients under age 6 years unless recommended by a dentist or physician. WARNINGS: Keep out of reach of infants and children. Pediatric patients under age 12 should be supervised in the use of this product. Patients under age 6 require special supervision to prevent repeated swallowing of rinse since they frequently swallow significant amounts while rinsing. Prolonged daily ingestion may result in dental fluorosis in patients under age 6, especially if the water fluoridation exceeds 0.6 ppm. Read directions carefully before using. DO NOT USE IF PRINTED NECK BAND IS BROKEN OR MISSING PRECAUTIONS: General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: No carcinogenesis was found in mice or female rats treated with fluoride at doses ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in male rats treated with 2.5 and 4.1 mg/kg of body weight. In another study, no carcinogenesis was observed in rats treated with fluoride up to 11.3 mg/kg of body weight. Epidemiological data provide no credible evidence for an association between fluoride, either naturally occurring or added to drinking water, and risk of human cancer. Fluoride ion is not mutagenic in standard bacterial systems but has been associated with chromosome aberrations in cultured human and rodent cells at doses much higher than expected human exposures. Some in vivo report chromosome damage in rodents while other studies using similar protocols report negative results. Potential adverse reproductive effects of fluoride exposure in humans has not been adequately evaluated. Adverse effects on reproduction were reported for rats, mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats demonstrated that lower concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount administered is incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to 12.2 mg fluoride/kg of body weight (rats) or 13.1 mg/kg of body weight (rabbits) did not affect litter size or fetal weight and did not increase frequency of skeletal or visceral malformations. There are no adequate and well-controlled studies in pregnant women. However, epidemiological studies conducted in areas with high levels of naturally fluoridated water showed no increase in birth defects. Heavy exposure to fluoride during in utero development may result in skeletal fluorosis which becomes evident in childhood. Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk, and caution should be exercised when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to 5 mg/kg of body weight. Pediatric Use: The use of PreviDent® Rinse as a weekly caries preventive in pediatric patients aged 6 to 16 years is supported by adequate and well-controlled clinical studies in students aged 6 to 12 years.1-3 Safety and effectiveness in pediatric patients below the age of 6 years have not been established. Please refer to the CONTRAINDICATIONS and WARNINGS sections. Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/v) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. ADVERSE REACTIONS: In patients with mucositis, gingival tissues may be hypersensitive to flavor or alcohol present in formulation. Allergic reactions and other idiosyncrasies are rarely reported. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) has been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) has been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (10 mL or two teaspoonfuls) of PreviDent® Rinse contains approximately 9 mg fluoride. One 16 fl. oz. bottle contains approximately 429 mg fluoride. DOSAGE AND ADMINISTRATION: For caries — Adults and pediatric patients over age 6 years, 2 teaspoonfuls (10 mL). Once a week, preferably at bedtime after thoroughly brushing the teeth, rinse vigorously around and between the teeth for one minute, then expectorate. DO NOT SWALLOW. For maximum benefit, do not eat, drink, or rinse mouth for at least 30 minutes afterwards. Rev. 02/09 0.4% Stable Stannous V ARNFluoride IS H INDICATIONS AND USAGE: For daily self-applied topical use as a dental caries preventive. It is well 5% GEL Sodium Fluoride PREVENTATIVE TREATMENT 5% Sodium Fluoride 5% Sodium Fluoride established that a 0.1% stannous fluoride rinse is a convenient wayPhosphate to applyFluoride fluoride to the surfaces of Acidulated Solution teeth to aid in the prevention of decalcification and dental caries. This is accomplished by increasing the resistance of tooth surfaces to acid dissolution. CONTRAINDICATIONS: Do not use in pediatric patients under age 12 years unless recommended by a dentist or physician. Not for systemic treatment. WARNINGS: Pediatric patients under 12 years of age should be supervised in the use of this product. Prolonged daily ingestion may result in various degrees of dental fluorosis in pediatric patients under age 6 years, especially in areas with high fluoride concentration in drinking water. Use in pediatric patients under age 6 required special supervision to prevent repeated swallowing of rinse. Do not use before mixing with water. This product may produce temporary surface staining of teeth. Adequate brushing may prevent these stains which are not harmful or permanent and may be removed by your dentist. Read directions carefully before using. Keep out of reach of infants and children. PRECAUTIONS: General: Not for systemic treatment. DO NOT SWALLOW. Carcinogenesis, Mutagenesis, Impairment of Fertility: In a study conducted in rodents, no carcinogenesis was found in mice or female rats treated with fluoride at doses ranging from 4.1 to 9.1 mg/kg of body weight. Equivocal evidence of carcinogenesis was reported in male rats treated with 2.5 and 4.1 mg/kg of body weight. In another study, no carcinogenesis was observed in rats treated with fluoride up to 11.2 mg/kg of body weight. Epidemiological data provide no credible evidence for an association between fluoride, either naturally occurring or added to drinking water, and risk of human cancer. Fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion is not mutagenic in standard bacterial systems. It has been shown that fluoride ion has potential to induce chromosomes aberrations in cultured human and rodent cells at doses much higher than those to which humans are exposed. In vitro data are conflicting. Some studies report chromosome damage in rodents while other studies using similar protocols report negative results. Potential adverse reproductive effects of fluoride exposure in humans has not been adequately evaluated. Adverse effects on reproduction were reported for rats, mice, fox, and cattle exposed to 100 ppm or greater concentrations of fluoride in their diet or drinking water. Other studies conducted in rats demonstrated that lower concentrations of fluoride (5 mg/kg of body weight) did not result in impaired fertility and reproductive capabilities. Pregnancy: Teratogenic Effects: Pregnancy Category B. It has been shown that fluoride crosses the placenta of rats, but only 0.01% of the amount administered is incorporated in fetal tissue. Animal studies (rats, mice, rabbits) have shown that fluoride is not a teratogen. Maternal exposure to 12.2 mg fluoride/kg of body weight (rats) or 13.1 mg/kg of body weight (rabbits) did not affect the litter size or fetal weight and did not increase frequency of skeletal or visceral malformations. There are no adequate and well-controlled studies in pregnant women. However, epidemiological studies conducted in areas with high levels of naturally fluoridated water showed no increase in birth defects. Heavy exposure to fluoride during in utero development may result in skeletal fluorosis which becomes evident in childhood. Nursing Mothers: It is not known if fluoride is excreted in human milk. However, many drugs are excreted in milk and caution should be exercised when products containing fluoride are administered to a nursing woman. Reduced milk production was reported in farm-raised fox when the animals were fed a diet containing a high concentration of fluoride (98-137 mg/kg of body weight). No adverse effects on parturition, lactation, or offspring were seen in rats administered fluoride up to 5 mg/kg of body weight. Pediatric Use: The use of Gel-Kam® Oral Rinse as a weekly caries preventive in pediatric patients aged 12 to 16 years is supported by adequate and well-controlled study in school children.1 Safety and effectiveness in pediatric patients below the age of 12 have not been established. Please refer to the CONTRAINDICATIONS and WARNINGS sections. Geriatric Use: Of the total number of subjects in clinical studies of 1.1% (w/v) sodium fluoride, 15 percent were 65 and over, while 1 percent were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. ADVERSE REACTIONS: Allergic reactions and other idiosyncrasies are rarely reported. OVERDOSAGE: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting, and diarrhea may occur soon after ingestion (within 30 minutes) and are accompanied by salivation, hematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight (i.e., less than 2.3 mg fluoride/lb body weight) has been ingested, give calcium (e.g., milk) orally to relieve gastrointestinal symptoms and observe for a few hours. If more than 5 mg fluoride/kg body weight (i.e., more than 2.3 mg fluoride/lb body weight) has been ingested, induce vomiting, give orally soluble calcium (e.g., milk, 5% calcium gluconate or calcium lactate solution) and immediately seek medical assistance. For accidental ingestion of more than 15 mg fluoride/kg of body weight (i.e., more than 6.9 mg fluoride/lb body weight), induce vomiting and admit immediately to a hospital facility. A treatment dose (two one-minute applications) of Gel-Kam® Rinse contains approximately 7.1 mg fluoride. One 10 oz. bottle contains approximately 436 mg fluoride. DOSAGE AND ADMINISTRATION: Adults and pediatric patients 12 years and older: use at least daily or more often as directed, following regular brushing and flossing. Pour the concentrated Rinse to the 1/8 fluid ounce mark in the mixing vial (to bottom mark). Add water to the 1 fl. oz. mark and mix. This prepares a 0.1% (w/v) stannous fluoride rinse. Use immediately after preparing the rinse. Place one half of the solution into the mouth and vigorously swish for 1 minute, then expectorate. Repeat the one-minute treatment with the remaining solution and expectorate. Pediatric patients under 12 years of age: consult a dentist or physician. Pediatric patients under 12 years of age should be supervised in the use of this product. For Home Irrigators: Prepare 1 fl. oz. of Rinse as described above. Pour into irrigator reservoir and add 4 more fluid ounces of water. Mix thoroughly. This prepares a 0.02% (w/v) stannous fluoride rinse. Use irrigator as directed. Rinse the irrigator with water after use. Rev. 03/09 www.colgateprofessional.com 10 DESCRIPTION: PreviDent® 5% Sodium Fluoride Varnish contains 22,600 ppm fluoride. It has a strong desensitizing action when applied to dental surfaces, treating hypersensitivity quickly and easily. This product sets rapidly on contact with saliva, resulting in patient comfort and acceptance. PreviDent® Varnish will leave a thin film on the teeth after application. ide Solution 5% Sodium Fluoride COMPOSITION: 1 mL of this suspension contains 50 mg sodium fluoride, equivalent to 22.6 mg fluoride VARNISH ion, in an alcoholic solution of natural resins. 5% Sodium Fluoride INDICATIONS: PreviDent® Varnish is a topical fluoride for the treatment of dentinal and post operative sensitivity. Dosage: To be administered by the dental professional for the treatment of dentin hypersensitivity. The fluoride content in this product is dosed in such a way that neither acute nor chronic side effects are to be expected if applied according to the instructions. DIRECTIONS FOR USE: Please observe when treating hypersensitive teeth 1.Wash and dry tooth surface. 2.Mix well prior to application. 3.Apply product with supplied brush in the conventional manner. 4.Thin excess varnish on the tooth’s surface until the varnish surface is dry. 5.Covers even moist teeth with a coating of varnish film for several hours which occludes the openings of the dental tubules. 6.Hardens on contact with saliva so the patient may leave immediately after application of the product. 7.It is recommended that the patient be instructed to eat only soft foods for 2 hours after treatment. CONTRAINDICATIONS: Ulcerative gingivitis and stomatitis. INTERACTIONS: When PreviDent® Varnish is applied, other fluoride preparations such as fluoride gels should not be administered during the same day. The routine use of fluoride tablets should be interrupted for several days after treatment. ADVERSE REACTIONS: Edematous swellings have been reported only in rare instances in some fluoride varnish products, especially after application to extensive surfaces. Dyspnea, although extremely rare, has occurred in asthmatic children. Nausea has been reported when extensive applications have been made. If required, varnish film can be removed with a thorough brushing. Store in a cool, dry place. Rev. 12/08 At-Home Fluoride 1. Joziak MT et al. Comparison of enamel fluoride uptake and fluoride release from liquid and paste dentifrice. J Dent Res. 2003; 82 (Sp issue). Abstract 1355. 2. Baysan et al, Reversal of primary root caries using dentifrices containing 5000 ppm and 1100 ppm fluoride. Caries Res, 2001; 35: 41-46. 3. Markowitz K. Arch Oral Biol 1991; 36:1-7 4. Jensen J & Barkvoll P, Clinical Implication of the Dry Mouth: Oral Mucosal Diseases, Annals NY Acad Sci, Vol 842, 156-162, 1998. 5. Colgate. Prevention of dental erosion by 5000 ppm fluoride treatment in situ. IADR General Session. 2010. 6. DePaola PF. In: Bowen WH & Tabak LA (eds.): Cariology for the Nineties. Rochester, University of Rochester Press, 1993, pp 25-35. 7. Driscoll WS, et al. J Am Dent Assoc 1982; 105: 1010-13. Over The Counter 8. Joziak MT, et al. Comparison of enamel fluoride uptake and fluoride release from liquid and paste dentifrice. J Dent Res. 2003; 82 (Sp Issue). Abstract 1355. 9. Miller S. Int Dent J 1994; 44(1 Suppl 1): 83-98. 10. Boyd RL. Int Dent J 1994; 44(1 Suppl 1): 119-130. 11. Marinho VCC et al. Fluoride mouthrinses for preventing dental caries in children and adolescents. The Cochrane Library 2007. Issue 3. 12. Hirschfield RE. J Dent Child 1978; 45: 458-460. 13. Keyes, P. and Englander HR, Fluoride therapy in the treatment of dentomicrobial plaque diseases. JOSPD 1975; 16-45. 14. Aasenden R et al. Archs Oral Biol 1972; 17:1705-1714. Distributed by: Colgate Oral Pharmaceuticals, Inc., a subsidiary of Colgate-Palmolive Company, New York, NY 10022 U.S.A. In-Office Fluoride Questions / Comments: 1-800-962-2345 15. ADA Council of Scientific Affairs. J Am Dent Assoc 2006; 137: 1151-1159 or call 1-800-2COLGATE to speak to your Oral Care Consultant today To Order: 1.800.372.4346 11 ©2012 Colgate Oral Pharmaceuticals, a subsidiary of Colgate-Palmolive Company, New York, NY 10022, USA 01/2012 SO407171