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Before Proceeding to the Medial Consultation Form please read
CONTRAINDICATIONS  and  WARNINGS 
and accept the Waiver of Liability


In order for Medical Wellness Center Physicians to provide you with the best care you need to reply honesty to all questions and you need to understand any and all risks and side effects associated with Prevident

CONTRAINDICATIONS: Anyone with the following conditions or taking the following medications should not use Prevident
  • Do not use Prevident if you are pregnant or trying to become pregnant because high exposure to fluoride in utero can result in skeletal fluorosis which becomes evident in childhood.
  • Do not use Prevident if you are breast feeding!
  • Do not use Prevident if you are allergic or hypersensitive to sodium fluoride.
  • Do not use Prevident if you are allergic to any of the inactive ingredients in Prevident gel or cream: purified water, sorbitol, hydrated silica, PEG-12, tetrapotassium, pyrophosphate, sodium lauryl sulfate, xantham gum, sodium benzoate, hydroxyethylcellulose, pluronic F-127, sodium saccharin, methyl paraben, titanium dioxide, propylparaben
  • Do not use Prevident if you have kidney disease
  • Do not use Prevident if you are on a doctor-prescribed Low-Salt or Salt-Free Diet.
  • Prevident  is not approved for use in children under age 6 and children ages 6 - 16 are required to RINSE their mouth after using Prevident.  Medical Wellness Center does NOT prescribe Prevident online to anyone under age 18.  In children Prevident use needs to be directly supervised and monitored by a physician as dental fluorosis and serious and possibly fatal side effects can occur.
 WARNINGS & PRECAUTIONS:
  1. Keep this medication out of reach of children, fluoride in too high doses can be toxic to children.
  2. Do NOT exceed the recommended dose.
  3. NEVER SWALLOW PREVIDENT.  If accidentally swallow a small amount of Prevident (typical dosage of Prevident contains about 2.5 mg of fluoride) you may experience immediate burning of the mouth and tongue and within 30 minutes you may experience nausea, vomiting, stomach pain, diarrhea.  Milk is an immediate antidote.  If you ingest 2.5mg fluoride/lb body weight (a 1.8 oz tube of Prevident contains 255mg) seek immediate emergency assistance as seizures and loss of consciousness can result.
  4. In general fluoride supplementation is not recommended if the level of fluoride in your drinking water is greater than 0.7ppm. But according to Colgate the manufacturer of Prevident, Prevident topical fluoride gel or cream may be used by ADULTS even in areas where the drinking water is fluoridated since topical fluoride cannot produce fluorosis.


SIDE EFFECTS:

  • If you experience gum irritation discontinue use of Prevident and consult your physician or dentist.
  • If you notice changes in the color or appearance of your teeth contact your dentist.
  • Nausea, vomiting, stomach pain, diarrhea, headache or muscle twitches may occur if a regular treatment dose of medication is accidentally swallowed.  If these symptoms occur contact your doctor, milk is an immediate antidote.
 

IMPORTANT PATIENT INFORMATION:
How to use Prevident Topical Fluoride

Prevident 5000 Plus or Prevident gel is to be used as an adjunct treatment to your regular daily dental hygiene routine and along with regular visits to your dental professional.  Prevident use helps to strengthen tooth enamel and prevent dental carries.

If using Prevident gel you must always brush your teeth first with your regular toothpaste as the topical gel formulation is not a dentrifice cleaning agent. If using Prevident 5000 Plus cream you can use this in place of your regular toothpaste as this formulation combines the cleaning power of a toothpaste with a maximum-strength fluoride. When using Prevident 5000 Plus in place of toothpaste you must NOT rinse your mouth nor swallow after brushing.  You must expectorate and spit out the Prevident.

  1. Always use Prevident just before bedtime after brushing and or flossing your teeth. Brush thoroughly and rinse mouth as usual before using Prevident.
  2. Apply a small ribbon of Prevident 5000 plus or Prevident gel on your toothbrush and gently message it into your teeth at the gum line mainly on the outside and inside surfaces for 2 minutes.
  3. Make sure you expectorate and SPIT it all out.  NEVER SWALLOW.
  4. Do NOT rinse your mouth after using Prevident.
  5. Do not eat or drink or rinse your mouth for 30 minutes after using Prevident.
  6. Use Prevident once daily
I DO NOT HAVE ANY OF THE ABOVE CONTRAINDICATIONS:
By accepting "I Agree" means that you have read the above contraindication and warnings and honestly acknowledge that you do not have any of the above contraindications to Prevident therapy.  Also, that I am aware that I need to inform my doctor  and dental professional that I am taking Prevident.
I agree, proceed to  Periostat Prescription Waiver of LiabilityI disagree - Periostat Contraindications
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