Fluoride Varnish

A review of the evidence of the clinical effectiveness of fluoride applied with a topical gel or by varnish was recently published by the Council on Scientific Affairs of the American Dental Association.

Three of their conclusions are:

“Fluoride varnish applied every six months is effective in preventing caries in the primary and permanent dentition of children and adolescents.

“Two or more applications of fluoride varnish per year are effective in preventing caries in high risk populations”. Among the definitions they use to define high risk patients are patients older than six years of age and with poor oral hygiene, in active orthodontic treatment or those that have irregular dental care.

"Fluoride varnish applications take less time, create less patient discomfort and achieve greater patient acceptability than does fluoride gel, especially in pre-school aged children."

In the original article these are conclusions 4, 5 and 6.

Compared to a four minute fluoride gel or foam application, varnish appears to be more caries protection in the adult dentition.

You may review the entire article by visiting http://www.ada.org/prof/resources/pubs/jada/reports/report_fluoride_exec.pdf. You will need the Adobe Reader to view this document.

Based on the review’s recommendations, in high risk patients I would consider applications of the fluoride varnish every six months. More frequent applications does not appear to give proportionately higher benefits. Patients who are developing white stains should be treated on an individual basis.

The caveat is that you need to consider how much fluoride is necessary for each child. In any but high risk patients, the varnish treatment is probably not necessary. High risk patients have poor oral hygiene, braces on their teeth, are not getting enough fluoride from other sources or are developing white stains.

If you have any other questions or to discuss if treatment is appropriate for your child, please e-mail Dr. Berko at drberko@drberko.com or speak with him in the office.

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