Clinical Effect of Two Fluoride Varnishes in Caries-Active Preschool Children: A Randomized Controlled Trial

Abstract

The prevention of dental caries in preschool children is a priority for dental services. The aim of the study was to investigate the caries-preventive effect of 2 fluoride varnishes in caries-active preschool children, and then compare the outcome with a non-varnish control group. After screening, 180 preschool children aged 36–71 months, with at least 1 noncavitated lesion, were enrolled and randomly allocated into 3 parallel groups, namely A: 1.5% ammonium fluoride varnish (Fluor Protector S), B: 5% NaF varnish (Duraphat), and C: professional tooth-cleaning. All children were recalled every third month for intervention and their parents were instructed to have them brush their teeth with a 1,000-ppm fluoride toothpaste twice daily. Caries were recorded at baseline and after 12 months by a calibrated examiner and the incidence was scored on noncavitated (d2) and cavitated (d3) level. We tested differences between the groups with the χ2 and two-sided t tests. One hundred and seventy-two children (95.6%) completed the trial and 56 (32.6%) and 35 (19.2%) developed new d2 and d3 lesions, respectively. Both varnishes reduced the incidence of caries compared with the control group, but there was no significant difference between group A and group B. Compared with group C, the relative risk for developing cavitated lesions was 0.39 (95% CI 0.22–0.62) in group A and 0.26 (95% CI 0.14–0.50) in group B. The total prevented fraction (Δd2d3mft) for group A and group B was 19.9 and 22.5% (p < 0.05), respectively. No adverse effects were observed or reported during the study period. In conclusion, the 2 fluoride varnishes demonstrated an equal capacity to reduce the incidence of caries in caries-active preschool children over a 12-month period in comparison with a control group.

Nonrestorative Caries Treatment: A Systematic Review Update

“… 43 , 44 Fluoride varnishes were also reported as effective compounds to prevent the development of early caries lesions in both primary and permanent teeth. 43 , 44 , 45 , 46 , 47 The caries-arresting potential of these varnishes, however, were mainly restricted to ICDAS 1-3 lesions rather than to active dentin lesions, where SDF achieves higher CAR percentages.…”

In vitro study of the preventive activity of fluoride varnish by X-ray diffraction

“…The search for new solutions motivated us to prove the possibility of choosing a means/method for preventive treatment of the initial carious lesions, with the local application of fluorides [26]- [28]. It is necessary: To carry out a timely and early diagnosis to cover the carious lesions in their early phase, applying preventive and non-invasive treatment, which saves time, and pain and protects the child from complicated caries.…”

Early childhood caries management using fluoride varnish and neutral fluoride gel: a randomized clinical trial

“…In this 12-month randomized clinical trial, the efficacy of neutral fluoride gel was shown to be similar to that of the varnish. Studies have reported that the use of varnish applied two to four times a year can reduce the incidence of ECC, 14,18 and this reduction could could be as high as 25% when compared with a placebo. 18 However, some clinical trials have shown no benefits in using fluoride varnish to reduce the incidence of caries in preschool children regardless of whether they were exposed 9,10,19 to fluoridated water and/or fluoridated toothpaste, or not.…”

“…20 T he World Hea lt h Orga n i zat ion (WHO) recommends two to four fluoride applications a year in children at high risk for caries, 1 but this frequency may not be effective in controlling ECC. 21 The contradictory results in the literature 9,10,14,18,20 can be explained by the methodological differences between studies, such as the heterogeneity of patients in presence or absence of caries at baseline and the interval between varnish applications. In the present study, the incidence of caries was higher in children with ECC at baseline than in children without caries, corroborating the findings of another study 9 and consistent with previous experience that caries is an important predictor of the occurrence of new lesions 6 .…”

“…13 Fluoride varnish is the most frequently used product in clinical trials in children. 7,9,10,14 and has been shown to be similar or even superior to acidulate gel in the in vitro formation of calcium fluoride on the enamel surface. 15 To the best of our knowledge, no randomized clinical trial has yet compared varnish and neutral fluoride gel.…”