Duraphat fluoride varnish. A 2-year clinical trial in 5-year-old children

The caries-preventive effect of Duraphat® lacquer versus fluoride mouthrinses was evaluated in a 5-year clinical trial. The lacquer group received Duraphat application every 6th month and a placebo rinse every 2nd week during the school year. The fluoride rinse group received a 0.2% sodium fluoride rinse every 2nd week during the school year and a placebo lacquer every 6th month. All children received regular dental examination and treatment in clinics established by the municipality in which the study took place. Fluoride content of the drinking water varied between 0.1 and 0.2 ppm F^––. Caries was recorded clinically and radiographically and increments calculated after 3 and 5 years. On teeth erupted at baseline the clinical caries increment after 5 years was 2.96 DMF-S in the lacquer group and 2.77 DMF-S in the fluoride rinse group, evaluated for the 248 3rd grades completing the study. Caries increment in teeth erupting during the trial was 2.20 DMF-S in the lacquer group and 2.30 DMF-S in the fluoride rinse group. The corresponding figures for radiographic caries increment were 1,01 and 0.82 DMF-S for teeth erupted at baseline, and 0.59 and 0.45 DMF-S for teeth erupting during the trial. None of the differences were statistically significant. Mean time needed to apply the lacquer was approximately 4 min, when working with a chairside assistant and 6 min, when working without a chairside assistant.

Section: Discussionmentioning

confidence: 99%

Caries-Preventive Effect of Duraphat® Varnish Applications versus Fluoride Mouthrinses: 5-Year Data

Kirkegaard¹,

Petersen

Poulsen³

et al. 1986

“…Fluoride varnish treatments effectively in hibit demineralization, resulting in highly significant car ies reductions, ranging from about 50 to 70% in fissures and even higher in the proximal surfaces [Petersson, 1975: Seppti, 1982. A number of clinical trials have confirmed the caries-preventive effect of fluoride varnishes, although some results are inconclusive, for ex ample for biannual application of Duraphat in the primary dentition in subjects with a high caries frequency or in cidence [Murray et al, 1977;Grodzka ct al., 1982;Peyron et al, 1992]. In child populations with low or moderate caries experience, however, as significant clinical effect has been documented [Holm.…”

Section: Experimental Laboratory and Clinical Trialsmentioning

confidence: 99%

Fluoride Mouthrinses and Fluoride Varnishes

Petersson¹

1993

The cariostatic efficacy of rinsing with a 0.05–0.2% neutral sodium fluoride solution has been clearly demonstrated, especially in supervised school-based programmes in moderate and high caries risk children. The cost-benefit effect, however, is questionable in populations with low caries prevalence, and fluoride rinsing programmes are gradually being replaced by more individual fluoride therapy comprising combinations of fluoride toothpastes, tablets, or varnishes. Fluoride varnishes were developed as individual alternatives to conventional topical fluoride application and are today gaining acceptance for clinical application. Two varnishes, Duraphat® containing 5%wt NaF and Fluor Protector® with 0.9% wt fluor silane, are available commercially. The clinical effects seem to depend mainly on application frequency, especially in high caries risk groups. The cost-benefit effect is high, but can be increased by delegating application to auxiliary personnel in conjunction with regular dental visits. Toxicologically both fluoride mouthrinses and fluoride varnishes are safe if used as directed.

“…However, differences of up to 36% greater rates of caries in the intensive group could not be ruled out, thus equivalence of the treatments cannot be concluded. Copyright © 2009 S. Karger AG, Basel For children in the primary dentition with high caries prevalence the standard semiannual application of fluoride varnish may not be as successful in preventing new tooth decay as the same treatment in low-and moderaterisk populations [Murray et al, 1977;Grodzka et al, 1982]. At the same time, the evidence for increasing the frequency of varnish treatments is mixed [Axelsson et al, 1987;Seppä and Tolonen, 1990].…”

mentioning

confidence: 99%

Randomized Equivalence Trial of Intensive and Semiannual Applications of Fluoride Varnish in the Primary Dentition

Weinstein¹,

Spiekerman²,

Milgrom

2009

For children in the primary dentition with high caries prevalence the standard semiannual application of fluoride varnish may not be successful in preventing tooth decay. Oftentimes this population is mobile and does not receive consistent preventive care. This trial tested whether an intensive fluoride 5% sodium varnish regimen (three applications/2 weeks) applied annually has an equivalent effect on caries progression in the primary dentition compared to single applications applied semiannually. This study was a randomized clinical trial with two treatment groups. All participants (n = 600; mean age ± SD = 55.3 ± 4.6 months) received three varnish applications (active varnish or placebo) at semiannual visits over 3 years. Once per year the intensive-treatment group received one set of three active treatments and three placebo treatments 6 months later, each time within 2 weeks. The standard group received one active and two placebo treatments every 6 months. Children were assessed clinically at baseline and 12, 24 and 36 months after the initiation of the study. The mean (SD) numbers of newly decayed primary tooth surfaces observed over 3 years were 9.8 (8.6) and 7.4 (7.7) in the intensive and standard groups, respectively. The adjusted rate ratio was 1.13 (95% CI = 0.94–1.37, p = 0.20). In conclusion, the trial failed to demonstrate clear evidence of a difference in efficacy. However, differences of up to 36% greater rates of caries in the intensive group could not be ruled out, thus equivalence of the treatments cannot be concluded.