Fluoride varnish can be used as an effective caries preventive measure for high-caries-risk children

Photograph of carious teeth

We recently reported on a other fluoride varnish study in a similar age group  conducted in the UK.  The aim of this study was to determine the efficacy of 5% sodium fluoride (NaF) varnish application in reducing caries increments in the permanent dentition of rural Brazilian school children over the course of 12 months.

Children aged 7–14 years who attended three schools in Brazil  were randomised to either a treatment (5% NaF varnish, n = 198) or a control group (placebo, n = 181). The schools were visited four times at 6-month interval for recruitment, dental examinations, and fluoride varnish applications.  Trained interviewers collected data on oral health habits and sociodemographic characteristics from the children with diet information being collected using a 7-day food frequency diary. Caries examinations were conducted using the International Caries Detection and Assessment System (ICDAS). The efficacy of fluoride varnish application on caries prevention was reported as a preventive fraction (PF).

They found that

Of the total sample (N = 379), 210 (55.4%) children had completed 12 months of follow-up including one or two applications of fluoride varnish or placebo. After 12 months of follow-up, the children in the varnish group showed significantly lower DFS increments than did children in the control group. This represents a preventive fraction of 40% (95% CI: 34.3–45.7%;P < 0.0001).

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The authors concluded

 The results of this study suggest that applications of  5% NaF varnish can be recommended as a public health measure for reducing caries incidence in this high-caries-risk population.

Arruda AO, Senthamarai Kannan R, Inglehart MR, Rezende CT, Sohn W. Effect of 5% fluoride varnish application on caries among school children in rural Brazil: a randomized controlled trial. Community Dent Oral Epidemiol. 2011 Dec 8. doi:10.1111/j.1600-0528.2011.00656.x. [Epub ahead of print] PubMed PMID: 22150341.

Related review

Marinho VCC, Higgins JPT, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD002279. DOI: 10.1002/14651858.CD002279.


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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