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Short Commentary: Fluoride Varnish

Fluoride Varnish

In the message board entitled “Fluoride Varnish,” questions were raised about the use of fluoride foams. Townie Jrdh3 mentioned that the ADA recommendations did not endorse the use of foams as highly as gels and varnishes. Townie mp2006 posted infor-mation from the recently published Executive Summary of Evidence-Based Clinical Recommendations on Professionally Applied Topical Fluoride that was published in the August, 2006 issue of JADA.

    Here are the conclusions of that report, based on an evaluation of the research:
  1. Fluoride gel is effective in preventing caries in school-aged children.

  2. Patients whose caries risk is low, may not receive additional benefit from professional topical fluoride application.

  3. There is considerable data on caries reduction for professionally applied topical fluoride gel treatments of four minutes or more. In contrast, there is laboratory, but no clinical equivalency data on the effectiveness of one-minute fluoride gel applications.

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

  5. Two or more applications of fluoride varnish per year are effective in preventing caries in high-risk populations.

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

  7. Four-minute fluoride foam applications, every six months, are effective in caries prevention in the primary dentition and newly erupted permanent first molars.

  8. There is insufficient evidence to address whether or not there is a difference in the efficacy of NaF versus APF gels.

Many hygienists are replacing tray applications of fluoride foams and gels with fluoride varnish. The clinical evidence is stronger for fluoride varnish and gels, compared to foams. Both clinical and laboratory studies show fluoride release to be the same for foams and gels. However, only two clinical trials have been published evaluating the effectiveness of fluoride foams in caries prevention. Based on these findings, the ADA panel was reluctant to recommend foams the same way they recommend fluoride varnishes and fluoride gels. To be effective, according to the research, professional fluoride treatments with gels and foams must be on the teeth for four minutes. If time is the concern, fluoride varnish should be the choice. It can be applied to all areas of risk, with no need to apply it to the entire mouth. Interdental surfaces, occlusal surfaces and gingival margins are the sites at greatest risk of dental caries. Varnish applications take only seconds and set rapidly allowing the patients to eat and drink immediately after. Select the fluoride application that best fits the needs of your patients.

The full report is available at: http://www.ada.org/prof/resources/pubs/jada/ reports/report_fluoride.pdf
 
“Many hygienists are replacing tray applications of fluoride foams and gels with fluoride varnish.”
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