Study examines effectiveness of fluoride varnish in preschoolers
SEATTLE, U.S.: Owing to its easy application, its affordable price and the low risk of swallowing the product, fluoride varnish (FV) has become a popular anti-caries treatment for children. A study by researchers from the University of Washington in Seattle has examined the effectiveness of FV in reducing dentinal caries in preschoolers. The findings showed only a minimal effect of FV in caries prevention and the researchers concluded that further studies are needed to assess the cost-effectiveness of the product in a dental setting.
The researchers systematically reviewed 20 clinical trials of FV conducted in 13 countries. They examined trials in which FV had been used alone or had been associated with an oral health program. The results of using FV were compared with the results of a placebo, usual care or no treatment. “As much as we want fluoride varnish to be effective, the current evidence doesn’t support a huge benefit for its use in young children,” said Dr. Joana Cunha-Cruz, research associate professor in the Department of Oral Health Sciences at the university.
The researchers noted that FV applications are aimed especially at children with high caries risk and should be used as a complement to other fluoride treatments, such as toothpaste or fluoridated water. However, they said that more recent clinical trials in low- and high-risk groups had failed to prove a protective effect of FV applications.
The study did not completely dismiss the effectiveness of FV. The findings showed that the risk of developing new caries declined by 12% among the children who had received FV, compared with those who had not. Although the benefit was rather insubstantial, FV could still serve as a cost-effective alternative in some cases.
Fluoride concentrations can vary among different varnishes. For highly effective topical treatment alternatives, Cunha-Cruz recommends using sealants, especially those with glass ionomer, or silver diamine fluoride. “The evidence still supports the use of fluoride toothpaste, which is easy and low-cost,” she noted. “The value of toothpaste lies in how it creates a daily presence of fluoride in the mouth.”
The research team has called for more studies on the cost-effectiveness of FV among different populations and in different application settings. In the meantime, Cunha-Cruz suggests reducing sugar intake to prevent dental caries.
The study, titled “Fluoride varnish and dental caries in preschoolers: A systematic review and meta-analysis,” was published online on June 20, 2019, in Caries Research.