Biannual Fluoride Varnish Applications in Preschoolers

The effectiveness of fluoride varnishes (FV) in reducing the incidence of caries in preschool children is lacking in sound evidence. A 24-month follow-up randomized placebo-controlled clinical trial involving children one to 4 years of age was conducted in Rio de Janeiro to assess whether the application of FV in preschool children at 6-month intervals decreases the incidence of caries and produces any adverse effects. Two groups of 100 children each participated in the study: FV and placebo varnish (PV). Two pediatric dentists performed the clinical ex­am­inations, and dental car­ies was recorded at the d2 (cavitated enamel) and d3 (dentine) levels using the International Car­ies Diag­nosis and Assess­ment Sys­tem. At baseline, the mean age of the participants was 2.4 years (SD 0.9) and the mean d3mfs was 0.8 (SD 1.9). Most of the children brushed their teeth with fluoride toothpaste and consumed fluoridated tap wa­ter. After 24 months, 89 and 92 children of the test and the control groups were an­alyzed, respectively. The study found that a total of 32 (35.9%) children in the FV group and 43 (46.7%) in the PV group presented new dentine caries lesions, showing relative and absolute risk reductions of 23% (95% CI: -9.5 to 45.9) and 11% (95% CI: -3.5 to 25.0). The mean caries increment differences between the test and control groups were -0.8 (95% CI: -2.0 to 0.4) at the d2 level and -0.7 (95% CI: -1.9 to 0.4) at the d3 level. Only 2 minor complaints regarding the intervention were re­ported. It concluded that al­though safe and well accepted, twice-yearly professional FV ap­plication, during 2 years of the study, did not re­sult in a significant decrease in caries incidence.

(Source: Caries Research, 2014, Vol­ume 48, Number 3)