Effect of 5% fluoride varnish application on caries among school children in rural Brazil: a randomized controlled trial.
ABSTRACT 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.
A double-blind, randomized, placebo-controlled trial was conducted with 379 children aged 7-14 years who attended three schools in Brazil between January 2006 and December 2007. During this period, each school was visited four times at 6-month interval for recruitment, dental examinations, and fluoride varnish applications. Recruited children were randomly assigned to either a treatment (5% NaF varnish, n = 198) or a control group (placebo, n = 181). Trained interviewers collected data on oral health habits and sociodemographic characteristics from the children. Information on the child's diet was collected through 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). Crude caries increments of decayed and filled surfaces (DFS) were compared between fluoride varnish and placebo groups. A generalized linear model (GLM) was constructed to test the differences in DFS increments between the groups after accounting for confounding factors.
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. At the baseline examination, the children in the treatment and control groups presented on average 6.2 and 5.6 DFS, respectively (P < 0.001). After 12 months of follow-up, the children in the varnish group showed significantly lower DFS increments than did children in the control group (10.8 versus 13.3; P < 0.007), with PF of 40% (95% CI: 34.3-45.7%; P < 0.0001).
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.
- SourceAvailable from: Regina Guenka Palma-Dibb[Show abstract] [Hide abstract]
ABSTRACT: Dental caries is still the most prevalent chronic disease affecting human populations. Among the preventive treatments performed, it has been reported that laser irradiation combined with topical fluoride can induce an even greater increase in enamel caries resistance. The aim of this study was to evaluate the Nd:YAG laser, with or without fluoride, in occlusal caries prevention of the primary dentition. A double-blind split-mouth study design was used. Fifty-two children with high caries risk (7.6 ± 1.4 years) were selected and received the following: G1-the first molar was a negative control, and the second received a resin sealant; G2-the first molar was a negative control, and the second received laser irradiation (50 mJ, 10 Hz, 0.5 W); G3-the first molar received only acidulate phosphate fluoride (APF), and the second received APF + laser; G4-fisrt molar received only fluoride varnish, and the second received fluoride varnish + laser. Patients were followed up to 12 months to evaluate the presence of white-spot lesions and/or caries cavities by three calibrated observers. Thirty-five patients completed the study. Significant differences were found between the treatment and control groups (p < 0.05). The laser-alone and resin sealant resulted in statistically lower caries formation than the negative control group (p < 0.05). Nd:YAG laser irradiation in primary teeth effectively prevented occlusal caries in pits and fissures when used alone with lower energy over a 1-year period.Lasers in Medical Science 08/2013; · 2.40 Impact Factor
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ABSTRACT: Background The Community Dental Services of Barts Health NHS Trust in City and Hackney and Tower Hamlets PCTs in East London have provided a school-based oral health intervention since 2009.Objective The aim of this paper is to present the programme development, outcomes and evaluation.Subjects and methods The programme consists of fluoride varnish applications linked to school dental screenings for three to six-year-olds, combined with oral health promotion for parents/carers. An outreach linkworker works closely with schools to help identify and support vulnerable families into the programme.Results In the first year of the programme 160 of the target children (42%) had one FV application and 81 children (21%) had two applications. In the second year 149 children (39%) had one FV application, and 113 (29%) had two applications. Amendments to the protocol increased programme participation in the third year, with 1,822 of the target children (61%) having one FV application and 1,586 (53%) having two applications.Conclusions The programme proved acceptable to the school staff, participating parents/carers and children. The Happy Teeth programme is proposed as a model for school-based fluoride varnish programmes.British dental journal official journal of the British Dental Association: BDJ online 10/2013; 215(8):E14. · 1.09 Impact Factor
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ABSTRACT: Background. A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. Types of Studies Reviewed. The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents—including mouthrinses, varnishes, gels, foams and pastes—with caries increment outcomes published in English through October 2012. Results. The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride cariespreventive agents. The panel makes recommendations for further research. Practical Implications. The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.5 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from “in favor” to “expert opinion for.” As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner’s professional judgment and the patient’s needs and preferences. Key Words. Caries prevention; caries; evidence-based dentistry; fluoride; practice guidelines; preventive dentistry.Journal of the American Dental Association (1939) 11/2013; 144(11). · 1.82 Impact Factor