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Title Application of Fluoride Varnish at Least Every 6 Months Reduces the Occurrence of Dental Caries in Adults at High Caries Risk
Clinical Question In adults at high caries risk, will the application of fluoride varnish reduce the occurrence of caries compared to no fluoride treatment?
Clinical Bottom Line Two or more applications of fluoride varnish per year is effective in reducing the caries prevalence in high-caries-risk adult populations.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21972457Gibson/2011Adults in 17 studiesSystematic review of randomized trials
Key resultsThis study thoroughly examined the efficacy of fluoride varnish on mitigating the effects of dental caries. A systematic analysis of 17 studies revealed significant contributions by NaF paste/gel in the treatment of caries in adults, more so than other categories of interventions. The NaF rinse was significantly related to positive outcomes for the older adult subpopulation. The best results for NaF varnish were seen with individuals exhibiting root surface lesions. The overall efficacy of supplemental fluoride treatments is greatly contingent upon the individual's risk for caries.
#2) 20671206Tan/2010306 elderly patientsRandomized Controlled Trial
Key resultsThis study by Tan aimed to examine the most effective means of preventing root caries in elderly institutionalized individuals. 306 elders were placed into 4 treatment groups (Individual oral hygiene instruction, OHI and 1% chlorhexidine varnish every 3 months, OHI and 5% sodium fluoride varnish every three months, and OHI and 38% silver diamine fluoride solution annually). Due to attrition in the study, only 203 individuals were followed for the entire duration of the 3 years. Results showed that SDF solution, fluoride varnish, and the chlorhexidine solution were more effective than providing oral health instruction alone. These methods are cost-effective ways to prevent dental caries in the elderly, though each have disadvantages that should be discussed with the patient.
Evidence Search ("dental caries"[MeSH Terms] AND ("adult"[MeSH Terms] OR "adult"[All Fields])) AND (("fluorides"[MeSH Terms] OR "fluorides"[All Fields] OR "fluoride"[All Fields]) AND ("paint"[MeSH Terms] OR "paint"[All Fields] OR "varnish"[All Fields])) AND "humans"[MeSH Terms]
Comments on
The Evidence
Validity: Gibson et al., 2011 conducted a systematic review of clinical trials that employed moderate to high caries risk adult patients. Seventeen studies were reviewed with categorization of the findings and subsequent quality evaluation checklist revealing quality evaluation scores. Tan et al., 2010 examined participants split into 4 groups with various treatment methods containing fluoride combinations of differing levels in 3 of the groups and individual oral hygiene instruction in the final group. Descriptive statistics revealed group level differences. An analysis of variance revealed an overall treatment effect. Perspective: Based on the research substantiating the use of fluoride treatment in at risk caries patients, further research should be conducted with broader populations to determine optimal dosages and frequency of use.
Applicability Fluoride varnish treatment should be used for patients as an effective preventative measure for caries, especially those at high risk of developing caries. Considering the poor compliance of some individuals with oral hygiene, periodic application of fluoride varnish will ensure provision of caries preventive measure to everybody in the population.
Specialty/Discipline (Public Health) (General Dentistry)
Keywords Adults, dental caries risk, fluoride varnish
ID# 2708
Date of submission: 03/30/2014spacer
E-mail malakouti@livemail.uthscsa.edu
Author Marjan Malakouti
Co-author(s) e-mail
Faculty mentor/Co-author Bennett T. Amaechi, BDS, MSc, PhD
Faculty mentor/Co-author e-mail Amaechi@uthscsa.edu
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