Fluoride varnish is a highly concentrated form of fluoride applied to the tooth surface, by dentists, dental hygienists or other health care professionals, as a type of topical fluoride therapy. It is not a permanent varnish but because of its adherence it can remain in contact with the tooth surface for several hours. It can be applied to enamel, dentine or cementum teeth and can be used to help prevent decay, tooth surface remineralization and to treat dentin hypersensitivity. There are over 30 fluoride varnish products on the market today, and they have a wide variety of compositions and delivery systems. This difference in composition causes pharmacokinetics to vary widely, an effect that is largely untested clinically.
Fluoride varnishes are relatively new in the United States, but they have been widely used in Western Europe, Canada, South Africa and Scandinavian countries since the 1980s as dental caries prevention therapy. They are recognized by the Food and Drug Administration for use as desensitis agents, but, at present, not as anti-decay agents. Canadian and European Studies have reported that fluoride varnish is as effective in preventing tooth decay as a professionally applied fluoride gel; However, it is not widely used for this purpose.
Fluoride varnishes consist of high fluoride concentrations as preparation of salt or silane in a solution of fast drying, alcohol and resin-based. The concentration, fluoride form, and method of expenditure may vary depending on the manufacturer. While most fluoride varnishes contain 5% sodium fluoride at least one fluoride varnish brand containing 1% difluorsilane in a polyurethane base and one brand containing 2.5% sodium fluoride that has been milled to perform similar to a 5% sodium fluoride product in a lacquer base.
Video Fluoride varnish
Clinical Recommendations
An expert panel hosted by the American Dental Association (ADA) Council on Scientific Affairs provides evidence-based clinical recommendations on topically applied professional fluoride apparatus, recipe-strength and home use for caries prevention. The Panel recommends the use of 2.22 percent of fluoride varnishes for people at risk of developing dental caries. As part of an evidence-based approach to care, this clinical recommendation should be integrated with the professional assessment of the practitioner and the needs and preferences of the patient.
United Kingdom
Fluoride varnish is widely used in the UK, following guidelines from various sources that support its efficacy. Public Health England, a UK government organization sponsored by the Department of Health, issued guidelines in 2014 recommending fluoride varnish applications at least twice a year for children and young adults. Similarly, the Scottish Intercontinental Guidelines Network and Scottish Dental Effectiveness Program have issued independent guidelines recommending at least twice a year of fluoride varnish applications, citing strong clinical evidence grounds. SIGN recommends fluoride varnish at a concentration of 2.2%, while SDCEP recommends 5%.
Maps Fluoride varnish
Type Varnish
Different lacquer products release various amounts of calcium, inorganic phosphate, and fluoride ions. MI varnish releases the largest amount of calcium and fluoride ions. Enamel Pro varnish releases most of the inorganic phosphate ions. Each type of varnish is designed to be used in certain situations.
Cost Effectiveness
Fluoride varnish treatments have a better result in preventing cavities at a lower cost than other fluoride treatments such as fluoride mouth rinses. For fluoride varnish treatment, the benefit to the cost ratio is 1.8: 1, whereas fluoride mouth rinse is 0.9: 1. With fluoride varnish treatments, one can save by preventing future restorations. Fluoride varnishes also require less maintenance for measurable effectiveness, therefore in the long run cost effective when compared to other treatments.
Advantages and Disadvantages
Benefits
- Fluorine varnishes are available in a variety of flavors that can be beneficial when caring for younger patients
- They dry out quickly and will be arranged even in the presence of saliva
- Since they do not require the use of fluoride trays they are suitable for use in patients with strong vomiting reflexes (See picture on right)
- Due to the small amount used and the fast setting time there is only a small amount of fluoride ingested
- It has a sticky consistency that helps it stick to the tooth surface allowing fluoride to stay in contact with the tooth for several hours
- Based on published findings, professionally applied fluoride varnishes do not appear to be a risk factor for dental fluorosis, even in children under 6 years of age. This is due to a decrease in the amount of fluoride potentially ingested during fluoride treatment due to the small amount used and compliance from the varnish to the teeth.
- Fluoride varnish treatment has been shown to reduce the number of S. mutansic bacteria more than tenfold.
- Varnish fluoride is a higher concentration than foam and gel. There was no significant difference in the amount of remineralization between gel, foam, and varnish. A study with larger sample sizes and longer periods of time may show different results.
- They can be implemented easily and quickly
Losses
- Due to the color and compliance of most fluoride varnishes, they can cause temporary changes to the color of the tooth surfaces as well as some fillers. When the varnish is worn out by eating and brushing, the yellowish color fades.
- Varnish is more expensive than gel and requires a different recipe with a gel that is sold freely.
- They do not have the bitter taste of some fluoride gel, but in some patients the taste of varnish can cause nausea especially when consuming food within 24 hours post-treatment.
Indications and contraindications
Indications to use
- Use as a topical fluoride agent in moderate and high-risk patients, especially children 5 and younger
- Desensitizing agent to open the root surface
- Fluoridated cavity varnish
- When higher fluoride concentrations are required for patients with high caries risk
- In the elderly to prevent increasing root dentin lesions, which may require higher fluoride concentrations
- In advanced enamel caries lesions, which may also require higher fluoride concentrations for remineralization
- Fluoride treatment for institutionalized patients or in other situations where patient settings, equipment and management may preclude the use of other fluoride delivery methods
- Prevention of caries on the open root surface
- Remineralization of lesions on the root dentine
- Fluoride applications around ribbons and orthodontic brackets (See picture to right)
- Treatment of fluoride in patients when there is concern that rinse, gel or fluoride foam may be ingested
Contraindications for use
- Areas with open cavities
- Patients at low risk or free of decay and living in areas with fluoridated water
- Treatment of areas where discoloration after treatment may be an aesthetic concern
See also
- Dental caries
- fluoride therapy
- Xerostomia
- Tooth fluorosis
- Dentin hypersensitivity
- Tooth recovery
- Dental operation
References
External links
- Canadian Dental Association
- American Dental Association
- Canadian Dental Hygiene Association
- American Dental Hygiene Association
- Centers for Disease Control and Prevention
Source of the article : Wikipedia
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