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Individualized Prevention
Published in Lars Granath, William D. McHugh, Systematized Prevention of Oral Disease: Theory and Practice, 2019
Lars Granath, William D. McHugh
In Chapter 4 it was concluded that on a population basis, there is a correlation between the fluoride content of surface enamel and caries. However, for the individual, there is a large variation in this relationship. We can conclude that caries-free enamel in highly caries-active individuals should be treated with a fluoride varnish, every third month, in order to maintain a reservoir of fluoride in the subsurface enamel to facilitate remineralization if caries occurs. Incipient carious lesions, on the other hand, should be treated more frequently with a less concentrated preparation, e.g., a daily rinse with a 0.025% sodium fluoride solution in addition to the routine use of fluoride toothpaste. Such a program can be difficult to accomplish and it should be remembered that if the continuous topical supply of fluoride is interrupted, the fluoride from the surface enamel will soon be released into the saliva with decreased caries-resistance as the result.48,49 A final recommendation with respect to utilization of fluoride is that one should be cautious with gels, because toxic concentration of plasma fluoride can easily be obtained.23
Dentistry and Oral Health
Published in Akshaya Neil Arya, Preparing for International Health Experiences, 2017
Brittany Seymour, Hawazin Elani, Jane Barrow
This would include fluoride gels or foams delivered in trays, dental sealants and fluoride tablets. However, fluoride varnish is probably the most common and convenient method of administration in a low-resource setting, requiring less time, follow-up and supervision and is often applied after restorative procedures by dentists, given a lack of hygienists in a short-term volunteer setting. As Class II Medical Devices approved by the Food and Drug Administration (FDA), fluoride varnishes must be administered by a licensed healthcare provider in most states. They are considered ‘off-label’ use for prevention of dental caries. If dentists use fluoride varnish for prevention purposes, they have the responsibility to be well informed about the product and its scientific basis for use. Evidence suggests that for optimal effectiveness, fluoride varnish must be applied at least twice biannually for at least 2 years (Association of State and Territorial Dental Directors, 2007).
Extended caries prevention programme with biannual application of fluoride varnish for toddlers: prevalence of dental fluorosis at ages 7–9 years and associated factors
Published in Acta Odontologica Scandinavica, 2023
Thalia Fatma Kassem, Zhina Fadhil, Maria Anderson
Fluoride varnish applications (2.26% F) are considered safe [16] for 12–15-month-old children who drink non-fluoridated water and use non-fluoridated toothpaste. Lockner et al. measured urinary excretion levels of fluoride in 3–4-year-old children after fluoride varnish applications. One group used fluoridated toothpaste (1000 ppm F) and one, non-fluoridated toothpaste. Independent of toothpaste, high levels of fluoride that sometimes exceeded WHO recommendations were found. Thus, the risk of developing dental fluorosis after topical applications of fluoride varnish biannually or quarterly was considered to be very low [17]. The present study seems to confirm this, as the children who had been introduced to fluoride toothpaste early and received topical applications of fluoride varnish twice a year (2.26% F) did not develop dental fluorosis more frequently than those who had not received fluoride varnish.
Nonrestorative treatment of initial caries lesion in primary teeth: a systematic review and network meta-analysis
Published in Acta Odontologica Scandinavica, 2022
Tamara Kerber Tedesco, Ana Flávia Bissoto Calvo, Ana Laura Pássaro, Mariana Pinheiro Araujo, Nathalia Miranda Ladewig, Samata Scarpini, Juan Sebastian Lara, Mariana Minatel Braga, Thais Gimenez, Daniela Prócida Raggio
Resin infiltration superiority might also be supported by the difficulty of biofilm control in proximal surfaces, especially for two evaluated interventions – fluoride varnish and toothbrushing/flossing, which have showed higher risk to caries progression in the direct comparisons. Although fluoride varnish might allow the remineralization of enamel lesions [4], the lack of biofilm control between applications could facilitate the progression of initial lesions. One previous study has demonstrated the non-compliance rate with daily flossing by children [25] reinforcing the higher probability for caries lesion development when fluoride varnish or toothbrushing/flossing are used singly. It is important to highlight that this finding is supported by six studies with high risk of bias, offering concerns specially because of selection bias – lack of description of random sequence generation and allocation concealment.
Direct restorations and enhanced caries prevention among 20- to 60-year-olds attending Helsinki City Public Dental Service – a register-based observation
Published in Acta Odontologica Scandinavica, 2023
Ulla Palotie, M. M. Vehkalahti, S. Varsio
An international expert group suggests a fluoride varnish every 3–6 months for caries risk patients [25]. Scientific literature on the effect of the caries prevention used at the dental office for adult patients and its cost-effectiveness is scarce [30]. According to Moller et al. [31], however, patients with preventive dental care appointments had fewer operative dental visits in USA. In comparison with the early 2000s and the situation in Finland, higher levels of diagnostic and preventive treatments have been recently reported in Ireland and in Australia [11,32], but between-country comparison of preventive measures is especially difficult because of ways of recording all or only selected preventive measures.