Fluoride Varnish as a Public Health Measure to Reduce Caries

Objective: to test the ability of fluoride varnish applied in schools to reduce dental caries among children.

Method: A cluster randomised controlled community trial run in 24 primary schools. Participants were positively consenting 6 to 8 year olds at the start, clustered by year group. Dental therapists applied fluoride varnish (Colgate Duraphat varnish 22,600 ppm) to primary and permanent teeth, in school, twice yearly for 26 months. Detailed dental examinations in school at baseline and 26 months recorded the presence and progression of carious lesions in both the primary and permanent molars.

Results: Baseline and final examinations were undertaken for 334 in the test group and 330 control. The maximum of 5 varnish applications were received by 263 (78%) of the test children. Mean D3FS at 26 months for both test and control was 0.21, 95% CI of the difference= -0.13, 0.12. Comparison at three levels of caries diagnosis in primary and permanent dentitions showed no statistically significant differences. Comparison for those children with baseline caries experience also showed no statistically significant difference. There was no evidence of any association of caries increment with fluoride milk availability.

Conclusion: The results of this study suggest that the use of fluoride varnish cannot be recommended as a public health measure for reducing caries among this population.