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Fluoride Varnish Efficacy in Preventing Early Childhood Caries

Center to Address Disparities in Children’s Oral Health and Comprehensive Oral Health Research Center of Discovery, University of California, San Francisco School of Dentistry, 3333 California Street, Suite 495, San Francisco, CA 94143-1361, USA

^* corresponding author, Jane.Weintraub{at}ucsf.edu

To determine the efficacy of fluoride varnish (5% NaF, Duraphat^®, Colgate) added to caregiver counseling to prevent early childhood caries, we conducted a two-year randomized, dental-examiner-masked clinical trial. Initially, 376 caries-free children, from low-income Chinese or Hispanic San Francisco families, were enrolled (mean age ± standard deviation, 1.8 ± 0.6 yrs). All families received counseling, and children were randomized to the following groups: no fluoride varnish, fluoride varnish once/year, or fluoride varnish twice/year. An unexpected protocol deviation resulted in some children receiving less active fluoride varnish than assigned. Intent-to-treat analyses showed a fluoride varnish protective effect in caries incidence, p < 0.01. Analyzing the number of actual, active fluoride varnish applications received resulted in a dose-response effect, p < 0.01. Caries incidence was higher for ‘counseling only’ vs. ‘counseling + fluoride varnish assigned once/year’ (OR = 2.20, 95% CI 1.19–4.08) and ‘twice/year’ (OR = 3.77, 95% CI 1.88–7.58). No related adverse events were reported. Fluoride varnish added to caregiver counseling is efficacious in reducing early childhood caries incidence.

KEY WORDS: dental caries • prevention • fluorides • preschool child • randomized controlled trial

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