Fluoride Varnish: A Weapon in the Fight Against Adult Caries
Though studies show it remains underutilized, fluoride varnish application can be a simple and effective tool to combat caries in patients of all ages
It’s no secret that caries risk factors don’t cease to exist after adolescence. In fact, they do quite the opposite and increase as we age, for example, as a result of numerous multisurface restorations or prescription medication use that leads to reduced salivary flow.
Although many oral health organizations across the globe recommend fluoride varnish as a key caries prevention tool in their clinical practice guidelines, recent studies show that it remains an underutilized weapon in the fight against adult caries, which affects approximately 92% of Americans to varying degrees.
For example, the ADA’s Health Policy Institute reports that nearly 30% of adults age 19 to 64 and 22% of adults age 65 and over have untreated caries. Low-income seniors in particular have experienced a sharp increase in untreated caries in recent years, with 42% of senior citizens living below the federal poverty level unwilling or unable to seek treatment.
Following clinical recommendations set forth by the ADA Center for Evidence-Based Dentistry, moderate caries risk patients should receive preventive fluoride varnish treatment every 6 months, while patients with a high caries risk, such as those with xerostomia, exposed root surfaces, or active caries within the past 2 years, should receive it every 3 to 4 months.
While fluoride varnish is only one component in a comprehensive caries prevention plan for any patient, it is a simple and effective tool to help combat a growing rate of caries in adult patients. Along with promoting good at-home oral hygiene habits, recommending fluoride varnish treatment to moderate- and high- risk caries patients can help boost both patient and practice health.
Here’s a handful of fluoride varnish options that offer easy application and a pleasant patient experience.
FLUORIDE VARNISHES
Centrix's FluoroDose comes in a convenient single-use LolliPack that contains one 0.3-mL dose of 5% sodium fluoride and a Benda Brush applicator that allows it to be mixed prior to application. The varnish dries in seconds upon contact with saliva and comes in 5 flavors: caramel, bubble gum, mint, cherry, and melon.
Available in raspberry and mint flavors, Colgate’s PreviDent Varnish comes in ready-to-use unit-dose packaging and dries to a natural enamel color after a quick application. The xylitol containing varnish offers 4 times greater fluoride uptake than competing brands.
Available in caramel, mint, strawberry, cherry, and bubble gum flavors, Medicom’s Duraflor Ultra uses an advanced formula that quickly releases fluoride within 2 to 4 hours so that patients get the maximum fluoride benefit while the varnish is still on their teeth. Easy-to-open 0.4-mL unit doses eliminate messes and the risk of cross-contamination.
Uniquely formulated with amorphous calcium phosphate, Premier’s Enamel Pro Varnish delivers high fluoride uptake in addition to tooth-building calcium and phosphate ions. Available in 3 flavors, it is indicated for treating dentinal hypersensitivity and postoperative sensitivity.
VOCO’s Profluorid offers easy application via a SingleDose delivery system, adheres well to moist surfaces, and sets quickly in seconds after contact with saliva. Its tooth-shaded color avoids teeth discoloration while a high immediate fluoride release relieves hypersensitivity.
Pulpdent’s Embrace Varnish is formulated with a xylitol coating that is dissolved by saliva allowing bioavailable calcium and phosphate ions to react with the fluoride ions in saliva and form protective fluorapatite on the teeth. It offers a pleasing taste and fills superficial, noncarious enamel lesions.
A bioavailable varnish treatment that contains calcium, phosphate, and fluoride, GC America’s MI Varnish offers a smooth, creamy texture upon application and remains on the teeth longer than other fluoride varnishes. It is available in unit-dose packaging in strawberry and mint flavors.
Ultradent’s Enamelast is a xylitol- sweetened, 5% sodium fl uoride varnish in a resin carrier. It is formulated with a patented adhesion-promoting agent to offer enhanced retention and has a smooth, nongritty texture. Unitdose applications are available.
Uniquely formulated to minimize clumping, dripping, or stringing, Dentsply Sirona’s Nupro White Varnish goes on white so it’s easy to see during application and then sets to a clear finish. Flexible packaging allows hygienists to choose how to hold the unit dose: snap it on the prophy grip, hold it between their fingers, or rest it on the dental tray.
Patterson 5% Sodium Fluoride White Varnish offers a smooth consistency for fast and easy application of a thin, even layer on the tooth surface. The white varnish completely hardens within 10 seconds of contact with saliva or moisture and dries to a natural tooth shade.
Acclean One Step, from Henry Schein, is a 5% sodium fluoride varnish that comes in convenient 0.4-mL unit-dose packaging with an application brush. It delivers the highest fluoride concentration available and offers smooth and even application in 5 patient-pleasing flavors: caramel, bubblegum, cherry, mint, and raspberry.
KEY RISK FACTORS FOR ADULT CARIES
•Exposed root surfaces
•Several multisurface restorations
•Xerostomia
•Prescription medication use
•Active caries in the past 2 years
•Chemotherapy or head and neck radiation therapy
•Cariogenic diet
•Poor oral hygiene or biofilm removal
•Restorations with overhangs and open margins
