A 2-year report on caries prevention by fluoride varnishes in a community with fluoridated water

The benefit of semi-annual applications of sodium fluoride varnish (Duraphat) and silane fluoride varnish (Fluor Protector) was studied in 11-13 year-old children with life-long exposure to fluoridated drinking water (1-1.2 parts/10(6)). Annual clinical and radiographic examinations were made on 67 children in the Duraphat group and 71 children in the Fluor Protector group. Fluoride varnish was applied semi-annually using the half-mouth technique. At the end of 2 years, the mean overall DMFS-increments on the control side and test side of the Duraphat group were 5.0 and 3.8 (p less than 0.01), respectively, and of the Fluor Protector group 3.7 and 3.3 (NS). The caries reductions were 24% and 12%, respectively. Since there were no differences between initial mean DMFS scores of the groups, it was assumed that lower increments in the Fluor Protector group were due to Fluoride ions crossing the midline and providing protection on the control side as well. When increments in the Duraphat control side and the Fluor Protector test side were compared, the caries reduction of Fluor Protector was 35% (p less than 0.01). Fluoride varnishes provide additional benefit even when fluoride intake from drinking water is optimal.     

In vitro fluoride uptake, distribution and retention by human enamel after 1- and 24-hour application of various topical fluoride agents

The in vitro fluoride acquisition by human enamel after a 1-hour and 24-hour application of APF, Duraphat (a resin varnish) or Fluor Protector (a polyurethane varnish) and subjection to various procedures was determined. Fluoride acquisition was the greatest in teeth treated with Fluor Protector and the least in APF-treated teeth. Fluoride uptake and distribution were increased by prolonging the contact time between the varnishes and enamel, and fluoride retention was decreased after subsequent exposure to synthetic saliva.     

A 2-year report on caries prevention by fluoride varnishes in a community with fluoridated water

Abstract – The benefit of semi-annual applications of sodium fluoride varnish (Duraphat®) and silanc fluoride varnish (Fluor Protector®) was studied in 11-13-year-old children with life-long exposure to fluoridated drinking water (1–1.2 parts/ 10⁶). Annual clinical and radiograpic examinations were made on 67 children in the Duraphat group and 71 children in the Fluor Protcctor group. Floride varnish was applied semi-annually using the half-mouth tecnique. At the end of 2 years, the mean overall DMFS- increments on te control side and test side of the Duraphat group were 5.0 and 3.8 ( P 0.01), respectively, and of te Fluor Protector group 3.7 and 3.3 (NS). The caries redutions were 24%and 12%, respectively. Since there were no differences between initial mean DMFS scores of te groups, it was assumed that lower increments in the Fluor Protector group were due to fluoride ions crossing the midline and providing protectioon on the control side as well. When increments in the Duraphat control side and the Fluor Protector test side were compared, the caries reducation of Fluor Protector was 35% ( P <0.01). Fluoride varnishes provide additional benefit even when fluoride intake from drinking water is optimal.     

The role of 'CaF2-like' material in topical fluoridation of enamel in situ

In this paper the role and importance of 'CaF2-like' material deposited on enamel (Fon) by means of an APF gel and the varnishes Duraphat and Fluor Protector are described and discussed. The amount of Fon, determined by KOH extraction, is a measure of the amount of CaF2-like material on the enamel surface. Fluoride in the enamel (Fin), determined by etching, is the amount of F- bound in the solid enamel. Fon and Fin data are presented after various F- treatments and after wearing enamel slabs in dentures for a period of 1 week. The results of this work show that if we compare the three fluoridating agents, APF gel, Duraphat varnish, and Fluor Protector varnish in situ, only Fluor Protector shows a measurable amount of Fon after 1 week. The amounts of Fon acquired by the enamel surface (one application) rank as APF gel approximately Duraphat much less than Fluor Protector. Most likely, Fon in situ leaches away through the pellicle, with an apparent diffusion coefficient of about 10(-6) cm2.sec-1. The Fin data show that after APF gel or Duraphat treatment a substantial amount of Fin leaches away during 1 week in situ; the Fin values of Fluor Protector do not change. The efficiency of the fluoridating agents is most likely determined by the application period and fluoride availability. For APF gel, Duraphat, and Fluor Protector about 5%, 1%, and 44% of the available fluoride participates in the fluoridation process. CaF2-like globules are known to precipitate after gel or varnish treatment on the enamel surfaces and can be dissolved in KOH solution.(ABSTRACT TRUNCATED AT 250 WORDS)     

Three-year report on caries prevention of using fluoride varnishes for caries risk children in a community with fluoridated water

The benefit of semiannual application of the sodium fluoride varnish Duraphat and the silane fluoride varnish Fluor Protection was studied in 11--13-year-old children with high caries activity and life-long exposure to fluoridated drinking water (1--1.2 parts/10(6)). Annual clinical and radiographic examinations were made of 62 children in the Duraphat group and 70 children in the Fluor Protector group. Fluoride varnish was applied semiannually using the half-mouth technique. After 3 years, for the Duraphat group mean total DMFS increments on the control side were 6.2 and on the test side 4.3 (P less than 0.001); for the Fluor Protector group the DMFS increments were 4.9 and 4.4, respectively (NS). The caries reductions were 30% and 11%. Since there were no differences between initial mean DMFS scores of the groups, it is possible that the increment in the Fluor Protector control side compared to the Duraphat control side was due to fluoride ions from Fluor Protector crossing the midline and providing protection on the control side as well. Therefore, we conclude that Duraphat proved effective, but definite conclusion of the effect of Fluor Protector cannot be made. Children with the highest DMFS increment on the control side (Duraphat) gained most from the applications.     

Three-year report on caries prevention using fluoride varnishes for caries risk children in a community with fluoridated water

Abstract – The Benifit of seminnual application of the sodium fluoride varnish Duraphat^(R) and the silane fluoride varnish Fluor Protector^(R) was studied in 11–13-year-old children with high caries activity and lifelong exposure to fluoridated drinking water (1–1.2 parts/10⁶). Annual clinical and radiographic examinations were made of 62 children in the Duraphat group and 70 children in the Fluor Protector group. Fluoride varnish was applied semiannually using the half-moth technique. After 3 years, for the Duraphat group mean total DMES increments on the control side were 6.2 and on the test side 4.3 ( P <0.001); for the Fluor Protector group the DMES increments were 4.9 and 4.4, respectively (NS). The caries reductions were 30% and 11%. Since ther were no differences between initial mean DMES scores of the groups, it is possible that the lower increment in the Fluor Protector control side compatred to the Duraphat control side was due to fluoride ions from Fluor Protector crossing the midline and providing protection on the control side as well. Therefore, we conclude that Duraphat proved effective, but definite conslusion of the effect of Fluor Protector cannot be made. Children with the highest DMES increment on the control side (duraphat) gained most from the applications.     

Fluoride concentration in plaque in adolescents after topical application of different fluoride varnishes

The aim of the study was to measure the fluoride (F) concentration in plaque after a single topical application of different fluoride varnishes with contrasting levels of F. Thirty adolescents (12–17 years) with fixed orthodontic appliances were randomly assigned to one of three groups: Bifluoride (6% F), Duraphat (2.23% F) and Fluor Protector (0.1% F). The varnishes were applied after professional cleaning in one upper quadrant, leaving the opposite quadrant untreated according to the split-mouth technique. Pooled plaque samples from each quadrant were collected at baseline and 3 days, 7 days and 30 days after the varnish treatment, and fluoride was analysed by microdiffusion. All fluoride varnishes increased the fluoride concentration in plaque compared with baseline, and the mean values varied between 23 and 138 ng F/mg after 3 days, depending on varnish F concentration. Compared with the control quadrant, statistically significant elevations were recorded for Bifluoride after 3 days and 7 days and Duraphat after 3 days, while no significant differences were revealed in the Fluor Protector group. The fluoride concentration in plaque was back to baseline levels for all participants in the Duraphat group after 7 days, while some individuals in the Bifluoride and Fluor Protector groups still registered slightly increased levels after 30 days. The results suggest that fluoride varnish treatments resulted in elevated fluoride levels in plaque adjacent to fixed orthodontic appliances for a period of up to 1 week, although different patterns was disclosed for the various brands. Received: 5 October 1999 / Accepted: 18 November 1999     

Results of the Sherbrooke-Lac Megantic fluoride varnish study after 20 months

The purpose of this study was to demonstrate the effectiveness of two fluoride varnishes (Duraphat and Fluor Protector) in the prevention of dental caries in children residing in a non-fluoridated community. At baseline, 787 grade one children (6-7-yr old) were examined and randomly allocated into a control and two treatment groups. At 20 months, 703 children remained in the study. The mean baseline caries experience and the mean number of permanent teeth present at 20 months were not significantly different among the treatment and control groups. The mean DMFS increments after 20 months were 1.70, 1.73 and 2.02 for Fluor-Protector, Duraphat and control groups respectively (% reductions of 15.8 and 14.4 for Fluor-Protector and Duraphat groups). The mean dfs increments for primary molars after 20 months were 1.56, 1.62 and 1.74 for Fluor-Protector, Duraphat and control groups respectively (% reductions of 10 for Fluor-Protector and 7 for Duraphat).     

Caries inhibiting effect of ammonium fluoride varnish in vitro

The reaction of incorporation of fluoride into tooth enamel from NH4F varnish, and Duaphat were measured using SEMq2 in vitro. Level of enamel uptake of fluoride was highest in teeth treated with NH4F varnish. Average depth of fluoride penetrated into enamel was more than 80 microns from the two varnishes. Prolonged coating duration from 24 hours to 1 week did not increase uptake and penetration of fluoride from both varnishes. The NH4F varnish was found to be superior to Duraphat in terms of inhibiting artificial caries lesion formation (P less than 0.001).     

A comparative evaluation of three fluoride varnishes: an in-vitro study

This study was conducted to compare the caries preventive efficacy of Fluoritop - SR; the first fluoride varnish manufactured in India with Fluor Protector and Bifluorid 12, the two commercially available fluoride varnishes which have to be imported from other countries and are cost prohibitive. The demineralization inhibitory effects and the antibacterial effects on Streptococcus mutans were studied (in vitro). Calcium and Phosphorus dissolutions were estimated as a measure of the demineralization inhibitory effect. Antibiotic sensitivity tests using the serial tube dilution method and disk diffusion method were used to evaluate the antibacterial effects of the fluoride varnishes. Of the three varnishes, Fluor Protector was seen to exhibit the highest demineralization inhibitory effect, while Fluoritop-SR was found to be comparable to Bifluorid 12 in its caries protective effects.     

Prevention of rat fissure caries by sodium fluoride varnish (Duraphat) with different fluoride concentrations

125 Osborne-Mendel rats were weaned at 22-23 days, inoculated with Streptococcus sobrinus and fed a cariogenic diet for 40 days. The control group received no treatment; the study groups received applications of Duraphat containing 2.3, 1.1, or 0.6% fluoride or a placebo varnish on days 21-23. The placebo varnish had no effect on caries. Fissure caries was significantly reduced by the 2.3 and 1.1% fluoride varnishes, whereas the caries reduction found after treatment with the 0.6% fluoride varnish was not statistically significant. These results suggest that reducing the fluoride content of Duraphat by half does not significantly reduce its caries-preventive effect, but the progress of caries seems to be somewhat slower with the 2.3% fluoride varnish.     

Fluoride concentration in whole saliva and separate gland secretions after topical treatment with three different fluoride varnishes

Fluoride concentration in whole saliva and in separate gland secretions was determined after a single application of each of 3 different fluoride varnishes with contrasting levels of fluoride in a randomized crossover design. The study group comprised 8 healthy schoolchildren aged 10-12 years treated with A: Bifluorid 12 (6% F); B: Duraphat (2.26% F); and C: Fluor Protector (0.1% F). Unstimulated and stimulated whole saliva, as well as stimulated parotid and submandibular-sublingual saliva, were collected at baseline and 1, 6, 12, and 24h after the varnish treatments. The fluoride concentrations were determined with an ion-selective electrode. Time- and dose-dependent concentration curves were obtained in all the collected secretions, A > B > C. In whole saliva, the fluoride levels were significantly elevated (P<0.01) 1 h after the A and B varnish applications compared with baseline, while the increase was insignificant for varnish C. Similar patterns were unveiled in the parotid and submandibular-sublingual secretions, although the increase in fluoride concentration was modest. The elevated levels did not exceed 6 h for any of the varnish tested. The results of this study suggest a correlation between the concentration of fluoride of the varnish and fluoride levels obtained in saliva after application.     

Duraphat与Fluor Protector抑制固定正畸矫治中牙釉质脱矿的比较研究

目的　使用激光龋齿探测仪,比较两种含氟物Duraphat与Fluor Protector抑制固定正畸矫治中牙釉质脱矿的临床效果。方法　选取接受直丝弓固定矫治的12-18岁青少年患者60例,其中男性23例,女性37例,平均年龄14.8岁。采用自身对照法,实验组A右上前牙及前磨牙涂布Fluor Protector,实验组B左下前牙及前磨牙涂布Duraphat,对照组A左上前牙及前磨牙不使用任何药物,对照组B右下前牙及前磨牙仅涂布0.9%的氯化钠水溶液。分别于患者粘接正畸托槽之前时、粘接托槽后1个月、粘接托槽后3个月使用DIAG-Noden激光龋齿检测仪测试受试牙牙面并记录数值,应用单因素方差分析比较各组数值是否有统计学差异。结果 （1）正畸托槽粘接后1个月、3个月时,2组涂布氟漆的实验组的DD值均低于2组未涂布氟漆的对照组（P<0.05）,说明Duraphat与Fluor Protector两种氟漆均显示了明显抑制釉质脱矿的能力。（2）正畸托槽粘接后1个月、3个月时,涂布Flour Protector的实验组A的DD值与涂布Duraphat的实验组B的DD值间比较差异无统计学意义（P>0.05）,说明两种不同浓度的氟保护漆在抑制牙釉质脱矿的能力方面没有明显优劣。结论　（1）接受固定矫治的患者存在釉质脱矿的易感性。（2）Duraphat与Fluor Protector两种不同浓度的氟化物对于正畸过程中牙釉质的脱矿均有抑制作用,二者抑制脱矿的能力没有明显差异。（3）DIAGNodent激光龋齿检测仪适合临床探查釉质的脱矿及龋损,对釉质表面的改变感应相当敏锐,帮助医师对龋病做出早期诊断,及早监控并采取合适的措施。     

Effect of four dental varnishes on the colonization of cariogenic bacteria on exposed sound root surfaces

The aim of this study was to evaluate the effect of four different dental varnishes on the colonization of mutans streptococci, total streptococci and lactobacilli on exposed sound root surfaces. Sixty-five individuals were randomly allotted to one of four groups for treatment with Cervitec((R) ) varnish containing 1% chlorhexidine and 1% thymol, a thymol varnish or one of two different fluoride varnishes, Fluor Protector and Duraphat. The varnish was applied to three buccal root surfaces in each patient at baseline and after 1 week. Dental plaque from the root surfaces was collected and analysed on four different occasions: at baseline, after 1 week, 1 month and 6 months. The Cervitec varnish caused a statistically significant reduction in the number of mutans streptococci over time. The reduction was significant at 1 week and 1 month relative to baseline. The numbers of total streptococci and lactobacilli were not significantly affected by treatment with Cervitec. No statistically significant difference over time was found for mutans streptococci, lactobacilli or total streptococci after treatment with the fluoride varnishes or the thymol varnish.     

Effects of a sodium fluoride solution and a varnish with different fluoride concentrations on enamel remineralization in vitro

Abstract – To study the efficacy of sodium fluoride varnishes and a NaF solution in remineralization of enamel, 120 slabs of non-carious human enamel enamel were presoftened for 6 h and randomly divided into six groups. The slabs were stored in synthetic saliva for 9 days, except for a daily 30-min immersion in 0.1 M lactic acid-NaOH buffer. During the 9-day period, one group of the slabs received no treatment, and the rest were treated once or three times with 2.3% or 1.1% sodium fluoride varnish Duraphat, or nine times with a 0.1% NaF solution. Finally, the slabs were demineralized for 1 h, and the amount of dissolved Ca and F was determined. Microhardness of enamel was determined initially, after presoftening, after the 9- day period, and after the 1-h demineralization. All fluoride treatments prevented enamel softening almost completely during the 9 days, but the control slabs softened markedly. Fluoride varnishes were more effective than NaF solution. Three applications of 2.3% Duraphat were slightly more effective than any of the other varnish treatments, but one treatment with 2.3% varnish was not more effective than treatments with 1.1% varnish. Enamel treated three times with 1.1% varnish showed the greatest acid resistance during the 1-h demineralization. The results suggest that the efficacy of the varnish was not proportional to the fluoride concentration but rather to the number of applications. Fluoride uptake by enamel was greatest with the most concentrated varnish. Enamel solubility was not, however, directly proportional to the fluoride content of enamel.     

In vitro enamel fluoride uptake from topical fluoride agents

The F acquired by enamel from APF, Duraphat and Fluor Protector was evaluated in this in vitro study. The topical F agents were applied to the tooth surfaces for 4 min, the teeth were suspended in synthetic saliva and the topical F agents removed after 2 h or 4 h. The teeth were resuspended in synthetic saliva for 1, 3 and 6 months, respectively. Three successive enamel biopsies were done on the control and experimental tooth halves and the F and P content of the etching solutions determined. The fluoride concentrations were adjusted to standardized depths of 3.0, 6.0 and 9.0 μm, respectively. Enamel acquired significantly more F from Fluor Protector and Duraphat than from APF. The fluoride acquired by enamel from the topical F agents was inversely related to the enamel F concentration prior to topical F application.     

A cluster randomised controlled trial to evaluate the effectiveness of fluoride varnish as a public health measure to reduce caries in children

This cluster randomised controlled study assessed the effectiveness of twice-yearly applications of fluoride varnish as a public health measure to reduce dental caries in children living in relatively deprived communities. The test (n = 334) and control (n = 330) children in 2 school years (unit of randomisation) attended 24 state primary schools and were 6-8 years of age at the start. Good baseline balance was found. Duraphat varnish was applied at school on 5 occasions over 26 months, by dental therapists. A combined visual and fibre-optic transillumination examination included all surfaces of primary and first permanent molars at baseline and after 26 months for small and large enamel and dentine lesions. At the final examination the only statistically significant difference was in the caries increment for small enamel lesions in the primary dentition, with the test children having fewer lesions. This study failed to demonstrate that the twice-yearly application of fluoride varnish provided at school reduced dental caries in children living in this community. The low level of response and a lower than expected caries increment had a major impact on the effectiveness of the intervention, since the children who participated were least likely to have benefited from the programme, whereas those who might have benefited did not consent.     

成膜基质对氟化物涂膜抑制釉质早期龋的效果

目的:比较含不同成膜基质的氟化物涂膜抑制釉质早期龋的效果。方法:将制备的90个釉质试样块随机分成6组,分别应用以5种成膜基质(珂巴树脂、渗透型丙烯酸树脂、甲基丙烯酸乙酯共聚树脂、聚合松香、聚乙烯醇缩丁醛)配制的氟涂膜材料和Duraphat氟涂膜进行处理。采用荧光显微镜和显微硬度计测定各组釉质试样块在pH循环前后的荧光值和硬度值的变化;并通过偏光显微镜观察其脱矿深度。结果:pH循环后各组釉质试样块的荧光值和硬度值均较pH循环前明显降低,其中渗透型丙烯酸组与其他组相比,荧光损失率和硬度值变化率最小,与其他各组相比差异均有统计学意义(P<0.05);偏光显微镜观察显示:各组釉质表面均无实质性缺损,渗透型丙烯酸组釉质脱矿深度最浅。结论:氟化物涂膜具有明显的抑制釉质脱矿的作用,含渗透型丙烯酸树脂的氟涂膜效果最好。     

Fluorine uptake in bovine enamel from various treatment agents

Bovine tooth enamel with a low and uniform fluorine content was used for the study of fluorine uptake by the Micro-Acid-Drop enamel biopsy technique from different treatment agents commonly used in Sweden. The fluorine concentration in the enamel was also measured after an exposure of the treated test surfaces in artificial saliva for 90 minutes. Sodium fluoride 0.2% and 2%, ferric aluminum fluoride solution and Duraphat varnish showed a high uptake of fluorine in the enamel with the highest concentration in the surface layer. Fluor Protector and the toothpastes showed a considerably lower fluorine uptake. After immersion in artificial saliva of the specimens, the concentration of fluorine in the enamel decreased.     

Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition

BACKGROUND: The aim of this study was to evaluate the effect of fluoride varnish on enamel caries progression in the primary dentition. METHODS: One hundred forty-two children in Head Start schools (3 to 5 years old) were randomized into the varnish and control groups. Children in the varnish group received fluoride varnish (Duraphat, Colgate-Palmolive Co.) at baseline and after four months, and children in the control group received no professional fluoride applications. Two calibrated examiners performed the examinations at baseline and at nine months. RESULTS: At nine months, the authors found that in the control group, 37.8 percent of active enamel lesions on occlusal, buccal and lingual surfaces became inactive, 3.6 percent progressed and 36.9 percent did not change. In the varnish group, 81.2 percent became inactive, 2.4 percent progressed and 8.2 percent did not change. The difference between the groups was statistically significant (P < .0001). The mean decayed surfaces, or ds, value in the varnish group was significantly lower after nine months than it was at baseline (P < .0001). When enamel lesions were included in the data analysis (along with dentinal lesions), the decayed with initial enamel lesions, missing and filled surfaces, or dEmfs, values; decayed with initial enamel lesions, missing and filled teeth, or dEmft, values; and decayed surfaces with initial enamel lesions, or dEs, values were significantly lower in the varnish group after nine months than they were at baseline (P < .0001). CONCLUSIONS: These results suggest that fluoride varnish applications may be an effective measure in reversing active pit-and-fissure enamel lesions in the primary dentition. CLINICAL IMPLICATIONS: Fluoride varnishes are safe, easy to apply and well-accepted by patients. This study shows that fluoride varnish may offer an efficient, nonsurgical alternative for the treatment of decay in children.