Assessing fluoride concentration uniformity and fluoride release from three varnishes

BACKGROUND: The authors investigated the fluoride content uniformity of three commercial fluoride varnishes, as well as their fluoride-release behaviors. METHODS: The authors examined 20 doses from each of two tubes of Duraphat (Colgate-Palmolive Co., New York) and Duraflor (Pharmascience Inc., Montreal), and 20 doses of individually packaged 0.25-milliliter and 0.40-mL units of CavityShield (OMNII Oral Pharmaceuticals, West Palm Beach, Fla.). Part of the dose was dissolved in chloroform, followed by fluoride extraction with distilled water. The authors painted the remaining varnish from five predetermined doses from each group onto plastic substrates for examination of fluoride release. Fluoride concentrations in the solutions were measured with a fluoride-selective ion electrode. RESULTS: One-way analysis of variance showed statistically significant differences between varnish groups. The fluoride content was more uniform in Duraphat and CavityShield than it was in Duraflor. The fluoride release profiles in terms of percentage of total fluoride released over time were different among different groups of varnishes and were similar among samples from the same test group. The authors found that Duraflor released consistently more fluoride in artificial saliva than did the other two varnishes. CONCLUSIONS: Fluoride content can vary between doses dispensed from the same tube. Uniformity also varies between different varnishes and affects the retention of fluoride in the varnish. CLINICAL IMPLICATIONS: Clinicians should be aware that the nonuniform appearance of fluoride varnish as squeezed out of the tube could indicate separation of ingredients, resulting in variation of fluoride content.     

Fluoride release from varnishes in two in vitro protocols

BACKGROUND: The authors conducted a study to evaluate fluoride released from fluoride varnishes that had been applied with two different protocols. Fluoride release information for these two approaches may allow clinicians to vary application intervals to better meet the needs of their patients. METHODS: The authors painted enamel slabs from exfoliated primary molar teeth either in a single application (five samples) or three times within a single week (five samples) with fluoride varnish (Duraphat, Colgate-Palmolive, New York). The samples were immersed in buffered calcium phosphate solution (pH 6) to simulate the oral environment; the amount of fluoride released was measured during a span of six months. RESULTS: The total release of fluoride was significantly higher in the three-application regimen (34.9 micromoles) than in the single application (23.7 micromol). The rate of release was slower using the three-application regimen. Thus, applying fluoride-release varnish three times in a single week produced greater and longer release of fluoride than did one application. CLINICAL IMPLICATIONS: Massed application of fluoride varnish during a single period during the year may be as effective as spaced single applications. This method can be a good alternative to delivering fluoride varnish to high-caries-risk patients who are mobile or difficult to recall.     

Fluoride varnish concentration gradient and its effect on enamel demineralization

PURPOSE: Two of the 4 fluoride varnishes available on the American market today are sold in 10-mL tubes of 5% NaF varnish (Duraphat and Duraflor). Pilot studies have shown that a separation of contents within these tubes exists. The purpose of the current study was 4-fold: (1) to measure the fluoride concentration gradient in 10-mL tubes of fluoride varnish, based on resting position of the tube prior to use; (2) to compare and contrast fluoride concentration gradients of Duraphat, Duraflor, and CavityShield; (3) to compare this gradient to the ability to inhibit caries in an artificial caries environment; and finally, (4) to determine if quantitative light fluorescence (QLF) can detect differences in lesions developed when exposed to an artificial caries environment and fluoride varnish. METHODS: Human teeth specimens were subjected to a caries challenge and treated with a sample of fluoride varnish from 1 of 5 categories: Duraphat stored horizontally and vertically for 1 week, Duraflor stored horizontally and vertically for 1 week, or a CavityShield 0.4 mL "unidose." All specimens were then analyzed with the QLF system and with confocal microscopy. RESULTS: Results showed no significant fluoride ppm differences exist between groups (P=.29). It was shown that the order in which Duraflor varnish was dispensed from tubes significantly affected the fluoride concentration (P<.05). The order effect was not significant for Duraphat (P=.99). QLF data analysis showed there was no significant difference (P>.05) in the amount of remineralization obtained by using any varnish stored in any position. CONCLUSIONS: These results indicate that all 3 brands of fluoride varnish are able to remineralize incipient in vitro carious lesions, regardless of what part of the 10-mL tube the varnish is taken from. However, a fluoride concentration gradient exists in tubes of Duraflor. Also, QLF is able to detect demineralized and remineralized incipient lesions.     

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).     

Deposition of fluoride on enamel surfaces released from varnishes is limited to vicinity of fluoridation site

The aim of the in-situ study was to determine fluoride uptake in non-fluoridated, demineralized enamel after application of fluoride varnishes on enamel samples located at various distances from the non-fluoridated samples. All enamel samples used were demineralized with acidic hydroxyethylcellulose before the experiment. Intra-oral appliances were worn by ten volunteers in three series: (1, Mirafluorid, 0.15% F; 2, Duraphat, 2.3% F and 3, unfluoridated controls) of 6 days each. Each two enamel samples were prepared from 30 bovine incisors. One sample was used for the determination of baseline fluoride content (BFC); the other was treated according to the respective series and fixed in the intra-oral appliance for 6 days. Additionally, from 120 incisors, each four enamel samples were prepared (one for BFC). Three samples (a–c) were placed into each appliance at different sites: (a) directly neighboured to the fluoridated specimen (=next), (b) at 1-cm distance (=1 cm) and (c) in the opposite buccal aspect of the appliance (=opposite). At these sites, new unfluoridated samples were placed at days 1, 3 and 5, which were left in place for 1 day. The volunteers brushed their teeth and the samples with fluoridated toothpaste twice per day. Both the KOH-soluble and structurally bound fluoride were determined in all samples to determine fluoride uptake and were statistically analyzed. One day, after fluoridation with Duraphat, KOH-soluble fluoride uptake in specimen a (=next) was significantly higher compared to the corresponding samples of both the control and Mirafluorid series, which in turn were not significantly different from each other. At all other sites and time points, fluoride uptake in the enamel samples were not different from controls for both fluoride varnishes. Within the first day after application, intra-oral-fluoride release from the tested fluoride varnish Duraphat leads to KOH-soluble fluoride uptake only in enamel samples located in close vicinity to the fluoridation site.     

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).     

Effects of fluoride varnish on color of esthetic restorative material

PURPOSE: This study determined the color stability of a compomer, hybrid ionomer, and composite after staining with three fluoride varnishes. MATERIALS AND METHODS: Five disks (10 mm in diameter, 2 mm thick) of each material were prepared in a mold and incubated at 100% relative humidity at 37 degrees C for 24 hours. Duraphat, Duraflor, FluorProtector, and water (control) were applied to the disks, which were subsequently brushed with a soft toothbrush and dentifrice. Color was measured at baseline, after staining, and after brushing using CIE L*a*b* (source C) against white background on a reflection spectrophotometer, and color change (delta E*) was calculated. Means (n = 5) and standard deviations were calculated and compared using a repeated-measures analysis of variance (ANOVA). Tukey-Kramer intervals (p = .05) were calculated to compare means. RESULTS: Varnishes Duraflor and Duraphat caused perceptible color changes (delta E* > 3.3) in compomer, hybrid ionomer, and composite after application; however, FluorProtector did not affect the color of the materials. After brushing, none of the materials exhibited perceptible values of delta E*, except the composite with Duraflor (delta E* = 5.4).     

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     

两种氟防龋涂膜材料的释氟性及抗脱矿能力的研究

目的 比较两种氟防龋涂膜材料的释氟性及其提高釉质的抗脱矿能力。方法 将两种市售的FQ氟涂膜和多乐氟涂膜分别涂覆于20 mm×20 mm的方形聚酯塑料载片表面，每个聚酯塑料载片浸于20mL去离子水中，分别于浸水后3 h、6 h、12 h及24 h测定氟离子浓度，计算释氟率；扫描电镜观察氟涂膜表面形貌。制备5 mm×5 mm×3 mm的牛切牙釉质块，自凝树脂包埋后表面打磨抛光，测定初始表面显微硬度(SMH0)，在釉质块表面涂覆氟涂膜，浸水12 h，然后去除氟涂膜，对釉质块进行pH循环脱矿，7天后测定釉质块表面显微硬度(SMH1)，计算脱矿后釉质表面显微硬度下降率，设立阳性对照和阴性对照。结果 FQ氟涂膜和多乐氟3 h、6 h、12 h、24 h释氟率分别为(2.73±0.27)%、(3.19±0.05)%、(3.58±0.19)%、(3.63±0.08)%和(0.16±0.02)%、(0.34±0.03)%、(0.43±0.03)%、(0.48±0.03)%；经过pH循环脱矿后，应用过氟涂膜的釉质表面显微硬度下降率显著低于未用氟涂膜的釉质（85.95±3.50）%,FQ氟涂膜和多乐氟的硬度...     

Studies of fluoride varnishes in Finland.

Despite the artificial fluoridation of drinking water in Kuopio, part of the children have high caries incidence. We therefore started our studies on fluoride varnishes in 1977 in an attempt to find a feasible means of applying fluoride topically in children at high risk of caries. In our first trial, the sodium fluoride varnish Duraphat was found to be effective in preventing caries, but the effectiveness of the silane fluoride varnish Fluor Protector could not be unequivocally established, despite the fact that Fluor Protector deposited markedly more fluoride in enamel than Duraphat. In a second study in children in a low-fluoride area, use of Duraphat was found to be more effective than fortnightly fluoride rinses or Fluor Protector. Increasing the frequency of application from two to four times a year did not increase the effectiveness of Duraphat even in highly caries-prone children in a 2-year trial. On the basis of peak values of fluoride in parotid saliva after application, use of either fluoride varnishes was considered safe. Although the fluoride content of the enamel remained elevated for at least two years after discontinuation of treatment with both varnishes, the caries preventive effect did not continue after the applications were stopped. This shows that increasing the fluoride content of enamel is not the main mechanism by which fluoride varnishes prevent caries, and that the applications need to be continued as long as caries is a problem.     

Effects of repeated fluoride varnish application on different restorative surfaces

AIM: The aim of this study was to assess the effect of repeated (twice) applications of two fluoride varnishes (Duraflor and CavityShield) on the surface micromorphology of a high-viscosity glass ionomer (Fuji IX GP), a compomer (F2000), and a flowable composite (Filtek Flow) using a profilometer and scanning electron microscope (SEM). METHODS AND MATERIALS: Fifteen specimens were prepared from each material, surface roughness (Ra) was measured with a profilometer, and an impression was made for epoxy replicas. The fluoride varnishes were applied to the experimental specimens of each material at repeated intervals of 48 hours. For all specimens, Ra was measured and SEM replicas were examined. RESULTS: The final Ra of glass ionomer was 3.49 +/- 0.59 (mean +/- SD) for CavityShield, 4.69 +/- 1.33 for Duraflor, and 2.96 +/- 1.53 for the controls. The final Ra of flowable composite was 0.53 +/- 0.20 for CavityShield, 2.61 +/- 3.08 for Duraflor, and 0.15 +/- 0.09 for controls. For glass ionomer and flowable composite, Duraflor was associated with a significantly higher roughness at the final measurement compared to controls (P < 0.05). SEM micrographs showed differing surface topographies which in many specimens confirmed Ra analysis. CONCLUSION: Fuji IX GP and Filtek Flow showed significantly higher roughness after two applications of Duraflor compared to controls.     

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.     

Differences in loosely bound fluoride formation and anticaries effect of resin‐based fluoride varnishes

International Journal of Paediatric Dentistry 2013; 23: 166–172 Objective. Our in vitro study evaluated calcium fluoride formation in enamel and the anticaries effect of seven resin‐based varnishes under cariogenic challenge. Methods. Enamel blocks were subjected to pH cycling. The experimental groups received fluoride varnish application, the positive control received topical fluoride gel treatment, and the negative control did not receive any treatment. The pH cycling surface hardness (SH₁) and integrated loss of subsurface hardness (ΔKHN) were then determined. We measured the amount of fluoride released into the demineralizing and remineralizing (DE–RE) solutions used in pH cycling. The fluoride concentration in the enamel was determined 24 h after application of the products as loosely bound fluoride and firmly bound fluoride. Results. Higher deposits of loosely bound fluoride were observed for Duofluorid, followed by Biophat. For Duraphat, Bifluorid, Duraflur, and Duofluorid, no difference was observed in the SH₁ and ΔKHN values, with the lowest mineral loss compared to the other groups. The Bifluorid and Duofluorid groups released high fluoride amounts into the DE–RE, and statistically significant difference was noted between them. Conclusions. The anticaries effect showed no correlation with higher deposited fluoride amounts, resin type, or fluoride source.     

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

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 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.     

Effect of fluoride varnishes on color stability of esthetic restorative materials

Fluoride varnish applications were applied to two hybrid resin composite materials, Z-100 (3M Dental Products, St Paul, MN, USA) and Esthet-X (Dentsply Caulk, Milford, DE, USA), shades A1 and A2 and a glass ionomer, GC Fuji IX GP Fast (GC Corporation, Tokyo, Japan), shade A2, to evaluate color stability. Specimens (12.6-mm dia x 2.3 mm) were prepared using a polyethylene frame, light-cured and polished through a 1-microm alumina finish. After the initial baseline color measurements, the discs were suspended in Fusayama artificial saliva (FAS) solution at 37 degrees C for 48 hours. Post immersion, the specimens were divided into five groups (n=15 each). The following fluoride varnishes were applied to four groups of test specimens: Duraphat (Colgate Oral Pharmaceutical, Inc, Canton MA, USA), Cavity Shield (OMNII Oral Pharmaceuticals, West Palm Beach, FL, USA), Duraflor (Pharmascience Inc, Montreal, Canada) and Fluor Protector (Vivadent, Ivoclar North America, Amherst, NY, USA). The varnish was allowed to dry for five minutes before immersion. The control group was not coated with varnish, although the specimens were immersed in FAS. All specimens were incubated in newly prepared FAS at 37 degrees C for 24 hours, cleaned with an electric toothbrush and the process repeated using newly prepared FAS. CIE L*a*b* color measurements were recorded five times: at baseline, after 48 hours FAS immersion, after cleaning the first and second fluoride varnish applications and after the final brushing using a commercial toothpaste (Crest). A Minolta CR-300 tristimulus colorimeter with an 8-mm aperture (Ramsey, NJ, USA) was used to record color measurements with the daylight (D65) setting. Calculations were performed for using CIE parameters deltaE*, deltaL*, delta a*, delta b*. Analysis of variance (ANOVA) and post-hoc test (Fisher's PLSD) were used for statistical analysis. After immersion in saliva, the tested glass ionomer (Fuji IX) produced the most significant color changes (deltaE*=1.19 and deltaL*=-1.03), indicating the effect of the color change was due to absorption. After fluoride varnish applications, Duraphat varnish produced significant changes in all tested materials and shades, resulting in color changes with deltaE greater than (>) 1 but less than (<) 3. These color changes are considered visually perceptible, yet have been reported in dental literature as clinically acceptable. Fluoride varnishes can be used without adversely affecting the color of restorative materials.     

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.     

Enamel fluoride uptake of a novel water-based fluoride varnish

Aim of the in situ-study was to evaluate fluoride retention in sound and demineralised enamel after application of a novel water-based fluoride (0.12% F) varnish Mirafluorid (Hager and Werken, Germany) compared to the resin-based varnish (2.26% F) Duraphat (Colgate, USA). Each five enamel specimens were prepared from 60 bovine incisors. In 150 of these specimens, incipient lesions were produced with acidic hydroxyethylcellulose (pH 4.8; 72 h), 150 specimens were not demineralised. The samples were equally (n=100) allotted to three groups (A: Mirafluord, B: Duraphat, and C: control). Each 80 specimens (40 demineralised and 40 sound) were varnished with either Mirafluorid or Duraphat or remained unfluoridated (controls). The other specimens were used for measuring base-line fluoride content of the respective tooth. Each six specimens (three demineralised and three sound) were fixed in intraoral appliances worn for 5 days by 10 volunteers in three series (A-C). During the experiment, the samples were brushed twice daily with fluoridated toothpaste. KOH-soluble and structurally bound fluoride (0-30 and 31-60 microm depth) was determined immediately, 1, 3 and 5 days after fluoridation. Fluoride uptake was calculated as compared to base-line content and statistically analysed. Immediately after fluoridation, uptake of KOH-soluble and structurally bound fluoride was similar for Mirafluorid and Duraphat in both demineralised and sound enamel. However, at day 1, 3 and 5 statistically significantly higher amounts of KOH-soluble and structurally bound fluoride were found in the samples treated with Duraphat. For Mirafluorid only the uptake for KOH-soluble fluoride and structurally bound fluoride in the first enamel layer (0-30 microm) of the demineralised samples was significantly higher compared to the controls (C). It is concluded that the novel fluoride varnish Mirafluorid deposits less KOH-soluble and structurally bound fluoride on both demineralised and sound enamel compared to Duraphat under in situ-conditions.     

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.     

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.