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Topical Sources of Fluoride, continued
Fluoride Gels
Professionally applied or prescribed for home use under professional supervision, fluoride gels are usually recommended for use twice per year. The Cochrane Collaboration concluded that there is a clear evidence of a caries-inhibiting effect of fluoride gels, with an average 21% reduction in decayed, missing, and filled tooth surfaces. The Centers for Disease Control and Prevention (CDC) concluded that the quality of evidence for using fluoride gel to prevent and control dental caries in children is Grade 1 and gave it a strength of recommendation of A, with targeted effort at high-risk populations.

Fluoride Varnish
Varnishes are a professionally applied, sticky resin of highly concentrated fluoride (up to 22,600 ppm). They have been used extensively in Europe, Scandinavia, and Canada as preventive intervention for dental caries. In the United States, fluoride varnish has been approved by the Food and Drug Administration for use as a
Cavity: An area of decay in a tooth .
cavity liner and root desensitizer, but not specifically as an anticaries agent. Therefore, for caries prevention, fluoride varnish would be an “off label” product.

Application frequency ranges from 2 to 6 times per year. A number of states have decided to reimburse medical professionals for the application of fluoride varnish to children’s teeth. (Learn more.) The Cochrane Collaboration concluded that fluoride varnishes applied professionally 2 to 4 times a year would substantially reduce tooth decay in children. The use of fluoride varnish leads to an average 33% reduction in decayed, missing, and filled tooth surfaces in the primary teeth and a 46% reduction in the permanent teeth. The CDC concluded that the quality of evidence for using fluoride varnish to prevent and control dental caries in children is Grade 1 and gave it a strength of recommendation of A, with targeted effort at populations at high risk for dental caries.

Related Videos:

View CDC Grading and Coding Systems
View Quality of Evidence Table
 
 
The topical effect of fluoride is its most potent effect in caries prevention.
 
Regular use of fluoridated toothpaste is an inexpensive and effective method of preventing caries.
 
The CDC strongly recommends the use of toothpaste and fluoride mouthrinses, gels, and varnishes in children.
 
Fluoride gels and varnishes are applied by a dental or medical professional in the office.
View the Chapter 6 Photo Gallery.