Fluoride varnish: is there any benefit?

Dr. Liji Thomas MD

Though hugely popular for preventing dental decay in children, fluoride varnish may not be anything but an expensive placebo, it turns out, from the results of a new study by University of Washington researchers.

Many dental care specialists as well as pediatricians have taken to fluoride varnish, which can be used to coat the teeth like a veneer of paint. Once applied with a brush, it dries over a few hours, protecting the teeth against caries. And the child won’t swallow it once it is dry. Almost any minimally trained person can do it.

The cost is also in its favor, at about $25 to $55 a pop, much cheaper than a full-scale dental appointment. However, the question raised by this new study is whether the treatment is worth even this investment..................................

What did they find?

The reviewers noted that the trials did not prove that fluoride varnish had any protective effect. This was despite the 12% reduction in the risk of new tooth cavities in this population, compared to those children who did not get this treatment. The lack of significance is due to the large prediction interval of 0.68 to 1.14. This means that future studies might predict a risk reduction by 32% or an increased risk by 14% respectively with the use of fluoride varnish. They also predicted that the varnish would have to be applied to 17 children for one child to benefit (with a predicted 50% rate of cavities in children). In their words, “This was a rather modest benefit, as a large number of the children developed new dentine caries lesions, regardless of fluoride varnish use.”