This collection of selected resources offers high-quality information about fluoride varnish. Use the tools below for further searching, or contact us for personalized assistance.
Used with permission from Joanna Douglass, B.D.S., D.D.S., University of Connecticut School of Dental Medicine. 2008.
Selected Journal Articles
American Dental Association, Council on Scientific Affairs. 2006. Professionally applied topical fluoride: Evidence-based clinical recommendations. Journal of the American Dental Association 137(8):1151–1159. Report; tool.
This report presents information on the use of professionally applied topical fluoride (gel, varnish, and foam). Topics include a definition of evidence-based dentistry; the rationale for evidence-based clinical recommendations on professionally applied topical fluoride; and the American Dental Association’s process for clinical recommendations, panel conclusions, and clinical recommendations (including a discussion of dental caries risk, a summary chart, and recommendations for additional research). A tool based on scientific evidence adapted from the report is also available.
This review aimed to develop a scientifically current and evidence-based protocol on the use of fluoride therapies in preventing dental caries. Topics include the effectiveness of fluoride varnish in preventing dental caries in a predominantly high-risk population, and particularly, in young children; the number, frequency, timing, concentration, and method of fluoride varnish application; and the cost-effectiveness of fluoride varnish. Recommended strategies are also discussed.
Grant JS, Roberts MW, Brown WD, Quinonez RB. 2007. Integrating dental screening and fluoride varnish application into a pediatric residency outpatient program: Clinical and financial implications. Journal of Clinical Pediatric Dentistry 31(3):175–178. Abstract available.
This article describes the outcome of implementing Into the Mouths of Babes (IMB) Varnish and Screening, a statewide physician-based preventive oral health program to serve children receiving public assistance. It describes the use of preventive oral health services and reimbursement accompanying implementation of the IMB program in a pediatric medical residency setting over a 31-month period. The authors concluded that the program provided an additional access point for preventive oral health services to children at high risk for early childhood caries and also provided a modest source of clinic income.
Milgrom P, Tut OK. 2009. Evaluation of Pacific Islands Early Childhood Caries Prevention Project: Republic of the Marshall Islands. Journal of Public Health Dentistry 69(3):201–203. Abstract available.
This article describes the evaluation of a Head Start–sponsored community program to reduce tooth decay in young children. The program included two groups: (1) children who received fluoride varnish three times per year and (2) children who received fluoride varnish three times per year plus supervised toothbrushing with fluoridated toothpaste twice per day at school. One year after program implementation, children in group 1 were at least twice as likely to develop tooth decay as children in group 2.
Miller EK, Vann WF. 2008. The use of fluoride varnish in children: A critical review with treatment recommendations. Journal of Clinical Pediatric Dentistry 32(4):259–264. Abstract available.
This article expands on the American Dental Association Council on Scientific Affairs’ 2006 recommendations for the use of professionally applied topical fluoride, with a specific focus on children ages 12 and under. The authors (1) review what is known about the safety of fluoride varnish for children, (2) underscore that varnish should be the only topical fluoride used for infants and children from birth to age 3 and for children with special health care needs, (3) recommend that varnish be the topical fluoride of choice for children ages 3–12, (4) provide best practice recommendations for varnish application techniques for use in children, and (5) comment on varnish products on the market.
Okunseri C, Szabo A, Jackson S, Pajewski NM, Garcia RI. 2009. Increased children’s access to fluoride varnish treatment by involving medical care providers: Effect of a Medicaid policy change. HSR: Health Services Research 44(4):1144–1156. Abstract available.
This article describes a change in Medicaid policy allowing medical providers to be reimbursed for fluoride varnish treatment (FVT) and the impact of the change on access to FVT for children enrolled in Medicaid in Wisconsin. Medicaid claims for FVT in 2002–2003 totaled 3,631. Following the policy change, claims for FVT increased to 28,303, with 38 percent submitted by medical providers. Overall, 49 percent of the increase in FVT claims was attributable to medical providers. In addition, the rate of FVT claims by dentists increased by over 300 percent after the policy was implemented. The change in FVT claims was highest for children ages 1 and 2, followed by children ages 2 and 3.
Altarum Institute. 2009. Topical Fluoride recommendations for high-risk children: Development of decision support matrix—Recommendations from MCHB expert panel. Washington, DC: Altarum Institute. 19 pp. Report; decision support matrix.
This report summarizes recommendations on the use of topical fluoride in preventing and controlling tooth decay from an expert panel convened on October 22–23, 2007, in Washington, DC. The matrix was developed primarily for a non-oral-health audience—program staff and non-oral-health professionals in public health settings (e.g., child care centers, Head Start programs, WIC, primary care) who work with infants and young children from birth to age 6 who are at high risk for tooth decay. Contents include background information, guiding questions, the development process, and conclusion and next steps. Topical fluoride recommendations for children are provided as appendices. The matrix offers recommendations on the use of topical fluoride—toothpaste, varnish, mouth rinses, gels, and foams.
Association of State and Territorial Dental Directors, Fluorides Committee. 2009. Fluoride varnish policy statement. New Bern, NC: Association of State and Territorial Dental Directors. 5 pp.
This policy statement supports the use of fluoride varnish, beginning with tooth eruption, for individuals at moderate to high risk for dental caries as an effective adjunct in programs designed to reduce lifetime caries experience.
Association of State and Territorial Dental Directors, Fluorides Committee. 2007. Fluoride varnish: An evidence-based approach. New Bern, NC: Association of State and Territorial Dental Directors. 15 pp.
This brief provides questions and responses to present the best available evidence to help professionals design and evaluate community-based programs that use fluoride varnish. Topics include a definition of fluoride varnish, how fluoride prevents tooth decay, advantages of fluoride varnish over other professionally applied fluorides, how dental caries in primary and permanent teeth can be prevented, how often fluoride varnish should be applied, Food and Drug Administration approval, fluoride varnish safety, whether fluoride varnish contributes to fluorosis, and what could improve the cost effectiveness of community-based programs. Appendices include a chart outlining fluoride varnish products and a summary of evidence-based clinical recommendations.
This fact sheet provides information about fluoride varnish and its uses, effectiveness, safety, service delivery, and reimbursement.
Bertness J, Holt K., eds. 2010. Fluoride varnish: A resource guide. Washington, DC: National Maternal and Child Oral Health Resource Center.
This resource guide provides information about the use and application of fluoride varnish. It offers annotated lists of journal articles, materials, and organizations that may serve as resources.
Michigan Department of Community Health, Oral Health Program. 2007. Fluoride varnish: Protect your child’s smile. Lansing, MI: Michigan Department of Community Health, Oral Health Program. 2 pp. English, Spanish, Arabic.
This brochure for parents provides information on the Varnish! Michigan program and the benefits of fluoride varnish for protecting primary teeth from decay. Topics include what fluoride varnish is and why it is recommended for infants and children, the safety of fluoride varnish, how it is applied, follow-up care, how long varnish and its benefits last, and costs to the family. The brochure is available in English, Spanish, and Arabic.
Texas Department of State Health Services, Oral Health Program. 2009. Fluoride varnish manual: Happy child, bright smile. Austin, TX: Texas Department of State Health Services, Oral Health Program. 29 pp.
This manual provides a guide for implementing a fluoride varnish program in Texas. It contains information about fluoride varnish advantages, protocols, and application. A list of resources, including the various types of fluoride varnish, ordering information, and costs are included. Also provided are sample documents such as program reporting forms, parent letters, and handouts. Instructions are supplemented with photographs.
