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Fluoride Varnish

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Key Facts

  Share these facts to help improve the oral health of children and adolescents and their families.

  • Fluoride varnish treatment effectively inhibits demineralization of teeth, resulting in highly significant dental caries reductions. 1
  • Fluoride varnish is an easy, safe way to apply topical fluoride to teeth. 2
  • Fluoridated toothpaste and fluoride varnish are the most effective chemical strategies to prevent early childhood caries.3
  • Fluoride varnish applied to the teeth of young children in primary care settings decreases dental caries experience, especially if applied frequently and close to the time of tooth eruption. 4
  • Professionally applied fluoride varnish can remineralize early enamel dental caries in children. 5
  • Children and adolescents treated with fluoride varnish experience, on average, a 37 percent reduction in their primary teeth and a 43 percent reduction in decayed, missing, and filled tooth surfaces in their permanent teeth. 6
  • Although it is recommended that most children receive a fluoride varnish application at least every 6 months, some children may need monthly applications to reduce early childhood caries risk. 7
  • Fluoride varnish is well tolerated by infants and young children, has a prolonged therapeutic effect, and can be applied by both oral health professionals and non-oral-health professionals in a variety of settings. 8
  • The U.S. Preventive Services Task Force recommends that primary care health professionals apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption and continuing through age 5. 9
  • Fluoride varnish can be provided as part of a regular child health clinic program (well or sick visit) by trained pediatricians, family physicians, nurse practitioners, health auxiliaries, or community health workers. 10
  • Home visiting models can introduce children and their families to preventive oral health practices, improve oral health literacy, establish dental homes, and provide fluoride varnish applications. 11
  • Collaborations between tribal, state, and federal agencies to provide effective tooth-decay-prevention interventions, such as water fluoridation of villages with suitable water systems and provision of fluoride varnishes, should be encouraged.12


  1. Sharma G, Puranik MP, Sowmya KR. 2015. Approaches to arresting dental caries: An update. Journal of Clinical and Diagnostic Research 9(5):ZE08–ZE11.
  2. Manski MC, Parker ME. 2010. Early childhood caries: Knowledge, attitudes, and practice behaviors of Maryland dental hygienists. Journal of Dental Hygiene 84(4):190–195.
  3. Garcia R, Borelli B, Dhar V, Douglass J, Gomez FR, Hieftje K, Horowitz A, Li Y, Ng M, Twetman S, Tinanoff N. 2015. Progress in early childhood caries and opportunities in research, policy, and clinical management. Pediatric Dentistry 37(3):294–299.
  4. Douglass JM, Clark MB. 2015. Integrating oral health into overall health care to prevent early childhood caries: Need, evidence, and solutions. Pediatric Dentistry 37(3):266–274.
  5. Marinho VCC, Worthington HV, Walsh T, Clarkson JE. 2013. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 7:CD002279.
  6. Gao SS, Zhang S, Mei ML, Lo EC, Chu CH. 2016. Caries remineralization and arresting effect in children by professionally applied fluoride treatment—A systematic review. BMC Oral Health.
  7. Ramos-Gomez F. 2014. A model for community-based pediatric oral heath: implementation of an infant oral care program. International Journal of Dentistry Epub 156821.
  8. Clark MB, Slayton RL; American Academy of Pediatrics, Section on Oral Health. 2014. Fluoride use in caries prevention in the primary care setting. Pediatrics 134(3):626–633.
  9. U.S. Preventive Services Task Force. 2014. Dental caries in children from birth through age 5 years: Screening. Rockville, MD: U.S. Preventive Services Task Force.
  10. American Academy of Pediatrics, Section on Oral Health. 2014. Maintaining and improving the oral health of young children. Pediatrics 134(6):1224–1229.
  11. Brickhouse TH, Haldiman RR, Evani B. 2013. The impact of a home visiting program on children's utilization of dental services. Pediatrics (Suppl 2):S147-–S152.
  12. Centers for Disease Control and Prevention. 2011. Dental caries in rural Alaska Native children: Alaska, 2008. MMWR Morbidity and Mortality Weekly Report 60(37):1275–1278.

OHRC Publications

This section contains OHRC-produced materials.


Barzel R, Holt K, eds. 2020. Fluoride varnish and silver diamine fluoride: A resource guide. Washington, DC: National Maternal and Child Oral Health Resource Center, 15 pp

National Maternal and Child Oral Health Resource Center
Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This guide provides an annotated list of resources on the use and application of fluoride varnish and silver diamine fluoride, including materials on data and surveillance, professional education and training, and public education. Descriptions of and contact information for relevant organizations are included. [Funded by the Maternal and Child Health Bureau]


National Center on Early Childhood Health and Wellness. 2014–. Healthy habits for happy smiles. Elk Grove Village, IL: National Center on Early Childhood Health and Wellness, 26 pp

Early Childhood Learning and Knowledge Center
Telephone: (866) 763-6481
E-mail: health@ecetta.info
Website: https://eclkc.ohs.acf.hhs.gov
Available from the website.

This series of handouts for pregnant women and parents of infants and young children provides simple tips on nutrition and oral health issues. Topics include brushing a young child’s teeth, choosing healthy drinks for young children, encouraging young children to drink water, giving young children healthy snacks, taking care of oral health for pregnant women, and taking care of an infant’s oral health. The series is available in English and in Spanish.


National Center on Early Childhood Health and Wellness. 2017. I like my teeth [oral health posters]. Elk Grove Village, IL: National Center on Early Childhood Health and Wellness, 8 items

National Center on Early Childhood Health and Wellness
American Academy of Pediatrics 345 Park Boulevard
Itasca, IL 60143

Telephone: (888) 227-5125
E-mail: health@ecetta.info
Website: https://eclkc.ohs.acf.hhs.gov/ncechw

These posters for consumers share simple, positive messages about brushing children’s teeth with fluoridated toothpaste, drinking fluoridated water, eating a healthy diet, and talking to the dentist or doctor about fluoride treatments for children. The posters are available in English and in Spanish.


Tinanoff N, Lowe E, Holt K, Goodman H. 2010. Maryland's Mouths Matter: Fluoride varnish and oral health screening programs for kids—Training for EPSDT medical providers in Maryland. Washington, DC: National Maternal and Child Oral Health Resource Center; Baltimore, MD: Maryland Department of Health, Office of Oral Health, 1 v

National Maternal and Child Oral Health Resource Center
Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This curriculum is designed to provide Early and Periodic Screening, Diagnosis, and Treatment medical providers (i.e., physicians, nurse practitioners) and other health professionals in Maryland with knowledge and skills to reduce the incidence of dental caries among children ages 3 and under and to contribute to the establishment of a dental home. The series of four modules provides information on the role of medical providers in children's oral health. Also included are a description of the dental caries process and instructions on how to conduct a dental caries risk assessment. The modules also address the provision of anticipatory guidance, the application of fluoride varnish, and the importance of referring young children to a dentist. [Funded in part by the Maternal and Child Health Bureau]


OHRC Library

This section contains recent materials, not including OHRC-produced materials.


ADA Center for Evidence-Based Dentistry. 2013. Topical fluoride for caries prevention: Full report of the updated clinical recommendations and supporting systematic review—A report of the Council on Scientific Affairs. Chicago, IL: ADA Center for Evidence-Based Dentistry, 118 pp

American Dental Association, Center for Evidence-Based Dentistry
211 East Chicago Avenue
Chicago, IL 60611-2678

Telephone: (312) 440-2500
Website: http://ebd.ada.org
Available from the website.

This report provides evidence-based recommendations for the use of professionally applied topical fluorides to prevent dental caries. The report addresses the impact of topical fluoride vs. no topical fluoride on new and early carious lesions; which topical fluoride was most effective in preventing, arresting, or reversing dental caries; and whether an oral prophylaxis before application improved fluoride uptake. The report also describes the systematic review of the literature, methodologies used to develop the clinical recommendations, limitations related to the evidence and review, and future research needs. An executive summary is also available.


Association of State and Territorial Dental Directors, Fluorides Committee. 2016. Fluoride varnish: An evidence-based approach—Research brief. [Reno, NV]: Association of State and Territorial Dental Directors, 19 pp

Association of State and Territorial Dental Directors
3858 Cashill Boulevard
Reno, NV 89509

Telephone: (775) 626-5008
Fax: (775) 626-9268
E-mail: info@astdd.org
Website: http://www.astdd.org
Available from the website.

This brief presents information to help health professionals design, implement, and evaluate community-based programs that apply fluoride varnish. Topics include a definition of fluoride varnish and how it prevents tooth decay; the characteristics, effectiveness, and safety of fluoride varnish; and recommendations for using fluoride varnish. The brief also provides tips for selecting cost-effective community and school dental-caries-prevention programs.


Kaiser Permanente. 2014. Protect your child's smile: Fluoride varnish for young children. Oakland, CA: Kaiser Permanente, 2 pp

Kaiser Permanente
One Kaiser Plaza, 19th Floor
Oakland, CA 94612

Telephone: (415) 987-2223
Secondary Telephone: (800) 556-7677
Website: http://www.kaiserpermanente.org
Available from the website.

This fact sheet for parents and other caregivers provides tips on oral hygiene and oral health care for infants and young children, including information about taking them to the dentist by age 1 and protecting their teeth with fluoride varnish. Topics include toothbrushing with fluoridated toothpaste; nutrition; how fluoride varnish is applied; and what to expect and what to do before and after fluoride varnish treatment. The fact sheet is available in English on one side and in Chinese or Spanish on the other side.


University of North Dakota School of Medicine and Health Sciences, Center for Rural Health. 2016. Fluoride varnish application in primary care settings. Grand Forks, ND: University of North Dakota School of Medicine and Health Sciences, Center for Rural Health, 2 pp

University of North Dakota School of Medicine and Health Sciences, Center for Rural Health
1301 North Columbia Road Stop 9037
Grand Forks, ND 58202-9037

Telephone: (701) 777-3848
Fax: (701) 777-6779
E-mail: ruralhealth@med.und.edu
Website: https://ruralhealth.und.edu
Available from the website.

This fact sheet presents findings from a survey of primary care health professionals in North Dakota to assess their knowledge about fluoride-varnish application and determine how many were providing and billing for the service. Contents include information about the percentage of pediatricians and family practice physicians who conducted oral health risk assessments, those who had a list of dentists for client referral, and who applied fluoride varnish for infants and children beginning at age 6 months.


Virginia Department of Health. 2017. Fluoride varnish: For children age six months and older. Richmond, VA: Virginia Department of Health, 1 p

Virginia Department of Health
P.O. Box 2448
Richmond, VA 23218

Telephone: (804) 864-7000
E-mail: questions@vdh.virginia.gov
Website: https://www.vdh.virginia.gov/
Available from the website.

This brochure for parents provides information about fluoride varnish for children ages 6 months and older. The brochure discusses what fluoride varnish is and what it does, whether it is safe, how it is applied, and how long its effects last. A photograph showing fluoride being applied to an infant’s teeth is included. The brochure is written in simple language and is available in English and in Spanish.


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