Fluoride Varnish Helps Prevent Tooth Decay In Very Young Children

The investigators examined cavity-free infants and young children, primarily from low-income Chinese or Hispanic families in San Francisco. All families received counseling on dental health, and children were randomized into three groups: those receiving fluoride varnish twice per year, those receiving it once per year, and those not receiving it at all. Of the initial 376 children enrolled, 280 completed the study.

According to study findings, children who did not receive any fluoride varnish were more than twice as likely to develop tooth decay as the children who were assigned to the annual fluoride varnish group. Children who did not receive fluoride varnish were nearly four times more likely to develop tooth decay than those assigned to receive it twice per year (four treatments over two years).

Study results are published in the February issue of the Journal of Dental Research, the journal of the International Association of Dental Research. The results are posted online at http://jdr.iadrjournals.org.

There are two important points that parents should be aware of as a result of this study, said Jane Weintraub, DDS, MPH, Lee Hysan Professor at the UCSF School of Dentistry and principal investigator of the study. "First, the results support the use of fluoride varnish to prevent tooth decay in very young children. Second, the results support parents bringing children for their first dental visit at age one when they are getting their first teeth."

"Fluoride varnish is relatively inexpensive, easy to brush onto a child's teeth, and can be part of a positive first dental visit to help prevent tooth decay," Weintraub said. "In contrast, when very young children get cavities, it is difficult for them to sit still for dental treatment. Often, young children needing many fillings receive care in the operating room, at great expense to their family and with the additional risks posed by general anesthesia. We now have an easy, low-cost way to keep teeth healthy."

Fluoride varnish is a resin containing concentrate fluoride that is brushed on teeth the same way that nail polish is painted onto nails. "Nail polish makes nails look good; fluoride varnish helps keep teeth looking good by preventing cavities," Weintraub said. It is meant to enhance the potential therapeutic benefit of fluoride by keeping the tooth enamel in contact with it.

Previously it has been shown to help prevent tooth decay for older school-age children who have their permanent teeth. According to the investigators, this was the first randomized study of children as young as six months of age, and it shows the efficacy of fluoride varnish to prevent tooth decay in young children's primary (baby) teeth.

The study was conducted at the San Francisco General Hospital Family Dental Center and the San Francisco Department of Public Health's Chinatown Public Health Center. The average age of the children enrolled in the study was 1.8 years old, with ages ranging from six months to 44 months at the start of the study. In addition to dental-health counseling, treatment with fluoride varnish and examinations for tooth decay, at each visit the children's parents were asked about adverse events or safety concerns; none associated with the fluoride varnish treatment were discovered.

The children who participated in the study were primarily from low-income, dentally underserved backgrounds. This made them well suited as participants for the study, according to Weintraub. "Statewide studies have shown that children from low-income Hispanic and Asian populations in California are at high risk for tooth decay," Weintraub said.

The study was supported by the UCSF Comprehensive Oral Health Research Center of Discovery, UCSF Center to Address Disparities in Children's Oral Health, National Institute of Dental and Craniofacial Research, National Center for Minority Health and Health Disparities, and NIH Office of Behavioral and Social Sciences Research.

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