Effect of School-Based Fluoride Varnish Programmes on Approximal Caries in Adolescents from Different Caries Risk Areas

Abstract

The aim was to evaluate, in a 3-year RCT study, school-based fluoride varnish programme on approximal caries incidence and approximal caries progression in 13- to 16-year-olds in high, medium and low caries risk areas on the Swedish west coast. Seven hundred and fifty-eight (89%) fulfilled the trial. Using a simple mobile unit, 2 dental nurses treated the adolescents with F varnish: (1) twice a year at 6-month intervals, (2) 3 times a year within 1 week, (3) 8 times per year during the semesters with 1-month intervals, and (4) no treatment (control). Radiographic caries recording was performed blindly by one of the authors. Concerning total approximal caries incidence, control groups in all areas developed more caries than F varnish groups, with the largest difference in the high risk area: 3.05 ± 3.37 new approximal caries lesions (mean ± SD) compared to 0.54 ± 1.26 for group 3, 0.95 ± 1.67 for group 1 and 1.40 ± 1.89 for group 2 (p < 0.001). More than 90% of the new approximal lesions in all the groups and in all areas consisted of new enamel lesions. Regarding progression of enamel lesions, there were only significant differences between groups 1–3 and group 4 in the high caries risk area. Prevented fraction for fluoride varnish treatment twice a year at 6-month intervals was 69% in high, 66% in medium and 20% in low risk areas. To conclude, school-based F varnish treatment every 6 months in 13- to 16-year-olds is excellent to prevent approximal caries in medium and high caries risk areas.

Body adiposity status in teenagers and snacking habits in early childhood in relation to approximal caries at 15 years of age

“…Most previous studies of BMI versus caries have only included cavities and fillings. In this investigation, however, initial approximal lesions, scored on bitewing radiographs, were included in the analyses, thereby providing a more complete picture of the total approximal caries situation, because up to 80–90% of decayed approximal surfaces are reported to be initial caries 17,26 .…”

Effect of xylitol and xylitol–fluoride lozenges on approximal caries development in high‐caries‐risk children

“…For example, in 11‐ to 12‐year olds, it has been shown that subjects with one approximal lesion or more have 2.5 times higher risk for new proximal caries lesions compared to those with a lower score 28 . An interesting approach to the problem is school‐based fluoride varnish treatments carried out every 6 months 29 . This outreach concept was proven successful, especially in young teenagers from a high‐caries community, and one of the reasons might have been that the children did not have to take own responsibility for the intervention.…”

Restorative treatment thresholds for occlusal primary caries among dentists in The Dental Practice-Based Research Network

“…At present, the only thresholds that can be definitely identified as not appropriate are those that call for surgical treatment when caries is confined to enamel, due to the potential for enamel lesions to arrest or reverse 11. Enamel-based thresholds for surgical treatment have become more of an issue as recent attention to risk assessment and development of diagnostic systems focus more attention on enamel lesions, alternatives to surgical treatment are shown to be effective,12,13 and long-term consequences of surgical treatment are considered 14,15,16,17,18…”