Effectiveness of Early Preventive Intervention with Semiannual Fluoride Varnish Application in Toddlers Living in High-Risk Areas: A Stratified Cluster-Randomized Controlled Trial

Anderson, M.; Dahllöf, Göran; Twetman, Svante; Jansson, Leif; Bergenlid, Ann-Cathrine; Grindefjord, Margaret

doi:10.1159/000442675

Cited by 52 publications

(66 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In agreement with our results, a number of studies reported that the combination of an oral health education program and the use of FV in public health programs reduced ECC [Weintraub et al, 2006;Holve, 2008;Lawrence et al, 2008;Sundell et al, 2013;Memarpour et al, 2015]. However, some studies found that the application of FV failed to reduce caries in high-risk preschool children [Anderson et al, 2016;Oliveira et al, 2014]. Our results showed that both intervention methods were important in reducing SECC, and should be considered by health care staff when designing free health care services for young children in public health centers.…”

Section: Discussionsupporting

confidence: 91%

Comparison of Oral Health Education and Fluoride Varnish to Prevent Early Childhood Caries: A Randomized Clinical Trial

Memarpour

Dadaein²,

Fakhraei³

et al. 2016

Caries Res

View full text Add to dashboard Cite

Early childhood caries, a serious health problem among young children, can be prevented with effective intervention. The aim of this study was to evaluate the efficacy of oral health education and a fluoride varnish in the prevention of caries in children under the age of 3 years. For this single-blind randomized parallel group 1-year clinical trial in Shiraz, 300 children aged 12-24 months with sound primary teeth were selected and randomly divided into three groups (n = 100): (1) control: no preventive intervention; (2) oral health counseling, and (3) oral health counseling and fluoride varnish at baseline and 6 months later. At baseline and 4, 8 and 12 months after the intervention, caries risk reduction was recorded as the primary outcome. The mothers' knowledge and performance regarding oral health in children was used as a secondary outcome. A total of 260 children (mean age: 20.49 ± 7.33 months) completed the study. Compared to group 1, caries risk reduction in group 2 was 28% (95% CI: -39.05 to -17.45) and 31% in group 3 (95% CI: -41.88 to -21.73). However, there was no significant difference between groups 2 and 3 (95% CI: -8.58 to 1.47). In all groups, mothers' knowledge and performance at baseline were low; however, they increased significantly in follow-up appointments in groups 2 and 3 (p < 0.001). Oral health education increased mothers' knowledge and performance regarding oral health in children. Oral health counseling alone or associated with the use of fluoride varnish reduced the caries incidence in young children.

show abstract

Section: Discussionsupporting

confidence: 91%

Comparison of Oral Health Education and Fluoride Varnish to Prevent Early Childhood Caries: A Randomized Clinical Trial

Memarpour

Dadaein²,

Fakhraei³

et al. 2016

Caries Res

View full text Add to dashboard Cite

show abstract

“…Thus, the null hypothesis could not be rejected. It is likely that the negative results were a consequence of, and mirrored the absent benefits of the fluoride varnish program on caries increment as reported from the main project [10] and from similar studies in young children [16, 17]. A second explanation could be that the semi-annual schedule of varnish applications was too infrequent to make a difference.…”

Section: Discussionmentioning

confidence: 90%

“…This cross-sectional study was carried out as a part of a cluster-randomized controlled field trial aiming to evaluate the effectiveness of fluoride varnish applications on caries development in toddlers living in multicultural areas in greater Stockholm, Sweden [10]. The original trial was designed with two parallel arms that compared children receiving a standard oral health program (reference group) with children who had the same standard oral health program supplemented with semi-annual fluoride varnish applications (test group).…”

Section: Methodsmentioning

confidence: 99%

“…Caries data was extracted from the clinical examination at 3 years of age performed by the child’s regular dental team as previously described [10]. The International Caries Detection and Assessment System (ICDAS II) was used according to Ismail and co-workers [13].…”

Section: Methodsmentioning

confidence: 99%

“…Fluoride varnish contains typically 5% sodium fluoride (22,600 ppm F) and after application, fluoride is slowly released to the oral biofilm over a period of several weeks. Since it is not fully clear whether or not this sustained fluoride release has an influence on the bacterial composition of biofilm, it was thought of interest to apply this research question in a current community oral health project [10]. The primary aim of the present study was to compare the oral microflora in preschool children participating in an extended preventive program with semi-annual fluoride varnish applications with children receiving a standard program with no varnish applications.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Oral microflora in preschool children attending a fluoride varnish program: a cross-sectional study

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundTo compare the oral microflora in preschool children attending a fluoride varnish program with a reference group receiving a standard oral health program without fluoride varnish applications. A second aim was to relate the microbial composition to the caries prevalence.MethodsFive hundred seven 3-year-old children were enrolled from a cohort of 3403 preschool children taking part in a community based oral health project. Two hundred sixty-three of them had attended caries-preventive program with semi-annual applications of a fluoride varnish since the age of 1 year (test group) while 237 had received standard preventive care (reference group). Oral samples were collected with a sterile swab and analysed with checkerboard DNA-DNA hybridization using 12 pre-determined bacterial probes. Caries and background data were collected from clinical examinations and questionnaires.ResultsGram-positive streptococci (S. intermedius, S. salivarius, S. oralis) were most frequently detected and displayed the highest counts in both groups. There were no significant differences between the groups concerning prevalence of any of the selected bacterial strains except for S. oralis that occurred less frequently in the reference group. In children with caries, V. parvula were significantly more common (p < 0.05) while strains of Lactobacillus, Bifidobacterium and Neisseria were more prevalent among the caries-free children (p < 0.05).ConclusionsA 2-year community program with semi-annual fluoride varnish applications did not seem to significantly influence the oral microflora in preschool children.Trial registration www.controlled-trials.com (ISRCTN35086887) 20131216 ‘retrospectively registered’.

show abstract

Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years

Chou

Pappas

Dana

et al. 2021

JAMA

View full text Add to dashboard Cite

IMPORTANCE A 2014 review for the US Preventive Services Task Force (USPSTF) found that oral fluoride supplementation and topical fluoride use were associated with reduced caries incidence in children younger than 5 years. OBJECTIVE To update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. DATA SOURCES Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to September 2020); surveillance through July 23, 2021.STUDY SELECTION Randomized clinical trials (RCTs) on screening, preventive interventions, referral to dental care; cohort studies on screening and referral; studies on diagnostic accuracy of primary care oral examination or risk assessment; and a systematic review on risk of fluorosis included in prior USPSTF reviews.DATA EXTRACTION AND SYNTHESIS One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality.RESULTS Thirty-two studies (19 trials, 9 observational studies, and 4 nonrandomized clinical intervention studies [total 106 694 participants] and 1 systematic review [19 studies]) were included. No study evaluated effects of primary care screening on clinical outcomes. One study (n = 258) found primary care pediatrician examination associated with a sensitivity of 0.76 (95% CI, 0.55 to 0.91) and specificity of 0.95 (95% CI, 0.92 to 0.98) for identifying a child with cavities, and 1 study found a risk assessment tool associated with sensitivity of 0.53 and specificity of 0.77 (n = 697, CIs not reported) for a child with future caries. No new trials of dietary fluoride supplementation were identified. For prevention, topical fluoride compared with placebo or no topical fluoride was associated with decreased caries burden (13 trials, n = 5733; mean caries increment [difference in decayed, missing, and filled teeth or surfaces], −0.94 [95% CI, −1.74 to −0.34]) and likelihood of incident caries (12 trials, n = 8177; RR, 0.80 [95% CI, 0.66 to 0.95]; absolute risk difference, −7%) in higher-risk populations or settings, with no increased fluorosis risk. Evidence on other preventive interventions was limited (education, xylitol) or unavailable (silver diamine fluoride), and no study directly evaluated primary care dentistry referral vs no referral. CONCLUSIONS AND RELEVANCEThere was no direct evidence on benefits and harms of primary care oral health screening or referral to dentist. Dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.

show abstract

Effectiveness of Early Preventive Intervention with Semiannual Fluoride Varnish Application in Toddlers Living in High-Risk Areas: A Stratified Cluster-Randomized Controlled Trial

Cited by 52 publications

References 28 publications

Comparison of Oral Health Education and Fluoride Varnish to Prevent Early Childhood Caries: A Randomized Clinical Trial

Comparison of Oral Health Education and Fluoride Varnish to Prevent Early Childhood Caries: A Randomized Clinical Trial

Oral microflora in preschool children attending a fluoride varnish program: a cross-sectional study

Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years

Contact Info

Product

Resources

About