Randomized controlled trial on fluoride varnish application for treatment of white spot lesion after fixed orthodontic treatment

Abstract

The purpose of this study was to determine the efficacy of fluoride varnish (5% sodium fluoride, Duraphat®, Colgate) in reverting white spot lesions (WSLs) after fixed orthodontic treatment. This study was a randomized, parallel group, controlled clinical trial. Using saline solution as control, 110 participants (mean age ± standard deviation: 16.6±3.2 years) ranging from 12 to 22 years old were randomly assigned to either the test group (group 1) or the control group (group 2). Application of fluoride varnish or saline was applied onto tooth surfaces with WSLs every month during the first 6 months after debonding. The labial (buccal) surfaces of the teeth were assessed by the use of a DIAGNOdent pen (DD) at the baseline, 3- and 6-month follow-up visits. After 6 months, 96 subjects with a total of 209 study teeth (47 subjects, 104 teeth in group 1; 49 subjects, 105 teeth in group 2) remained. The WSLs had a mean DD reading at baseline of 17.66±5.36 in group 1 and 16.19±5.70 in group 2, which decreased by 5.78 and 2.44, respectively, at the 3-month follow-up visit and decreased by 7.56 and 3.09, respectively, at the 6-month follow-up visit. The mean baseline DD readings in the two groups were similar (t test, P>0.05). There was statistically significant differences between the mean DD readings of the two groups at the 3-month (P<0.05) and at the 6-month follow-up visits (P<0.01). Topical fluoride varnish application is effective in reversing WSLs after debonding and should be advocated as a routine caries prevention measure after orthodontic treatment.

Therapeutic potential of Brazilian fluoride varnishes: an in vivo study

“…This finding corroborates those of previous studies (6,10,12,16,18,19). There was a 45.7% reduction in WSL size, which is in agreement with previous studies (9,10,12,16).…”

“…Fluoride varnishes have gained popularity due to their high concentration and safety during application (8). A number of studies have demonstrated that fluoride varnishes are able to remineralize incipient carious lesions as well as prevent decay when used with other preventive measures, such as diet control and reduction of dental biofilm (9)(10)(11)(12).…”

Effect of CO2 Laser and Fluoride Varnish Application on Microhardness of Enamel Surface Around Orthodontic Brackets

“…5 Modern dentistry concentrates more on prevention of lesions than their operation. 9 Orthodontists should assess patients' risk factors throughout the treatment to prevent white spot lesions. Presence of the following factors increases the probability of white spot lesions occurrence: inappropriate oral hygiene, caries history or high decay missing filled surfaces (DMFS), and lack of preventive methods, such as fluoride or antibacterial compositions.…”

Emphasizing Minimally Invasive Strategies for Improved Dental Care of Children

“…A very common example of this occurs immediately after removal of orthodontic brackets, whereby zones of non-cavitated demineralization developed (even as early as one month into bracket placement) about the previously bonded bracket [19,23]; however, these zones are usually able to remineralize to some extent over a month or two using standard oral hygiene practices combined with the natural remineralizing potency of saliva [23][24][25]. However, topical remineralization therapies may be used to accelerate the recovery [19,26].…”