TABLE 2

Summary of Topical Fluoride Preventive Treatments

Author, Year, QualityStudy DesignInterventionsCountry; Setting; Fluoridation StatusAge at EnrollmentSample SizeF-U, yMean Caries IncrementAbsolute Reduction in Caries IncrementReduction in Caries IncrementOther Dental Caries Outcomes
Lawrence et al 200828 GoodCluster RCT (20 clusters)A: 0.3–0.5 mL 5% sodium fluoride varnish applied to full primary dentition every 6 moCanada; Rural Aboriginal communities; Water fluoridation status: No fluoridation2.5 y11462dmfs2.4 (1.8)a18% (29%)aA versus B
B: No fluoride varnishA: 11.0 (4.3)aDental caries in aboriginal cohort: 72% (595/832) vs 75% (247/328), adjusted OR 0.72 (95% CI 0.42–1.25); NNT 26
B: 13.4 (6.1)aDental caries in those caries-free at baseline: 44% (157/354) vs 58% (73/126); adjusted OR 0.63 (95% CI 0.33–1.1); NNT 7.4
P = .24 (P = .18)a
Slade et al 201131 GoodCluster RCT (30 clusters)A: 0.25 mL of 5% sodium fluoride varnish to maxillary anterior teeth/molars, mandibular molars/incisors every 6 mo, education/advice to caregiver with toothbrush/paste provided, community oral health promotion programAustralia; Rural Aboriginal communities; Water fluoridation status: 81% to 92% had <0.6 ppm F2.8 y6662dmfs2.324%
B: No interventionsA: 7.3
B: 9.6b
P < .05
Weinstein et al 200132 FairRCT with 3 treatment groupsA: One application of 5% fluoride varnish at baseline and 6 moUnited States; Head Start programs; Water fluoridation status: NR3–5 y1111Clinical dmfs A: 4.6Not calculatedNot calculated
B: Three applications of 5% fluoride varnish within 2 wk of baselineB: 3.2
C: Three applications of 5% fluoride varnish within 2 wk of baseline and 6 moC: 4.7
P = .65
Radiographic mean dmfs
A: 0.9
B: 0.5
C: 0.1
P = .28
Weinstein et al 200933 FairRCT with 2 treatment groupsA: One 5% fluoride varnish treatment and 2 placebo treatments every 6 moUnited States55–56 mo5153dmfs2.424%Adjusted rate ratio of new tooth decay in primary surfaces 1.13 (95% CI 0.94–1.37)
B: One set of 3, 5% fluoride varnish treatments over 2 wk once per year and 3 placebo treatments over 2 wk, 6 mo laterRecruitment setting: Head Start programsA: 7.4
Water fluoridation status: NR (Yakima voters approved fluoridation in 1999)B: 9.8
P = .001
Weintraub et al 200634,c FairRCTA: 0.1 mL of 5% sodium fluoride varnish per arch applied twice per year with 4 intended applicationsUnited States; Family dental center and public health center serving primarily low-income, underserved Hispanic and Chinese populations1.8 y2802d2+fsd1.059% (A + B vs C)A vs B vs C
B: 0.1 mL of 5% sodium fluoride varnish per arch applied once per year with 2 intended applicationsWater fluoridation status: Approximately 1 ppmA: 0.7Caries lesions at 12 mo: 13% (11/83) vs 15% (13/86) vs 29% (27/92); RR 0.45 (95% CI 0.24–0.85); NNT 7 for A vs C and 0.52 (95% CI 0.28–0.93); NNT 8 for B vs C
C: No fluoride varnishB: 0.7Caries lesions at 24 mo: 4.3% (3/70) vs 14% (10/69) vs 24% (15/63); RR 0.18 (95% CI 0.06–0.59); NNT 6 for A vs C and 0.61 (95% CI 0.30–1.26); NNT 11 for B versus C
C: 1.7
P < .01 for A or B vs C
  • ANOVA, analysis of variance; CI, confidence interval; d2+fs, number of decayed or filled surfaces; F-U, follow-up; NNT, number needed to treat; NR, not reported; RCT, randomized controlled trial; RR, relative risk.

  • a Children caries-free at baseline.

  • b Adjusted.

  • c In the fluoride varnish treatment group, some children received a placebo varnish instead of fluoride varnish due to protocol errors.

  • d Participants were caries-free at baseline.