pediatric-sealants-fluoride

Resources for sealant and fluoride varnish use with pediatric patients

One study recently found that sealant application may be more effective than fluoride varnish application in preventing tooth decay in the permanent teeth of children. Read more about this study and get resources for your treatment decisions below.

In a recent Cochrane Oral Health Blog, there was discussion about a systematic review of the evidence to determine if (1) dental sealants, (2) sealants together with fluoride varnishes, or (3) fluoride varnishes are more effective for reducing tooth decay on biting surfaces of permanent back teeth in young people. The research was conducted by a team led by Anneli Ahovuo-Saloranta from the Finnish Office for Health Technology Assessment (FinOHTA) on behalf of the Cochrane Oral Health Group. (1)

The methods included data from eight randomized controlled clinical trials. A total of 1,746 children aged 5 to 10 years participated in the trials, and were randomly assigned to receive dental sealant, sealant together with fluoride varnish, or fluoride varnish applications. According to the blog, “some evidence submits that applying resin-based sealants to the occlusal surfaces of permanent posterior teeth in children may reduce tooth decay in the permanent teeth of children by 3.7% over a two-year period, and by 29% over a nine-year period, when compared with fluoride varnish applications” (1). The number increases to 14.4% with resin-based sealants plus fluoride varnish.

Resources for sealant and fluoride varnish use with pediatric patients

February 18, 2016

sealants fluoride varnish pediatric patients

One study recently found that sealant application may be more effective than fluoride varnish application in preventing tooth decay in the permanent teeth of children. Read more about this study and get resources for your treatment decisions below.

In a recent Cochrane Oral Health Blog, there was discussion about a systematic review of the evidence to determine if (1) dental sealants, (2) sealants together with fluoride varnishes, or (3) fluoride varnishes are more effective for reducing tooth decay on biting surfaces of permanent back teeth in young people. The research was conducted by a team led by Anneli Ahovuo-Saloranta from the Finnish Office for Health Technology Assessment (FinOHTA) on behalf of the Cochrane Oral Health Group. (1)

The methods included data from eight randomized controlled clinical trials. A total of 1,746 children aged 5 to 10 years participated in the trials, and were randomly assigned to receive dental sealant, sealant together with fluoride varnish, or fluoride varnish applications. According to the blog, “some evidence submits that applying resin-based sealants to the occlusal surfaces of permanent posterior teeth in children may reduce tooth decay in the permanent teeth of children by 3.7% over a two-year period, and by 29% over a nine-year period, when compared with fluoride varnish applications” (1). The number increases to 14.4% with resin-based sealants plus fluoride varnish.

READ MORE | Sealing to the limit: Sealants represent a safe and effective preventive measure across a variety of care settings

Unfortunately, the obtainable evidence is of low to very low quality because of the small number of included studies, and due to problems with the studies’ structures. The majority of the studies had a fairly short follow-up time, according to the authors.

There are a multitude of resources on fluoride varnish. According to the Association of State and Territorial Dental Directors, “programs using fluoride varnish will be more likely to demonstrate benefits and reduce dental caries in at-risk populations when applications are offered at least at six-month intervals over at least two years in duration in combination with counseling. Dental sealants and water fluoridation are the cornerstones of individual and community practice to prevent and control dental caries” (2; emphasis mine).

The National Maternal and Child Oral Health Resource Center (OHRC) developed a publication, “Fluoride Varnish: A Resource Guide,” to provide information to health professionals, program administrators, educators, researchers, policymakers, and others about the use and application of fluoride varnish.

New York State published Improving the Oral Health of Young Children: Fluoride Varnish Training Materials and Oral Health Information for Child Health Care Providers, which is a very comprehensive webpage.

READ MORE | Pro-fluoridation group targets ‘inaccurate’ information surfacing in U.S. communities

South Carolina Department of Health and Environmental Control published “Fluoride Varnish Manual for Health Professionals” in 2011. These are but a few of the available resources.

Similarly, there are guides for the use of dental sealants. “Dental Sealants, A Resource Guide, Third Edition” published in 2010, is one resource, for example.

Examine some of these resources available to us to help formulate your own evidence-based decisions regarding varnish and sealants.

References
1. Sealants versus fluoride varnish – which is better for preventing decay in children’s teeth. Editorial base blog: Cochrane Oral Health. https://cochraneohg.wordpress.com/2016/01/19/sealants-versus-fluoride-varnish-which-is-better-for-preventing-decay-in-childrens-teeth. Published January 19, 2016. Accessed February 18, 2016.
2. Association of State and Territorial Dental Directors, Fluorides Committee. Fluoride Varnish: An Evidence-Based Approach. Association of State and Territorial Dental Directors website. http://www.astdd.org/docs/Sept2007FINALFlvarnishpaper.pdf. Published September 2007. Accessed February 18, 2016.


Maria Perno Goldie, RDH, MS, is editorial director of RDH eVillage Focus.

http://www.dentistryiq.com/articles/2016/02/resources-for-sealant-and-varnish-use-with-pediatric-patients.html?cmpid=DIQ_CR_Feb-22-2016

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