The Hygiene Perspective on Fluoride Varnish

When it comes to fluoride varnish, you may have grown accustomed to some patient grumbling. From the uncomfortable, gritty feeling that their last fluoride varnish treatment left behind to adult patients claiming that it’s for "kids only"—there’s certainly some skepticism in the air. But the truth, as touted by the American Dental Association, is that in-office fluoride varnish treatment is safe and effective in preventing tooth decay for both children and adults.

“Risk factors do not end at age 16—they continue and even become more numerous,” said Donna Brogan, a registered dental hygienist and educational consultant. “Young adults still drink acidic drinks and snack between meals just like they did as teenagers, but they have added risk factors such as irregularity of dental care, medications, and exposed root surfaces.”

One increased risk factor lies in the hundreds of xerostomia-causing medications that are prescribed for anxiety, depression, hypertension, diabetes, and allergies. According to Brogan, saliva is vital in returning the mouth to a neutral pH after eating or drinking, and not having enough of it due to a dry mouth increases the risk of decay in adults.

Although Brogan does apply fluoride varnish if patients have dentin hypersensitivity, more often than not, she uses it for caries prevention. “One of the major problems we face as dental professionals is changing the habits of a patient,” she shared, adding that recommending biofilm removal devices, home therapies, and rinses or gels is useless if patients don’t use them after leaving the office. “All we really have control over is what happens in the operatory.”

Some fluoride varnishes on the market today even go beyond caries prevention—offering specially designed formulas that tackle hypersensitivity and release tooth-building ions for stronger teeth. Here are some of our favorite fluoride varnishes that are as patient-pleasing as they are effective.

Smooth and Simple

Centrix FluoroDose is a 5% sodium fluoride, white cavity varnish in a patented single-use delivery system. The smooth, nonclumpy formula stays clear after a quick, swipe-on application and dries in seconds after it comes in contact with saliva. FluoroDose remains on the tooth for 6 to 8 hours to provide optimal fluoride uptake. Each LolliPack contains a single dose of FluoroDose for easy cleanup, plus a Benda Brush applicator for easy mixing.

Duraflor Halo from Medicom is gluten-free, sweetened with xylitol, and available in MelonMint, Spearmint, and Wild Berry flavors. The white fluoride varnish has a silky-smooth consistency that doesn’t clump, making application simple. Duraflor Halo comes in a peel-and-apply, one-step package that reduces mess and the risk of cross-contamination. The 5% sodium fluoride varnish dries to a natural white color to ensure patient compliance.

Hypersensitivity Relief

Uniquely formulated to provide hypersensitivity relief, Nupro White Varnish from Dentsply Sirona Preventive releases over 7 times the amount of fluoride as the leading varnish brand over a short, 2-hour period. It can be applied smoothly with minimal clumping, dripping, or stringing. The gluten-, SLS-, and dyefree varnish comes in Mint, Bubblegum, Grape, Raspberry, and Caramel flavors, and can be easily applied to wet teeth.

A light-cured varnish for prolonged hypersensitivity relief, PRG Barrier Coat from Shofu seals and protects exposed dentinal tubules to prevent pain. It is ideal for patients experiencing loss of enamel, gingival recession, or temporary sensitivity caused by whitening. It can be applied in a thin coating of 5 mm, and proprietary GIOMER technology means it is clinically proven to recharge fluoride, neutralize acid, and reduce plaque buildup.

Tooth Building

Enamel Pro Varnish from Premier Dental Products lauds itself as the first advanced fluoride varnish optimized to release the valuable tooth-building ions calcium and phosphate. Teeth are desensitized by depositing amorphous calcium phosphate (ACP) and fluoride into the tubules, where the ACP crystallizes and forms apatite, a tooth-like mineral. It is recommended for treatment of dentinal hypersensitivity and reducing postoperative sensitivity.

MI Varnish from GC America contains both ACP and casein phosphopeptides (CPP) to enhance enamel acid resistance and boost fluoride levels in saliva. In the oral cavity, CPP and ACP bind to oral surfaces like teeth, dentin, oral mucosa, and biofilm to release toothbuilding calcium and phosphate ions into saliva. MI Varnish has a smooth, creamy texture upon application and does not change color. It is available in Strawberry and Mint flavors.

TAILORED TREATMENT

There are many options for fluoride varnish, but not every option is the best for every patient. In her office, Brogan conducts a risk assessment on each patient and provides them with customized recommendations for prevention. While the ADA has evidence-based clinical recommendations for patients at high- and moderate-risk for caries, Brogan says professional judgment plays a part, too. “If a patient has numerous risk factors—such as exposed root surfaces, visible biofilm, or multisurface restorations—I will increase the number of applications per year to 3 or more,” she said.

Whatever the circumstances, Brogan considers fluoride varnish to be a game-changer. “Applying fluoride varnish 2 to 4 times a year has proven to reduce decay in children, adults, and seniors, and all the patient has to do is open wide. It is the fastest, easiest caries-reduction strategy we have access to,” she concluded.

Shop all Fluoride Varnish from DHP.