Effect of Three Types of Fluoride Varnish in Preventing Early Childhood Caries
Effect of Three Types of Fluoride Varnish in Preventing Early Childhood Caries
This study evaluates and compares the effect of two types of calcium- and
 phosphate-containing fluoride varnishes to conventional fluoride varnishes in preventing
 early childhood caries.
Fluoride vanish is the most commonly used professionally applied topical agent. Traditional
 fluoride vanish application has been reported to exhibit significant caries inhibiting effect
 in both permanent teeth and primary teeth. The greatest advantage of fluoride vanish is its
 ability to adhere to tooth tissues for a longer period of time that enables improved fluoride
 uptake. It allows continuous release of fluoride ions into enamel, dentine, plaque, and
 saliva.The main action of topical fluoride is to retard demineralization and promote
 remineralization of enamel by the uptake of calcium and phosphates from saliva. The proposed
 mechanism of action of topical fluoride is the formation of intraoral calcium fluoride
 reservoirs, which are retained on enamel and slowly released to inhibit mineral loss during
 demineralization.

 However, the formation of the intraoral calcium fluoride reservoirs is limited by the
 availability of intraoral calcium and fluoride ions. Low concentration of salivary calcium
 and phosphate ions leads to mineral deposition only at the surface of enamel as a result of
 low ion concentration gradient. Deposition of minerals at the surface of enamel alone may not
 improve the structural properties of the deep part of the incipient carious lesions. Hence,
 many manufacturers have modified fluoride vanish to include calcium and phosphate ions in an
 attempt to further improve efficacy of fluoride varnishes.

 The in vitro remineralizing effects of calcium- and phosphate-containing fluoride vanishes
 are encouraging and scientifically sound, a longitudinal, high quality clinical study is
 needed to verify the laboratory findings.
Inclusion Criteria:

 -  Generally healthy children age between 3-4 of age with unremarkable medical history
 and at high caries risk with at least one carious lesion (precavitated or cavitated)
 (Agouropoulos et al 2014). The high caries risk children are chosen because it is
 anticipated that they will benefit more from the topical fluoride varnish application
 than the low caries risk children.

 Exclusion Criteria:

 -  Patients who had received professional fluoride application in the past 6 months

 -  Patients with underlying medical history or special health care needs

 -  Patient who are uncooperative or refuse the treatment

 -  Patient who are allergic to milk protein (as MI VarnishTM contains "casein, a
 milk protein)

 -  Patient with contraindication for fluoride varnish e.g. hypersensitivity to
 colophony and/or any other constituents

 -  Patient who have primary teeth with enamel hypoplasia