29 May 2012

Implementing a Fluoride Varnish Program for the Adult Patient

Countless studies have shown the significance of using fluoride varnish in the young when they are considered at great risk for dental caries.  The benefits of applying a topical fluoride varnish are now being realised by the dental community.

Fluoride varnish has been widely used and accepted in the prevention of caries in the European market since the 1970s, while use in the U.S. was not until the American Dental Association Council reported their recommendations in 2006 that the dental profession has become more aware of the value of implementing a topical fluoride varnish as an improvement in delivering higher concentrations of fluoride to the groups at highest risks for dental caries. Australia and New Zealand are now also more aware of using varnish treatments to help reduce the risk for dental caries.

Topical Fluoride Considerations:

  • Varnish       22,600 ppm
  • APF            12,300 ppm
  • NaF            9,000 ppm
  • Rinse          3,300 ppm

When it becomes necessary to strengthen the enamel and root surfaces in the occurence of acid challenges, the greatest concentration of fluoride under the least toxicity is the optimal goal in prevention. As the population of adults overs the age of 65 continues to increase, so does the potential for systemic diseases and chronic illnesses, therefore, it will be critical for the oral healthcare team to identify a variety of oral implications associated with commonly used drug therapies.  The most common oral manifestation associated with drugs is xerostomia.(2)  Xerostomia is identified when there is a dysfunction of salivary flow through the oral cavity.  It is associated with altered taste and plaque formation and an increased risk for candidacies, systemic diseases and root caries.

Dental hygienists will be expected to recognise the changes in salivary production, as it is an important benefit in preventing caries in the adult patient. 

When you consider the associated risk factors known when treating the adult patient, for a topical agent that can deliver a higher concentration of fluoride with minimal side effects and no systemic implications, a fluoride varnish is becoming the optimal choice of treatment.

Premier® Enamel Pro® Varnish is the only fluoride varnish fomulated to deliver ACP.

 

Desensitises Dentin
  • ACP works together with fluoride to desensitize dentin.
  • Enamel Pro Varnish is proven to diminish hydraulic conductance by 73%.(3)
  • ACP and fluoride provide semi-permanent occlusion with fluorapatite.(4) 
Significantly more available fluoride(6)
  • Provides more available fluoride to all tooth surfaces(5)
  • Enamel Pro Varnish with ACP technology delivers 4X more fluoride uptake into the enamel than the leading brand transparent varnish.(6) 

 

(1) Weintraub, J.A., et al.  Fluoride varnish efficacy in preventing early childhood caries. J Dent Res 85 (2) 2006; 172-176.
(2) Stephenson, R., Causes of Xerostomia. RDH. J. May 2008; 46-52.
(3) "Effect of Calcium Phosphate Containing Fluoride Varnish on Dentin Permeability", Tung, M.S., Torres, J., (ADAHF Paffenbarger Research Center, NIST, Gaithersburg, MD and U.S. Navy Dental Corps., Bethesda, MD), J Dent Res 86(Spec Iss A):0985, 2008 (www.dentalresearch.org).
(4) Tung, M.S., Eichenmiller, F.C., Paffenbarger Research Center. ADAHF. NIST, Gaithersburg, MD, "Dental Applications of Amorphous Calcium Phosphates", Journal of Clinical Dentistry, Vol. 10, Issue 1, 1999.
(5) 85th General Session in New Orleans, LA; Ting, M.S., Hwang, J., Malerman, R., McHale, W.A., "Reactivity of Varnish Containing Calcium, Phosphate and Fluoride Salts", J Dent Res 86 (Spec Iss A): 1078, 2007.
(6) Source: "Final Report: Sound Enamel Fluoride Uptake Study #08-151, Method #40SV", Dental Products Testing Thermametric Technologies Inc., Indiana University Emerging Technologies Center, March 2008.

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