Ask 100 dental professionals what they recommend for dental decay if the patient is a child or even an adult.

Fluoride varnish will likely be the consensus.

But then ask what the treatment plan for fluoride varnish is, and how effective is it in preventing cavities?

No consensus. Unsure about the effectiveness.

Let me give you an example.

Public Health England publishes recommendations on what’s best for caries throughout life.  It says fluoride varnish twice a year for kids and adults.

Yet the only randomized controlled study of fluoride varnish and adult patients, shows that even at 4 applications a year, there was no meaningful preventive effect in adults.

And in kids, a new study reports fluoride varnish is ineffective in high risk groups.

So what’s the explanation for the failure of fluoride varnish? This product is not sufficiently antimicrobial to adjust the dysbiosis in the plaque throughout the mouth. Sure, it might arrest decay at the site of an emerging lesion, but fluoride varnish does little to change the composition of the plaque on the next tooth or at the gum line.

60% of teeth adjacent to a decaying tooth develop cavities over 5 years. That is why fluoride varnish has little preventive effect in high risk groups.

 

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