Fluoride varnish can be safely and effectively applied to infants and toddlers, developmentally disabled patients, and patients with active gag reflexes. Varnish can be applied to at-risk surfaces in a matter of seconds. An effective application is quick and easy.

Fluoride varnishes are most effective when used on early white spot lesions which have an intact surface layer, similar to what Jessie presented with in Part 1 of this online course. Once obvious cavitation has occurred, it is more appropriate to place a restoration. They are effective in controlling caries progression by enhancing remineralization at the tooth surface and inhibiting demineralization.

With its ease of application and the relative safety in its use, it is an ideal prevention-oriented technique to be promoted in community-based health programs, whether it is applied by dental professionals or medical professionals.

Some fluoride varnish preparations that are available in the US include:

Duraflor (Pharmascience Inc., New Jersey) and Duraphat (Colgate -Hoyt) appear to be particularly suitable fluoride varnishes for infants and toddlers when professionally applied. Both of these varnishes come in tubes.

CavityShield (Omnii Products, West Palm Beach, FL) is a newer product with the advantage of being a unit-dosed varnish. Each individual package, which comes with an applicator brush and fluoride varnish, contains either 0.25 ml. or 0.40 ml. depending on the number of teeth that are going to be treated. The advantages to this system are:

it avoids waste
a controlled amount of fluoride is dispensed, thus preventing over application
the chance of over-ingestion is reduced, preventing any remote chance of fluoride toxicity

The cost per dose of the CavityShield system has been estimated at approximately $3.00-$3.75 per application. The cost per dose of Duraflor is estimated at $1.00-$2.00 per application, and with Duraphat it is estimated to be $1.25-$2.50 per application.