A comparison of the costs and patient acceptability of professionally applied topical fluoride foam and varnish.
OBJECTIVE
In Canada and the United States, professionally applied topical fluorides (PATF) are usually applied as a gel or foam. However, fluoride varnish has also been found to be effective for caries prevention and may be a preferred method because less time is required and fluoride exposure can be better controlled. The goal of this study was to compare the costs and patient acceptability of two methods of PATF (foam and varnish).


METHODS
The study population was a convenience sample of high-risk children from the York Region and the city of Hamilton, Ontario, Canada, who had been identified as requiring fluoride therapy (n = 256). Children received from dental hygienists either fluoride foam applied in trays or fluoride varnish painted on tooth surfaces. An observer recorded the time to perform each procedure, adverse outcomes, and the satisfaction of children with treatment.


RESULTS
The varnish technique took significantly less time compared to foam (5.81 vs 7.86 minutes; P < .0001). Significant differences between procedure times were found in all age groups, but the largest difference was for children aged 3-6 years (5.22 vs 8.61 minutes; P < .0001). Signs of gagging were observed in a lower proportion of participants who received varnish (3.8% vs 15.1%; P < .01), and this difference was largest for children aged 3-6 years (2.6% vs 29.7%; P < .01). The cost per varnish application, for children aged 3-6 years, was substantially less after labor costs were considered (dollar 3.43 vs dollar 4.43, CDN).


CONCLUSIONS
Varnish applications were found to take less time and resulted in fewer signs of discomfort. These results support the use of fluoride varnish in caries prevention programs, especially for younger children.
Hawkins
Robert
R
Community Dentistry, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ontario, Canada M5G 1G6. robert.hawkins@utoronto.ca
Noble
James
J
Locker
David
D
Wiebe
David
D
Murray
Heather
H
Wiebe
Peter
P
Frosina
Carolyn
C
Clarke
Martha
M
D000293:Adolescent; D000367:Age Factors; D001294:Attitude to Health; D002327:Cariostatic Agents / Q000008:administration & dosage* / Q000191:economics; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000517:prevention & control; D003733:Dental Caries Susceptibility; D004304:Dosage Forms; D005460:Fluorides, Topical / Q000008:administration & dosage* / Q000191:economics; D005683:Gagging / Q000502:physiology; D017048:Health Care Costs; D006801:Humans; D007764:Lacquer / Q000191:economics; D009864:Ontario; D017060:Patient Satisfaction; D013997:Time Factors; D016896:Treatment Outcome
D002327:Cariostatic Agents; D004304:Dosage Forms; D005460:Fluorides, Topical