title: Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000ppm fluoride toothpaste.
  
  
  METHODS
  424 preschool children, 2-5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity.
  
  
  RESULTS
  The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p=0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments.
  
  
  CONCLUSIONS
  Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000ppm fluoride toothpaste.
  
  
  CONCLUSIONS
  In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000ppm fluoride toothpaste is used daily.
authors.affiliation: University of Athens Dental School, 2 Thivon Str, GR 11527, Athens, Greece. Electronic address: agourop@dent.uoa.gr.
authors.forename: A
authors.initials: A
authors.lastname: Agouropoulos
authors.affiliation: Odontologisk Institut, Sektion 05, Panum Instituttet, Nørre Allé 20, 2200 København N, Denmark. Electronic address: stwe@sund.ku.dk.
authors.forename: S
authors.initials: S
authors.lastname: Twetman
authors.affiliation: Zafeiropoulou Panou 29 Kerkyra, P.C. GR 49100, Municipality Kerkyras, Prefecture Kerkyras, Greece. Electronic address: npandis@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Pandis
authors.affiliation: University of Athens Dental School, 2 Thivon Str, GR 11527, Athens, Greece. Electronic address: kavvadiakaterina@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Kavvadia
authors.affiliation: University of Athens Dental School, 2 Thivon Str, GR 11527, Athens, Greece. Electronic address: lipap@dent.uoa.gr.
authors.forename: L
authors.initials: L
authors.lastname: Papagiannoulis
mesh_terms: D002021:Buffers; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000382:microbiology / Q000517:prevention & control*; D003733:Dental Caries Susceptibility / Q000502:physiology; D003774:Dental Plaque Index; D004311:Double-Blind Method; D004338:Drug Combinations; D005459:Fluorides / Q000627:therapeutic use; D005460:Fluorides, Topical / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006267:Health Education, Dental; D006293:Health Promotion; D006801:Humans; D009909:Oral Health; D009910:Oral Hygiene / Q000193:education; D010512:Periodontal Index; D010919:Placebos; D011140:Polyurethanes / Q000627:therapeutic use; D012463:Saliva / Q000382:microbiology / Q000502:physiology; D012571:School Dentistry / Q000379:methods; D012821:Silanes / Q000627:therapeutic use; D013295:Streptococcus mutans / Q000302:isolation & purification; D014099:Toothbrushing / Q000379:methods*; D014100:Toothpastes / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D002021:Buffers; D002327:Cariostatic Agents; D004338:Drug Combinations; D005460:Fluorides, Topical; D010919:Placebos; D011140:Polyurethanes; D012821:Silanes; D014100:Toothpastes; C022599:Fluor Protector; D005459:Fluorides
keywords: Early childhood caries; Fluoride toothpaste; Fluoride varnish; Preschool children