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Effectiveness of fluoride varnishes on oral health: A systematic review

Background: Professionally topical fluoride such as fluoride varnish was approved for preventing and remineralizing dental caries in primary and permanent dentitions. As such, fluoride varnish occupies a privileged place since it is the only topical fluoride for professional use applicable for children under 6 years of age, due to its simplicity, speed, rapidity and safety of use. The aim of this study was to investigate the efficacy of professional fluoride varnish in preventing and managing dental caries in primary teeth. Method: A systematic search of publications from 2013 to 2020 was conducted using 3 databases: PubMed, Cochrane Library and Web of Science. The key words used were “fluoride varnish, children, prevention, remineralization and early childhood caries”. Reviews, non-English articles, and irrelevant studies were excluded. Results: in this article, a total of 08 reports were retained: 4 systematic reviews and 4 trials were included in this review. Three reports investigated the preventive effect on primary teeth using fluoride varnish: 2 comparing fluoride varnish with no treatment and 1 comparing fluoride varnish with standard health program. Two trials investigated the managing effect of dental caries on primary teeth comparing fluoride varnish with standard health program. 1 review reported an arresting effect on dentine caries using silver diamine fluoride. 4 Meta-analysis were performed using 5% Sodium fluoride varnish, to prevent and manage caries, and the preventive fraction ranged from 23% to 70%; highest percentage of 69.9% preventive fraction was observed. Conclusion: The effectiveness of fluoride varnish for the prevention of dental caries was proved, however it depended on the individual caries risk, the area of living of the child and if it is used in complement with a standard health program. On the other hand, the effectiveness of fluoride varnish for the management of dental caries depended on the localization of dental caries.