The Dentist Magazine.

Children’s tooth decay preventable with low-cost, easy treatment

Published: 21/04/2017

Research has found that applying fluoride varnish to children’s teeth is just as effective at preventing tooth decay as the alternative and could save the NHS money.

The study, funded by the National Institute for Health Research (NIHR) and led by Cardiff University, is published today in the Journal of Dental Research.

Dental caries is amongst the most common diseases to affect humankind. Thirty-five percent of the global population – 2.4bn people – have untreated caries in their permanent teeth. The first adult molars which erupt at age six are particularly vulnerable to decay. Tooth decay is caused by a build-up of plaque. Diet is a major factor in the growth of plaque, with sugary foods and drinks being the main contributors. Rates of decay are often higher in children who live in disadvantaged communities.

Decay on first adult molars can be prevented by two different treatments: fissure sealants and fluoride varnish. Fissure sealants are plastic coatings applied to teeth to stop food and bacteria from becoming stuck, these last for several years. Alternatively, fluoride varnish can be applied to teeth twice a year to give added protection.

The ‘Seal or Varnish?’ study led by Professor Ivor Chestnutt, from Cardiff University School of Dentistry, in collaboration with Cardiff and Vale University Health Board Community Dental Service, aimed to discover which of these treatments is most effective and offers the best value for money for children aged six to seven years.

Just over 800 children were treated over a three-year period, they were given either fissure sealants or fluoride varnish. In children who had the fluoride varnish treatment, 17.5 per cent had decay in their molars that was bad enough to need a filling or for the tooth to be taken out after three years. In the sealant treated group, 19.6 per cent of children had decay in their first molars. Over the three years, there was a cost saving of £68.13 per child in the varnish group.

Professor Chestnutt said, “Our research has shown that the fluoride varnish does prevent tooth decay just as well as a more difficult and expensive treatment. Fluoride varnish is simple to apply and requires less complex intervention than that required for placing plastic sealants. This study provides invaluable evidence for National Health Service dental services in the UK and has implications for dental prevention around the world”.

Dinah Channing, community dental service manager at Cardiff and Vale University Health Board, said, “The results of this trial provide important evidence as to how we tackle the still unacceptable levels of tooth decay in disadvantaged children.”

The study was coordinated by the Centre for Trials Research at Cardiff University.

Read the article in the Journal of Dental Research at  http://journals.sagepub.com/doi/full/10.1177/0022034517702094