Extended caries prevention programme with biannual application of fluoride varnish for toddlers: prevalence of dental fluorosis at ages 7–9 years and associated factors

Abstract

Objective

To investigate the prevalence of and factors associated with dental fluorosis in children living in areas of high caries risk in Stockholm and who had participated in a prospective, parallel, cluster-randomized, controlled caries prevention trial between ages 1 and 3 years.

Materials and Methods

The study group comprised a random sample of the children who had completed the 2-year prevention trial (n = 2536) in 2011–2014. All children were instructed to use fluoride toothpaste; the test group received fluoride varnish applications twice a year. Dental fluorosis prevalences in the reference (n = 220) and the test (n = 234) groups were compared. Presence of fluorosis was determined using the Thylsturp & Fejerskov (TF) index on photos of the permanent maxillary incisors.

Results

No significant difference in dental fluorosis was observed between the two groups. Nearly one-third (29.7%) of the children in the study cohort exhibited dental fluorosis (TF index ≥ 1). Associations with use of fluoride toothpaste at age 1 year and with socioeconomic status factors were found.

Conclusions

Biannual applications of fluoride varnish in toddlers was not associated with dental fluorosis, which when found was rarely of aesthetic concern. Parental education in tooth-brushing routines is recommended.

Keywords:

• Dental fluorosis
• fluoride toothpaste
• fluoride varnish
• children
• prevention

Acknowledgements

The authors thank the dental clinics, the dental staff, and the parents and children. Without their involvement, this study could not have been performed. Also, they thank Anna Warnqvist for collaboration regarding statistics.

Disclosure statement

The authors declare that they have no proprietary, financial, professional, or other personal interests of any nature or kind in any product, service, or company that could be construed as influencing the position presented in this paper.

Data availability statement

The datasets analysed in the current study are available from the corresponding author on reasonable request.

Geolocation information

Sweden.

Additional information

Funding

This work was supported by the Stockholm County Council.