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These studies suggest that fluoride varnishes and mouthrinses are effective in preventing dental caries and increasing enamel hardness, though there are concerns about dental fluorosis and the cost-benefit ratio in low caries prevalence populations.
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Fluoride varnishes have been extensively studied for their role in preventing dental caries, particularly in children. A study conducted in a non-fluoridated community demonstrated that two fluoride varnishes, Duraphat and Fluor Protector, significantly reduced the incidence of dental caries in children over a 20-month period. The study found that the mean DMFS (Decayed, Missing, and Filled Surfaces) increments were lower in the treatment groups compared to the control group, with reductions of 15.8% and 14.4% for Fluor Protector and Duraphat, respectively. Another study confirmed that fluoride varnishes are effective in decreasing the depth of man-made dental caries, with higher concentrations of fluoride providing better protection.
Fluoride mouthrinses and varnishes are both effective in caries prevention, but their application and cost-benefit ratios differ. Mouthrinses containing 0.05-0.2% sodium fluoride have shown significant cariostatic efficacy, especially in school-based programs for children at moderate to high risk of caries. However, in populations with low caries prevalence, the cost-benefit effect is questionable, leading to a preference for individual fluoride therapies such as varnishes. Fluoride varnishes like Duraphat and Fluor Protector are gaining acceptance for their ease of application and effectiveness, particularly when applied frequently in high-risk groups.
Public awareness and behavior towards fluoride use are crucial for its effectiveness in preventing dental caries. A community service project in Lamraya Aceh Besar demonstrated that educational interventions significantly increased public knowledge about the role of fluoride in preventing dental caries. However, a study evaluating young people's knowledge and behavior regarding dental fluorosis revealed gaps in understanding the function and effects of fluoride. Many participants used excessive amounts of fluoridated toothpaste and reported ingesting it during childhood, indicating a need for better education on proper fluoride use.
While fluoride is beneficial in preventing dental caries, excessive intake can lead to dental fluorosis, characterized by discoloration and pitting of the enamel. A study in Cuenca Canton found a higher prevalence of dental fluorosis in rural areas compared to urban areas, likely due to higher fluoride content in drinking water and salt. Another study in the Ratatotok District confirmed that fluoride content in well water was correlated with the occurrence of dental fluorosis among school children. These findings highlight the importance of monitoring fluoride levels in community water supplies to prevent overexposure.
Fluoride varnishes are not only effective in preventing dental caries in children but also in managing root caries lesions in elderly populations. A study on frail institutionalized elderly people showed that a combination of fluoride and chlorhexidine varnishes effectively controlled the severity of existing root caries lesions over a 12-month period. This non-invasive method can be easily applied by dental hygienists and is beneficial for high-risk groups, including those with neuromuscular conditions or dry mouth.
Fluoride remains a cornerstone in dental caries prevention, with varnishes and mouthrinses offering effective solutions for different populations. However, public education on proper fluoride use and monitoring of fluoride levels in community water supplies are essential to maximize benefits and minimize risks such as dental fluorosis. Continued research and tailored interventions can further enhance the efficacy and safety of fluoride in dental health.
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