Effectiveness of sodium fluoride varnish to prevent dental caries in school children between age of 6 and 7 years: A randomised controlled trial in a low resource setting
Abstract Background Dental caries among children is a significant public health problem world over with multiple factors playing a major role as risk factors in initiation and contnuation of the disease. Fluoride varnish application is an effective intervent in preventing dental caries. Objective of this study was to evaluate the effectiveness of six monthly application of sodium fluoride varnish in prevention of dental caries in deciduous teeth, permanent incisors and molars in children between six and seven years in a low resource setting, Sri Lanka. Method This was a double-blind, randomized controlled trial (NCT02877888). The study population was school children aged six to seven years, living in a district of Sri Lanka. Recruited children were randomly assigned to either a treatment (n=161) or to control group (n=162) using block randomization. Children in the treatment group received fluoride varnish professionally applied every 6 months combined with counselling on maintenance of oral hygiene and diet for a period of 2 years. The control group was only subjected to counselling on maintenance of oral hygiene and diet. Caries examinations were conducted using the International Caries Detection and Assessment System (ICDAS). The primary outcome studied was the number of new caries in the two study groups. Results At the baseline assessment, the propotion of students with dental caries was higher in the intervention groupl (80.9%) compared to the control group (48.4%). Similarly the mean number of teeth with dental caries in a student was higher in the intervention group (1.35). At each time interval, the mean number of new dental caries was significantly lower in the intervention group. When independent effect of the intervention on development of new dental caries was assessed, application of fluoride varnish every 6 months for a period of 2 years was significantly associated with less number of new dental caries compared to controls. Conclusion Implementation of fluoride varnish application in a low resource setting is an effective method of preventing dental caries among children. A national level programme would contribute to the reduction of prevalence of dental caries in this age group. Trial registration: NCT02877888