The two types of fluoride available for the dental professional to use to prevent or reduce caries are neutral sodium fluoride gels, foams, and varnish and acidulated phosphate fluoride gels and foams. Sodium and acidulated fluoride forms calcium fluoride in enamel after use. However, sodium fluoride’s main benefit is that it does not etch porcelain and ceramic restorations.
For many decades, an operator-applied professional fluoride method by disposable mouth tray was used with a 1.23% APF gel or a 2% sodium fluoride. This procedure offered a method that was convenient to use and was somewhat tolerated by patients. However, sodium fluoride varnish is recommended as the standard of care for children by both the American Academy of Pediatric Dentistry and the American Dental Association. There are several reasons, such as patient compliance, the higher ppm of fluoride in varnish, and the ability to place it intraorally in any setting.
The AAPD and ADA continuously update their websites posting current evidence-based policies. The ADA Council on Scientific Affairs has posted several Clinical Practice Guidelines, including Topical Fluoride for Caries Prevention. Current guidelines indicate 2.26% sodium fluoride varnish and 1.23% APF fluoride gel is recommended over other types of fluoride. Other ADA Clinical Practice Guidelines include: Non-fluoride Caries Preventive Agents, Fluoride Supplements, and Fluoride Toothpaste for Young Children, to name a few. I’ve always said you “don’t have to be en expert on everything, you just need to know where to find it.” Almost monthly, I’m on the AAPD and ADA websites reviewing current professional guidelines and policies.
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