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 the professional fluoride method included a disposable mouth tray 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 AAPD and ADA. There are several reasons, such as patient compliance, the higher ppm of fluoride in varnish (22,600 ppm), 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 Evidence-based Dentistry Clinical Practice Guidelines include Topical Fluoride for Caries Prevention. For children younger than 6 years, current guidelines indicate 2.26% sodium fluoride varnish at least every 3-6 months. With patients 6-18 years of age, 2.26% sodium fluoride varnish or 1.23% APF fluoride gel for 4 minutes at least every 3-6 months. I’ve always said you “don’t have to be an expert on everything, you just need to know where to find it.” I’m frequently on the AAPD and ADA websites reviewing current professional guidelines and policies.
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