FLORIDE VARNISH

INTRODUCTION
Fluoride varnish is a highly concentrated form of fluoride which is applied to the tooth's surface, by a dentist, dental hygienist or other health care professional, as a type of topical fluoride therapy able to stay in contact with the tooth surface for several hours

It may be applied to the enamel, dentine or cementum of the tooth and can be used to help prevent decay, remineralise the tooth surface and to treat dentine hypersensitivity

COMPOSITION
Fluoride varnish is composed of a high concentration of fluoride as a salt or silane preparation in a fast drying, alcohol and resin based solution.The concentration, form of fluoride, and dispensing method may vary depending on

the manufacturer. While most fluoride varnishes contain 5% sodium fluoride at

least one brand of fluoride varnish contains 1% difluorsilane in a polyurethane base

APPLICATION PROCEDURE
Although it is not necessary to do a professional prophylaxis prior to the application of a fluoride varnish, it is recommended that the teeth be cleaned with a toothbrush
Wiping with a cotton gauze is adequate in cases where there is no heavy plaque or debris. The teeth should be lightly dried with air or a cotton gauze. The varnish will adhere even if the teeth are moist. Isolate the teeth (eg. with cotton rolls) to prevent recontamination with saliva A small amount of varnish (eg. 0.5ml) is dispensed. The entire dentition may be treated with as little as 0.3-0.6 ml.

A small brush or applicator is then used to apply the varnish The varnish will set on contact with the slightly moist teeth

The patient is instructed to avoid brushing for the rest of the day. Normal oral hygiene procedures can begin again the following day.
In order to be effective in decay prevention the varnish should be reapplied at least twice yearly

Advantages
Fluoride varnishes are available in different flavours which can be advantageous when treating younger patients They do not have the bitter taste of some fluoride gels They are easily and quickly applied

They dry rapidly and will set even in the presence of saliva
Because they do not require the use of fluoride trays they are suitable for use in patients with a strong gag reflex Due to the small amounts used and the rapid setting time there is only a small or negligible amount of fluoride ingested

Application requires very little equipment and so it can be applied in settings where a dental operatory is not available It has a sticky consistency which helps it to adhere to the tooths surface thereby allowing the fluoride to stay in contact with the tooth for several hours Based on published findings, professionally applied fluoride varnish does not appear to be a risk factor for dental fluorosis, even in children under the age of 6. This is due to the reduction in the amount of fluoride which may potentially be swallowed during the fluoride treatment because of the small quantities used and the adherence of the varnish to the teeth.

Disadvantages
Due to the colour and adherence of most fluoride varnishes they may cause a
temporary change in the surface colour of teeth as well as some filling materials. As the varnish is worn away by eating and brushing the yellowish colour fades

Indications
Use as a topical fluoride agent on moderate and high-risk patients, especially children 5 and younger Desensitizing agent for exposed root surfaces Fluoridated cavity varnish Fluoride treatment for institutionalized patients or in other situations where setting, equipment and patient management might preclude the use of other fluoride delivery methods

Caries prevention on exposed root surfaces Fluoride application around orthodontic bands and brackets Fluoride treatment on patients when there is a concern that a fluoride rinse, gel or foam might be swallowed

Contraindications
Areas with open cavities Patients that are at low-risk or are decay-free and live in an area where the water is

fluoridated
Treatment of areas where discoloration after treatment may be an aesthetic concern