237906 A public health cluster randomised control trial of the effectiveness of fluoride varnish delivered in the school setting

Wednesday, November 2, 2011: 9:30 AM

Martin Tickle, Professor , School of Dentistry, University of Manchester, Manchester, United Kingdom
The aim of this study was to measure the effectiveness of fluoride varnish in preventing caries in the permanent dentition when delivered in the school setting. The study design was a cluster randomised, two-compartment, parallel trial. A total of 2967 children aged 7-8 years, attending 190 schools were recruited into the trial. Participating schools were randomised into test and control groups using a two stage stratification approach, based on location and school size. Children in the test group received fluoride varnish containing 22,600 ppm fluoride as sodium fluoride applied, three times a year for three years to the first permanent molars. The control group received no intervention. The primary outcome measures were DFS and DFT increment, in addition the change in caries prevalence was compared and adverse reactions were also recorded. Assessment was performed by trained and calibrated examiners blind to the allocation. Over 60% of children received all 9 applications of fluordie varnish. At follow up DFS increment was 0.68 (SD 2.13) in the control group and 0.65 (SD 2.17) in the test group, there was no statistically or clinically significant difference between the groups. Only 12 adverse reactions were recorded, all of which were clinically inconsequential. In conclusion fluoride varnish can be effectively delivered in a primary school setting and adverse reactions are rare, but we could find no evidence to support use of fluoride varnish to prevent caries in first permanent molars when delivered as a public health intervention in schools in the UK.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health or related research

Learning Objectives:
Compare the potential effectiveness of fluoride varnish as a public health intervention in the USA based on the findings of a large community randomised control trial conducted in a UK population.

Keywords: School-Based Programs, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior research professor at the University of Manchester and as part of a research team was responsible for the design and delivery of this study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.