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Custom Care: Exploring Fluoride Varnish Options for Diverse Patients

Fluoride is a key protector of our patients' oral health, by preventing decay and treating hypersensitivity. Recommendations have shifted from using trays with fluoride gel or foam and a one-minute rinse to including fluoride varnish options with concentrations ranging from 2.1% to 5% sodium fluoride, enabling personalized treatments for patients. 

 

Many patients recognize the benefits of fluoride, but the main challenge is patient acceptance and ensuring compliance with post-treatment protocols. Advancements in fluoride options enable tailored approaches by combining varnishes with education, risk assessment, and evidence-based preventive solutions. 

 

Statistics indicate 90% of adults aged 20 and older have had decay on at least one permanent toothi. This statistic prompts us to reassess our treatment recommendations and evaluate our patient acceptance rates for fluoride. What is the fluoride acceptance rate in your practice? Is this rate lower than the proportion of patients who present with decay or sensitivity in your office? It is essential that we investigate the underlying factors contributing to this discrepancy.

 

The following are common reasons patients may choose not to accept fluoride treatment:

  • Patients may express dissatisfaction with the fluoride application's taste, texture, or appearance. 
  • There may be reluctance regarding the post-operative instructions provided.
  • Their insurance plan may not cover the treatment, leading to financial concerns. 
  • Patients may have apprehensions regarding potential fluoride exposure. 
  • A lack of understanding regarding the necessity and perceived benefits of the treatment can also contribute to their hesitation.

These concerns have driven improvements in fluoride products. It is crucial to offer a variety of options suited to the patient's specific needs, preferences, and risk levels. The 5% fluoride varnish has long been considered the gold standard in varnish treatments and is supported by the American Dental Association (ADA) and the Canadian Dental Association (CDA). 

 

Identifying patients who could benefit from fluoride varnish treatments improves clinical outcomes and practice profits. Clinicians should classify patients by their caries risk: low, moderate, or high. Tools and charts are vital for accurately identifying those needing fluoride therapies. Using these charts, providers can more readily identify the patient's caries risk, boosting patient acceptance, while promoting better oral health. 

 

For example, patients categorized as low risk may receive either in office 2.1% fluoride treatment or a 5% fluoride varnish. In contrast, patients identified as moderate or high risk may be provided with fluoride varnish and be advised to utilize toothpaste containing 5000 ppm fluoride daily, offering increased protection against decay and sensitivity. 

 

Using Ultradent’s Enamelast™ 5% varnish offers a professional-grade solution that effectively addresses many patient objections. Its smooth, non-gritty texture and nearly invisible application ensure patient comfort and satisfaction. The patented formula delivers a smooth feeling with superior fluoride release and absorption, making it an excellent choice for dental professionals. This varnish is kosher and gluten-free and is now available in various flavours or unflavoured options. For an eco-friendly option, it can also be administered using a syringe. Enamelast is ideal for post-IPR treatment, caries prevention, and desensitization procedures.

 

Additional 5% varnish options to consider are Duraflor® Ultra and Duraflor® Halo from Medicom. Duraflor® Halo is a traditional varnish with an easy peel and apply unit dose packaging. While Duraflor® Ultra also contains Xylitol, it dries clear and releases fluoride at 2, 4, and 24 hours. These features lead to enhanced patient compliance. Both options are suitable for patients with sensitivity concerns and require caries prevention.

A new fluoride alternative from Solventum is now available. This product provides a water-based solution containing 2.1% fluoride treatment. It allows clinicians to apply fluoride prior to a recall exam, and it requires a 15-minute wait after application. It is available in three flavour options: mint, watermelon, or flavourless. The ready-release 2.1% fluoride formula provides similar fluoride uptake to traditional 5% varnish, making it a convenient and effective choice for patients with caries. 

 

As we deepen our understanding of fluoride's benefits, we must refine our approaches to ensure patients accept and embrace these vital treatments. Customizing fluoride applications to meet each patient's unique needs and preferences is crucial in maximizing treatment effectiveness, boosting compliance and revenue. With a wide array of fluoride options at our disposal, dental professionals have the power to strategically engage patients, addressing common reservations and highlighting the compelling evidence supporting fluoride's role in preventive care. Since many adults experience dental decay, practices must assess and proactively enhance their fluoride acceptance rates. Fostering patient education and offering appealing, varied treatment options will strengthen understanding and cultivate a strong appreciation for fluoride's necessity in maintaining dental health. 

Identifying patients who benefit most from fluoride improves outcomes and practice profits. Clinicians should classify patients by caries risk:

Click Here to Download the Caries Risk Assessment Chart 

REFERENCES

i Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2019. Last Reviewed November 2022 - https://www.nidcr.nih.gov/research/data-statistics/dental-caries/adults

About the Author

Kerry Lepicek, RDH & International Speaker

Kerry Lepicek is an experienced dental hygienist with over 20 years of clinical practice. Kerry’s expertise includes oral biofilm, halitosis, the oral-systemic connection, and the dental hygiene process of care. She is focused on educating patients and the dental profession on health and wellness. Kerry is involved in various dental organizations, including section editor for Women in Dentistry, the Research Advisory Committee for the Ontario Dental Hygiene Association, and on the advisory board for RDH Magazine. She recently received the Distinguished Services Award from Ontario Dental Hygienists Association (ODHA) for outstanding contributions to the dental hygiene profession and the Association.

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This article was published in the Clinical Life™ magazine: 

Fall/WiInter 2025 edition

 

Clinical Life™ magazine is a premier periodical publication by Clinical Research Dental Supplies & Services Inc. Discover compelling clinical cases from Canadian and US dental professionals, cutting-edge techniques, product insights, and continuing education events.

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