Effectiveness of Fluoride Varnish in Prevention of Early Childhood Caries in 3-4 Years Old Children - A 36 Month Prospective Community Based Randomized Controlled Trial

Evidence for the benefit of applying Fluoride Varnish FV to permanent teeth is generally very positive. However, the caries-inhibiting effect of FVs on primary teeth is still debatable. To assess the effectiveness of fluoride varnish in prevention of early childhood caries in children over the period of 3 years in high fluoride areas. A double-blind cluster-randomized controlled trial was undertaken amongst 3-4 years old children. The varnish application was done at three points in the intervention group. Experimental group showed significantly lesser increment in mean ICDAS score than control group at both 12 month and 36 months. Preventive fraction was 72.4% at 12 months and 18.2% at 36 months. Multiple linear regression showed that at 12 months, intervention was the significant predictor with varnish group having 0.140 (95% CI 0.175-0.230) lower net caries increment. At 36 months, baseline ICDAS score and intervention were the significant predictors. This study suggests that fluoride varnish is an effective and a safe mode of prevention of early childhood caries in children residing in high fluoride zone. However, the overall effect is influenced by the baseline caries status.