skip to main content
Washington State Institute for Public Policy
Back Button

Oral health: Fluoride varnish treatment for permanent teeth

Health Care: Obesity and Diabetes
  Literature review updated October 2014.
Open PDF
Fluoride varnish is a form of fluoride that temporarily adheres to the tooth in order to maintain contact between the fluoride and the tooth for several hours. In the studies we reviewed, fluoride varnish was applied every three to six months over a 12- to 36-month time period.

The analysis presented here reflects the effect of fluoride varnish applied to permanent teeth.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Adjusted effect size(ES) and standard error(SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
0 14 3589 -0.267 0.086 8 -0.267 0.002

Citations Used in the Meta-Analysis

Bravo, M., Llodra, J.C., Baca, P., & Osorio, E. (1996). Effectiveness of visible light fissure sealant (Delton) versus fluoride varnish (Duraphat): 24-month clinical trial. Community Dentistry and Oral Epidemiology, 24(1), 42-46.

Clark, D.C., Stamm, J.W., Robert, G., & Tessier, C. (1985). Results of a 32-month fluoride varnish study in Sherbrooke and Lac-Megantic, Canada. Journal of the American Dental Association, 111(6), 949-53.

Hardman, M.C., Davies, G.M., Duxbury, J.T., & Davies, R.M. (2007). A cluster randomised controlled trial to evaluate the effectiveness of fluoride varnish as a public health measure to reduce caries in children. Caries Research, 41(5), 371-376.

Holm, G.B., Holst, K., & Mejàre, I. (1984). The caries-preventive effect of a fluoride varnish in the fissures of the first permanent molar. Acta Odontologica Scandinavica, 42(4), 193-197.

Koch, G., & Petersson, L.G. (1975). Caries preventive effect of a fluoride-containing varnish (Duraphat) after 1 year's study. Community Dentistry and Oral Epidemiology, 3(6), 262-266.

Liu, B.Y., Lo, E.C., Chu, C.H., & Lin, H.C. (2012). Randomized trial on fluorides and sealants for fissure caries prevention. Journal of Dental Research, 91(8), 753-758.

Milsom, K.M., Blinkhorn, A.S., Walsh, T., Worthington, H.V., Kearney-Mitchell, P., Whitehead, H., & Tickle, M. (2011). A cluster-randomized controlled trial: fluoride varnish in school children. Journal of Dental Research, 90(11), 1306-1311.

Modeer, T., Twetman, S., & Bergstrand, F. (1984). Three-year study of the effect of fluoride varnish (Duraphat) on proximal caries progression in teenagers. European Journal of Oral Sciences, 92(5), 400-407.

Skold, U.M., Petersson, L.G., Lith, A., & Birkhed, D. (2005). Effect of school-based fluoride varnish programmes on approximal caries in adolescents from different caries risk areas. Caries Research, 39(4), 273-279.

Tagliaferro, E.P., Pardi, V., Ambrosano, G.M., Meneghim, M.C., da, S.S.R., & Pereira, A. C. (2011). Occlusal caries prevention in high and low risk schoolchildren. A clinical trial. American Journal of Dentistry, 24(2), 109-114.

Tewari, A., Chawla, H. S., & Utreja, A. (1991). Comparative evaluation of the role of NaF, APF & Duraphat topical fluoride applications in the prevention of dental caries--a 2 1/2 years study. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 8(1), 28-35.