Title:  Equivalence between massive versus standard fluoride varnish treatments in high caries children aged 3-5 years

Abstract:  Aim The low-income Hispanic population of Yakima County, Washington, USA has high rates of childhood decay [Uroux et al., 1996] suggesting that previously used preventive methods have not been effective. This study aimed to compare the effect of different dosing regimens of a fluoride varnish (50-mg NaF/ml) on the development of dental caries in 156 3-5 year old low-income children residing in Yakima County, WA. The study tested the hypothesis that the three treatments were equivalent. Methods Children were entered into the study if they had >1 carious lesions in their primary molars. All children received clinical examinations and two bitewing radiographs at baseline, 6 and 12 months. Enrolled children were randomly assigned to one of three treatments: (1) a fluoride varnish application at baseline and 6 months; (2) three fluoride varnish applications within 2 weeks at baseline (annual massive); and (3) three fluoride varnish applications within 2 weeks at baseline and 6 months (semi-annual massive). Results Baseline clinical examinations showed: mean dmfs (SD) = 11.5 (11.6); mean dmft (SD) = 6.0 (4.1). The primary dependent measure was radiographic: the change in decayed, missing, or filled surfaces (dmfs) of eight primary molar proximal tooth surfaces per child. There was a small difference between the three groups in dmfs change from 0 to 12 months (group 1: 0.9 (2.7), group 2: 0.5 (2.2), and group 3: 0.1 (1.9), p=.28. Conclusions Differences between treatments were not significant; suggesting that both massive fluoride varnish regimens may be equivalent to a semi-annual application.