Extended caries prevention programme with biannual application of fluoride varnish for toddlers: prevalence of dental fluorosis at ages 7–9 years and associated factors

Abstract

Objective To investigate the prevalence of and factors associated with dental fluorosis in children living in areas of high caries risk in Stockholm and who had participated in a prospective, parallel, cluster-randomized, controlled caries prevention trial between ages 1 and 3 years. Materials and Methods The study group comprised a random sample of the children who had completed the 2-year prevention trial (n = 2536) in 2011–2014. All children were instructed to use fluoride toothpaste; the test group received fluoride varnish applications twice a year. Dental fluorosis prevalences in the reference (n = 220) and the test (n = 234) groups were compared. Presence of fluorosis was determined using the Thylsturp & Fejerskov (TF) index on photos of the permanent maxillary incisors. Results No significant difference in dental fluorosis was observed between the two groups. Nearly one-third (29.7%) of the children in the study cohort exhibited dental fluorosis (TF index ≥ 1). Associations with use of fluoride toothpaste at age 1 year and with socioeconomic status factors were found. Conclusions Biannual applications of fluoride varnish in toddlers was not associated with dental fluorosis, which when found was rarely of aesthetic concern. Parental education in tooth-brushing routines is recommended.