Clinical trial finds fluoride varnish formulations offer equal caries prevention
Two-year trial shows both standard and enhanced fluoride varnishes equally prevent caries in high-risk children.
Study compares enhanced and conventional fluoride varnish
A randomised controlled trial from the University of Hong Kong assessed whether a fluoride varnish containing functionalised tricalcium phosphate (fTCP) could prevent early childhood caries better than standard fluoride varnish. The double-blind study enrolled 3-year-olds with untreated active caries and followed them over two years. Children were randomly assigned to receive either a standard 5 percent sodium fluoride varnish or a version containing fTCP. Before varnish application, all active carious lesions were treated with silver nitrate to promote caries arrest. This two-step protocol was applied every six months.
Both varnishes showed equivalent prevention in high-risk children
The researchers found no significant differences between the two groups in overall caries outcomes. Rates of new cavities and increases in decayed, missing or filled teeth were comparable between treatments. Surface-level analysis showed slightly fewer sound tooth surfaces developed caries in the fTCP group, particularly on mandibular posterior teeth, but this difference was not statistically significant. The authors concluded that both varnishes offered equivalent preventive efficacy.
Disease persistence highlights need for combined prevention strategies
Despite twice-yearly fluoride applications, more than four in five children developed at least one new cavitated lesion during follow-up. The researchers noted that exposure to fluoridated water and fluoridated toothpaste may have limited the scope for additional remineralisation benefit from the fTCP formulation. The findings support use of either varnish formulation in kindergarten-based prevention programmes, but the fTCP-containing product retains dual clinical value because previous work showed improved arrest of cavitated lesions. The study underscores the need to combine varnish application with broader caries-prevention measures for children with high caries risk. The research was published in the April 2026 issue of Dental Research.
Frequently asked questions
What is functionalised tricalcium phosphate in fluoride varnish?
Functionalised tricalcium phosphate (fTCP) was developed to prevent calcium and phosphate from reacting prematurely with fluoride during storage. This allows these ions to be released at the tooth surface after application, potentially enhancing remineralisation.
Did fTCP fluoride varnish prevent more caries than standard varnish?
No. The study found no statistically significant difference between fTCP-containing varnish and standard 5 percent sodium fluoride varnish in overall caries prevention. Both formulations offered equivalent preventive efficacy in 3-year-olds with active caries.
Can fluoride varnish alone prevent caries in high-risk children?
No. Over 80 percent of children in the study developed at least one new cavity despite twice-yearly varnish applications, showing that fluoride varnish must be combined with broader prevention measures such as improved oral hygiene and dietary changes.
How often was the fluoride varnish applied in this trial?
The varnish was applied every six months over a two-year period. Before each application, all active carious lesions were treated with silver nitrate to promote caries arrest.
Should dentists use fTCP varnish instead of standard fluoride varnish?
The study suggests either formulation is suitable for kindergarten-based prevention programmes. However, fTCP varnish may retain value for caries arrest; previous research showed it improved arresting cavitated lesions compared to standard varnish.
