Dear RDH:
In the February 1998 issue of RDH, an excellent article was written about the overuse of fluoride ("Topical Fluorides" by Mary D. Cooper, RDH, MS, and Connie Myers Racher, CDA). It is true that most professionals readily apply fluoride treatments without first assessing the need for administration. It is apparent that it is necessary to look at the entire patient profile before considering fluoride use.
As an addendum to their article, I want to provide information on a fluoride product that is relatively new in the United States. Duraflor (PharmaScience Laboratories, Inc.) is a sodium fluoride varnish that has been used in Canada for more than 15 years.
Duraflor is a 5 percent sodium fluoride varnish that is quick to work with. It hardens on contact with saliva, delivering a high concentration of fluoride directly to the tooth surface. Because this varnish sets immediately on the tooth?s surface, its ingestion rate is minimal. This has been proven in many clinical trials.
From my readings, fluoride varnishes have been used all over the world as a caries reduction agent. According to Jong?s Community Dental Health (4th edition) by George M. Gluck and Warren M. Morganstein, OThe original purpose for their development was to increase the uptake of fluoride by enamel, when it was thought that this factor would lead to greater caries protection. Fluoride varnishes do increase the fluoride concentration in saliva for a longer period of time than do other professionally applied fluoride products. In addition, Fluoride in Dentistry, written by Ole Fejerskov, Jan Ekstrand and Brian A. Burt, states, OFluoride varnishes are particularly useful in handicapped children or for application after restorative treatment is complete under general anesthesia. They also may be used to target fluoride to specific tooth surfaces, roots for example, incipient lesions or the margins of restorations. Fluoride varnishes are safe because the amount of varnish usually used is 0.3-0.5 mL, which delivers only 3-6 mg of fluoride.O
I am a registered dental hygienist, and I currently work for Pharmascience Laboratories Inc. as their Dental Therapeutics Advisor. I also practice in a pediatric office and see the benefits for fluoride varnish use. I want to thank the authors of this article for highlighting the problem with overuse of fluoride. I hope that this will inspire others to be more cautious with the use of fluoride in the future.
Ellen R. Fein, RDH
Summit, New Jersey
