An Observational Study of the Association of Fluoride Varnish Applied During Well Child Visits and the Prevention of Early Childhood Caries in American Indian Children

Objectives To determine if fluoride varnish applied at well child care visits would decrease the prevalence of dental caries in a group of American Indian children at high risk for early childhood caries. Methods This was an observational study in an American Indian community. Starting in 2002 all children received fluoride varnish applications at well child care visits at 9, 12, 15, 18, 24 and 30 months. The Head Start class of 2003 served as historical controls and students in 2004 and 2005 had increasing number of fluoride varnish treatments. All children entering Head Start from 2003 to 2005 had dental exams to determine the number of decayed, missing and filled surfaces (dmfs) present. The number of dmfs for each child was correlated with the number of fluoride varnish treatments received. Results Children with 4 or more treatments had 15.5 dmfs (95%CI 10.8–20.4) versus children with no fluoride varnish treatments who had 23.6 dmfs (95%CI 19.5–25.8) for a 35% decrease in overall caries. Children who received 1, 2 or 3 treatments showed no significant difference in dmfs when compared with children who had no fluoride varnish applications. Conclusions Fluoride varnish applied at well child care visits can reduce early childhood caries in American Indian children. Consideration should be given to making fluoride varnish more available to American Indian and Alaska Native children at well child visits. These findings may be applicable to other children who are at increased risk for early childhood caries.