Muneeb Muhammed AliIV BDS

• A dental varnish is a coating liquid for teeth, which is applied in thin layers and converted to a consistent, solid film by chemical or physical processes

Introduction:-

• In dentistry, only water- or solvent-based liquid systems are used, as they enable simple, quick and reliable application on the surfaces to be treated.

Basic requirements:-• It should be Homogeneous quality

• Release of active substances

• Patient comfort

• Easy, safe application

• Biocompatibility

• Good storage stability

The main tasks of dental varnishes are:-

1.Protection of the teeth from caries:-To protect the teeth from caries through the

release of active substances – fluoride or antimicrobial substances are used. Fluoride reduces the demineralization of dental enamel and antimicrobial substances combat cariogenic bacteria.

2.Enhancing the esthetics of the tooth shade Varnishes that contain bleaching agents are applied

to remove discolorations or to whiten the teeth

3.Desensitization of sensitive tooth necks

Desensitizing sensitive tooth necks can be achieved via the creation of a mechanical block,

i.e. a physical layer covering exposed dentin tubule. This prevents or minimizes any

conduction of pain stimuli into the tubule via effectively sealing them. A sustainable seal below

the tooth surface istherefore ideal.

Types:-

• Fluoride varnishes

• Antimicrobial varnishes

• Desensitizing varnishes

• Tooth whitening varnishes

• Physically cured varnishes

• Chemically cured varnishes

Based on Curing:-

Fluoride varnish

• Flouride Varnish was first developed in europe by Schmidt in 1964

• Fluoride Varnish is a protective coating that is painted on a teeth to prevent CAVITIES

• A fluoride varnish should provide protection from demineralization or erosion

Indication:-• For moderate-high caries risk patients

• As a primary preventive measure

• As a treatment for hypersensitive teeth

• To decrease post operative sensitivity

• Used as a cavity liner

1.Duraphat• First Fluoride varnish developed in Germany

• Yellow viscous material containing 22,600 ppm fluoride as sodium fluoride in a neutral colophonium base (NaF Contains 2.2%fluoride)

• Duraphat has shown caries reduction of between 30-40% in permanent dentition and 7-44% in the primary dentition

2.Carex:-Contains a lower fluoride concentration than Duraphat (1.8% flouride) and has efficacy equivalent to that of duraphat as a caries preventive agent

Types:-

3.Fluorprotector• Clear polyurethane based product containing 7000 ppm

fluoride (Silane flouride with 0.7%F in polyurethane base)

• It has a range of efficacy between 1% and 17% but its clinical effectiveness is questionable

4.Duraflour:-5% NaF in alcoholic suspension of natural resins

Techniques of Varnish Application• Oral prophylaxis

• Teeth are dried,but not isolate with cotton rolls

• A total of 0.3-0.5 ml of varnish equivalent to 6.9-11.5 mg F is required to cover full dentition

• Application is done using single tufted small brush starting with proximal surfaces

• After application patient is made to sit with the mouth open for 4 minutes before spitting to let Duraphet set on teeth

• Patient is asked not to rinse or drink anything at all for one hour and not to eat anything solid but take liquids and semisolids only till the next morning so that contact between varnish and tooth surface for about 18 hours maintained for prolonged interaction between fluoride and enamel

Advantages of fluoride varnish over professionally used fluorides

• Easy to use and fast to apply

• Gels and foams require the use of suction , air drying the teeth , trays that may trigger gag reflexes

• Safe and posses less risk of adverse reaction beacause only small amount is used

• It does not require the use of dental equipment or instruments

Disadvantages:-

• Yellowish discoloration of teeth gradually fades

• Undesirable taste in mouth after application

Recent Varnish “DURAFLOR HALO’’

One of the recent varnish that have been introduced in the market

They have couple of advantage over other varnish

1. No Discoloration (Esthetically pleasing)

2. No bad taste (Comes in flavours mint and berry)

3. More acceptable by children thus fits with any age

Antimicrobial varnishes

• An antimicrobial protective varnish can reduce the bacteria and help shift the bacterial balance to a healthier level

• By reducing the bacterial count, an antimicrobial varnish can also minimize other problems caused by bacteria, such as inflammation of the gingiva

• Chlorhexidine thymol varnish is commonly used antimicrobial varnish.it has antimicrobial activity against all gram positive and gram negative microorganisms

Desensitizing varnishes

• Type of varnish indicated for the treatment of dentinal sensitivity

• Contraindicated in ulcerative gingivitis and stomatitis

Tooth whitening varnishes• A tooth whitening varnish contains an

oxidant, usually a peroxide, which diffuses into the tooth after the application of the varnish

• Peroxide is unstable in the oral cavity. Their decomposition produces oxygen, which converts stains and discolouration into colourless compounds

• the varnish contains no or very little of the active substance, thus there is no added benefit to the varnish remaining on the tooth, and it should be easily removed

Clinical Studies:Treatment of hypersensitive tooth necks

Title: Evaluation of a fluoride varnish for the treatment of dentine hypersensitivity

Location: Lund University, Sweden

Time: 1990

Authors: B. Collaert, G. Söderholm, G. Bratthall, H. de Bruyn

The study included 15 patients, who had suffered from dentin hypersensitivity for an average of more than 6.5 years. Sensitivity to blown air or scratching on the tooth surface was determined at the beginning of the study as well as after 1 and 4 weeks. Furthermore, the patients reported and rated their sensitivity to temperature and tooth brushing. A placebo solution was applied at baseline 0; at baseline 1 and after one week, Fluor Protector was administered.

Results: In week 4, the sensitivity to all stimuli (blown air, scratching, temperature) was significantly reducedEleven patients felt a clear reduction in symptoms after treatment with Fluor Protector, such that they were no longer affected by their hypersensitive teeth during eating/drinking or tooth brushing. The remaining 4 patients still considered their hypersensitivity to be too severe. These four patients all suffered from hypersensitivity of all teeth

Fluor Protector reduces dentin hypersensitivity, even if it has persisted for years

Bibliography:-

• Article on Dental Varnish Systems in Focus by Dr Thomas Hirt Dr Thorsten Bock Carlo Bolis Dr Kathrin Fischer (February 2016)

•  • Essentials of Preventive and Community Dentistry

4th edition by Soben Peter•  • Fluoride Varnish in the Prevention of Dental

Caries in Children and Adolescents:A Systematic Review By Amir Azarpazhooh Patricia A. Main

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