Fluoride varnishes available in the market place are all
5% NaF, including Durafl or, Duraphat, Cavity Shield, and
Vanish (this latter product has the advantage of being a
white varnish). Sealants include Fluor Protector, which is
a silane sealant, and Pro Seal. MI Paste Plus is a casein
phosphopeptide-amorphous calcium phosphate (CCPACP)
material also available.
Dr. Staley cited a number of studies from 1999 to the
present in the dental and orthodontic literature, all of
which are in vitro studies. The fl uoride hypothesis states
that fl uoride ions applied to the teeth will inhibit formation
of white spot lesions. Todd found that Duraflor varnish is better than a placebo (non-fl uoride varnish) or control,
which reduces but does not eliminate demineralization.
Novak found Duraphat and Durafl or treated enamel surfaces to
have similar lesion depths that were less than controls. Wittenberger
repeated applications of Duraphat on different samples
at 1, 7, and 14 days, and found progressively smaller lesions
and greater enamel protection, suggesting that repeat varnish
applications helps reduce white spot lesions. Juhlin found
Fluor Protector to exceed Duraphat and in turn controls in
protection levels. Flor Protector acted as both a fl uoride source
and a physical barrier but did not totally eliminate decalcifi cation.
Ogaard compared Flor Protector with a chlorhexidine
rinse and found comparable 30% reductions in demineralization.
Loucks found decreasing depth of lesions with Flor
Protector, Delton, and Pro Seal respectively.