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What do systematic reviews say?

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Evidence found and GRADE certainty

65 questions · 86 findings · 13 reviews

No studies found 6 · 7%GRADE not reported 75 · 87.2%Very low 2 · 2.3%Low 1 · 1.2%Moderate 2 · 2.3%High 0 · 0%

Fluoride varnish vs No fluoride treatment

Dimensional change (size) of early enamel caries lesions · Patients (mainly children) with white spot lesions (WSL)

In one trial, professionally applied sodium fluoride varnish significantly reduced the size of early enamel caries lesions compared with no fluoride treatment; ungraded.

1 finding from 1 review

Fluoride varnish vs Fluoride in dentifrice

Caries increment, surface index D(M)FS · Children or adolescents

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in varnish versus fluoride in dentifrice across randomization year; the review did not state whether the difference was significant and certainty was not graded.

1 finding from 1 review

Fluoride varnish vs Fluoride gel

Caries increment, surface index D(M)FS · Children or adolescents

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in varnish versus fluoride in gel across randomization year; the review did not state whether the difference was significant and certainty was not graded.

1 finding from 1 review

Fluoride varnish vs Fluoride in rinse

Caries increment, surface index D(M)FS · Children or adolescents

The illustrative network meta-regression estimated an SMD for caries increment for fluoride in varnish versus fluoride in rinse across randomization year; the review did not state whether the difference was significant and certainty was not graded.

1 finding from 1 review

Fluoride varnish vs placebo or no treatment

Adverse effects / specific side effects (oral allergic reactions, mucosal irritation, adverse symptoms such as nausea, gagging, vomiting) · Children and adolescents aged 16 years or less
1 finding from 1 review

Silver diamine fluoride (SDF, including SDF + fluoride varnish) vs Other standard-of-care caries treatments pooled (placebo, ART, or ART + fluoride varnish)

Oral health-related quality of life · Children with dental caries

SDF had no significant effect on oral health-related quality of life versus pooled standard-of-care caries treatments (SMD -0.06, 95% CI -0.20 to 0.08; ungraded).

1 finding from 1 review

P11-4 + fluoride varnish vs Fluoride varnish

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

P11-4 plus fluoride varnish was significantly better than fluoride varnish alone (SMD -0.71, 95% CI -1.13 to -0.29); certainty of evidence not assessed (no GRADE).

1 finding from 1 review

6% sodium fluoride with 6% calcium fluoride varnish vs no treatment

Remineralisation of early enamel caries · Children with early enamel caries (permanent dentition)

One trial found 6% sodium fluoride plus 6% calcium fluoride varnish significantly reversed early enamel caries versus no treatment; ungraded and not meta-analysed.

1 finding from 1 review

Fluoride varnish vs Untreated lesions (single-arm before vs after proportion)

Remineralisation of early enamel caries · Patients (mainly children) with white spot lesions (WSL)

Professionally applied 5% sodium fluoride varnish remineralised about two-thirds of early enamel caries lesions in children (pooled proportion 63.6%, 95% CI 36.0% to 91.2%; 4 studies); certainty was not GRADE-rated and heterogeneity was very high (I2=96%).

1 finding from 1 review

Sodium fluoride (NaF) varnish, applied every 3 months, plus OHI vs inactive control

Root carious lesions prevention · Older adults with root caries (community-dwelling or residential elders)

In elders, sodium fluoride varnish gave a 64% prevented fraction for root caries vs water, lower than SDF (71%) (p<0.01; ungraded).

1 finding from 1 review

Fluoride varnish vs no treatment

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment differed between fluoride in varnish and no treatment at randomization years 1954 to 1990; certainty was not graded.

1 finding from 1 review

Fluoride varnish vs placebo

Caries increment, surface index D(M)FS · Children or adolescents

In the illustrative network meta-regression the SMD for caries increment showed a treatment-by-year interaction and differed between fluoride in varnish and placebo at randomization years 1954 to 1980; certainty was not graded.

1 finding from 1 review

Fluoride varnish combined with fluoride toothpaste vs Fluoride varnish

Unacceptability of treatment (drop-outs / leaving study early) · Children and adolescents aged 16 years or less

Fluoride varnish combined with fluoride toothpaste showed no clear difference in unacceptability of treatment (drop-outs / leaving study early) compared with fluoride varnish alone; GRADE not reported.

1 finding from 1 review

Silver diamine fluoride (SDF) plus fluoride varnish vs Atraumatic restorative treatment + fluoride varnish (ART+FV)

Oral health-related quality of life · Children with dental caries

SDF plus fluoride varnish did not significantly differ from ART plus fluoride varnish for oral health-related quality of life (MD 0.16, 95% CI -0.1 to 0.42; ungraded).

1 finding from 1 review

Fluoride varnish vs CPP-ACP

Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…

Fluoride varnish did not differ significantly from CPP-ACP (SMD -0.07, 95% CI -0.44 to 0.29); certainty of evidence not assessed (no GRADE).

1 finding from 1 review