Non-Cochrane · intervention · PM41613509
Effectiveness of Fluoride Varnish Versus Conventional Glass Ionomer in Preventing Occlusal Caries: A Systematic Review and Meta-Analysis.
Dh Alharbi Abdullah, Almasoud Masoud, Alfadhli Fahad, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.102436
Findings
Population Children and adolescents with newly erupted caries-free permanent (or primary) molars
4 findings
| Fluoride varnish (FV) | Conventional glass ionomer cement (GIC) sealant | Patient-reported anxiety and pain during application At application | RR 0.29 [0.04, 2.17] Low Downgraded: imprecision, inconsistency 2 studies · 736 participants |
| Fluoride varnish (FV) | Conventional glass ionomer cement (GIC) sealant | Incidence of occlusal caries involving dentin (ICDAS 4 or higher) 12 to 24 months follow-up | RR 0.98 [0.80, 1.21] -2 [-25, 26] per 1,000 Moderate Downgraded: imprecision 4 studies · 3228 participants |
| Fluoride varnish (FV) | Conventional glass ionomer cement (GIC) sealant | Plaque accumulation (Visible Plaque Index, VPI) | SMD 0.11 [0.01, 0.21] Moderate Downgraded: imprecision 3 studies · 1472 participants |
| Fluoride varnish (FV) | Conventional glass ionomer cement (GIC) sealant | Caries of adjacent second molars 12 to 24 months follow-up | RR 0.99 [0.80, 1.23] -1 [-25, 29] per 1,000 Low Downgraded: imprecision, indirectness 3 studies · 2929 participants |
Included primary studies 5
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chiu 2025 Glass ionomer fissure sealants versus fluoride varnish application on children's behaviour: a randomised controlled trial. PMID:39495397 | 2025 | this review only | Plaque accumulation (Visible Plaque Index, VPI); Patient-reported anxiety and pain during application | not extracted yet |
| Lam 2021 Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A… PMID:34284374 | 2021 | this review only | Incidence of occlusal caries involving dentin (ICDAS 4 or higher); Caries of adjacent second molars; Plaque accumulation (Visible Plaque Index, VPI); Patient-reported anxiety and pain during application | not extracted yet |
| Lam 2024 Effectiveness of glass-ionomer sealant versus fluoride varnish application to prevent occlusal caries among preschool children over 18-24… PMID:39357618 | 2024 | this review only | Incidence of occlusal caries involving dentin (ICDAS 4 or higher); Caries of adjacent second molars; Plaque accumulation (Visible Plaque Index, VPI) | not extracted yet |
| Oliveira 2013 Comparison of the caries-preventive effect of a glass ionomer sealant and fluoride varnish on newly erupted first permanent molars of… PMID:23153006 | 2013 | this review only | Incidence of occlusal caries involving dentin (ICDAS 4 or higher) | not extracted yet |
| Uchil 2021 Clinical effectiveness of resin-modified glass ionomer-based fluoride varnish for preventing occlusal caries lesions in partially erupted… PMID:34379856 | 2022 | this review only | Incidence of occlusal caries involving dentin (ICDAS 4 or higher); Caries of adjacent second molars | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents with newly erupted primary or permanent molars who were caries-free at baseline | Children, mean age 4.5 years; 1,626 patients and 5,060 teeth (n=5) |
| Intervention | Fluoride varnish (FV) | Fluoride varnish (n=5) |
| Comparison | Conventional glass ionomer cement (GIC) sealant | Conventional GIC sealant (n=5) |
| Outcomes | Occlusal caries incidence (ICDAS >=4); caries of adjacent second molars; Visible Plaque Index; patient-reported anxiety and pain | Occlusal caries (n=4); second molar caries (n=3); VPI (n=3); anxiety and pain (n=2) |
| Study designs | Randomized controlled trials | RCTs: parallel group (n=4), split mouth (n=1) |
| Timing | Not specified | 12 to 24 months; single visit for anxiety and pain |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Partial Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |