Related Experiment Video
Updated: Apr 28, 2026
Evaluating the Effects of Different Polishing Methods on Color Stability of Dental Restorations in Pediatric Dentistry
Published on: June 6, 2025
Relative Effectiveness of School-Based versus Clinic-Based Fluoride Varnish Application
P-Y Lin1, J Wang2, D-Y Hsu1,3,4
1Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Insights
Clinic-based fluoride varnish (FV) application is more effective in preventing caries-related treatments for primary molars than school-based application. Dentists may recommend additional clinic-based FV services for children receiving only school-based applications.
Area of Science:
- Dental Public Health
- Pediatric Dentistry
- Preventive Dentistry
Background:
- Fluoride varnish (FV) application is a key preventive measure for early childhood caries (ECC).
- Evaluating the comparative effectiveness of different delivery settings (school-based vs. clinic-based) is crucial for optimizing oral health programs.
Purpose of the Study:
- To investigate the relative effectiveness of school-based versus clinic-based fluoride varnish (FV) application within a single public health program in Taiwan.
- To assess the association between FV application setting and the occurrence of caries-related treatments and ECC in primary molars.
Main Methods:
- A population-based analysis (Phase 1) using Taiwan's National Health Insurance Research Database (NHIRB) of 347,544 children born in 2015-2016.
- A fieldwork cohort (Phase 2) of 1,479 children examined for ECC, with data linked to NHIRB.
- Logistic regression analysis to determine associations between FV application setting and caries outcomes.
Main Results:
- School-based FV application was associated with significantly higher odds of dental restoration, endodontic treatment, and tooth extraction compared to clinic-based application (P < 0.0001).
- The risk of ECC was initially higher with school-based FV application (P < 0.05), but this association diminished after covariate adjustment.
- These differences were more pronounced in urbanized areas.
Conclusions:
- Clinic-based fluoride varnish (FV) application demonstrates superior effectiveness in reducing caries-related treatments for primary molars.
- Findings suggest that clinic-based FV application is more beneficial, especially in urban settings.
- Consideration should be given to supplementing school-based FV programs with clinic-based services for enhanced caries prevention.
Objective:
This study investigated the relative effectiveness of school-based versus clinic-based fluoride varnish (FV) application within a single program in Taiwan.
Methods:
Data for the phase 1 study (population-based analysis) were extracted from Taiwan's National Health Insurance Research Database (NHIRB). The phase 1 cohort included 347,544 children born in 2015 or 2016 who received FV application services at school, in a dental clinic, or in both settings. FV services were recorded using specific codes: 88 and 89 for school-based FV application and 81 and 87 for clinic-based FV application. During follow-up, primary molars were assessed for caries-related treatments. The phase 2 (fieldwork) cohort included 1,479 children examined for early childhood caries (ECC). Their data were linked to the NHIRB to obtain corresponding data on the FV application. In both phases, logistic regression was performed to determine the associations of application setting with the odds of caries-related treatments and ECC.
Results:
The odds of the following treatments were significantly higher with school-based FV application than with clinic-based FV application (all Ps < 0.0001): dental restoration (odds ratio [OR] = 1.09; 95% confidence interval [CI], 1.06-1.11), endodontic treatment (OR = 1.21; 95% CI, 1.16-1.26), and tooth extraction (OR = 1.33; 95% CI, 1.25-1.42). This difference was particularly prominent in moderately and highly urbanized areas. Furthermore, the risk of ECC was higher with school-based FV application (OR = 1.52; 95% CI, 1.10-2.11; P < 0.05) than with school-based FV application. However, after covariate adjustment, both groups had similar risk estimates (OR = 1.03; 95% CI, 0.71-1.50).
Conclusions:
Clinic-based FV application significantly reduces the likelihood of caries-related treatments for primary molars. Future studies should consider our findings when evaluating the effectiveness of FV application.Knowledge Transfer Statement:Compared with school-based FV application, clinic-based FV application significantly reduced the likelihood of caries-related treatments, particularly among children residing in urban areas. For children who received only school-based FV application services, dentists may recommend additional clinic-based FV application services. Our findings may guide future studies aimed at evaluating the effectiveness of FV application.
More Related Videos
05:30Roughness Impact of Piezoelectric Dental Scaler on Two Distinct Flowable Composite Filling Materials
Published on: January 10, 2025
07:42Quasistatic Mechanical Testing for Computer-Aided Design and Manufacturing Occlusal Veneers Cemented to Milled Dentin Analog Material
Published on: December 20, 2024