A comparison of the costs and patient acceptability of professionally applied topical fluoride foam and varnish

J Public Health Dent. 2004 Spring;64(2):106-10. doi: 10.1111/j.1752-7325.2004.tb02736.x.


Objectives: In Canada and the United States, professionally applied topical fluorides (PATF) are usually applied as a gel or foam. However, fluoride varnish has also been found to be effective for caries prevention and may be a preferred method because less time is required and fluoride exposure can be better controlled. The goal of this study was to compare the costs and patient acceptability of two methods of PATF (foam and varnish).

Methods: The study population was a convenience sample of high-risk children from the York Region and the city of Hamilton, Ontario, Canada, who had been identified as requiring fluoride therapy (n = 256). Children received from dental hygienists either fluoride foam applied in trays or fluoride varnish painted on tooth surfaces. An observer recorded the time to perform each procedure, adverse outcomes, and the satisfaction of children with treatment.

Results: The varnish technique took significantly less time compared to foam (5.81 vs 7.86 minutes; P < .0001). Significant differences between procedure times were found in all age groups, but the largest difference was for children aged 3-6 years (5.22 vs 8.61 minutes; P < .0001). Signs of gagging were observed in a lower proportion of participants who received varnish (3.8% vs 15.1%; P < .01), and this difference was largest for children aged 3-6 years (2.6% vs 29.7%; P < .01). The cost per varnish application, for children aged 3-6 years, was substantially less after labor costs were considered (dollar 3.43 vs dollar 4.43, CDN).

Conclusions: Varnish applications were found to take less time and resulted in fewer signs of discomfort. These results support the use of fluoride varnish in caries prevention programs, especially for younger children.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Attitude to Health*
  • Cariostatic Agents / administration & dosage*
  • Cariostatic Agents / economics
  • Child
  • Child, Preschool
  • Dental Caries / prevention & control
  • Dental Caries Susceptibility
  • Dosage Forms
  • Fluorides, Topical / administration & dosage*
  • Fluorides, Topical / economics
  • Gagging / physiology
  • Health Care Costs
  • Humans
  • Lacquer / economics
  • Ontario
  • Patient Satisfaction
  • Time Factors
  • Treatment Outcome


  • Cariostatic Agents
  • Dosage Forms
  • Fluorides, Topical