Fluoride Varnish For The Prevention Of White Spot Lesions During Orthodontic Treatment: A Systematic Review And Meta-Analysis

Prim Dent J. 2025 Mar;14(1):82-90. doi: 10.1177/20501684251327612. Epub 2025 May 13.

Abstract

Background and aim: White spot lesions are a potential side effect of orthodontic treatment. This occurs frequently, with a prevalence ranging from 50% to 90%. The lesions typically occur on the labial surface of the gingival region of the tooth. Caries prophylaxis requires use of soluble fluoride to prevent demineralisation and stimulate remineralisation of enamel and dentine. The administration of fluoride varnish is a controlled and professional way of delivering high-fluoride concentrations that do not rely on patient compliance. This meta-analysis will assess the effectiveness of fluoride varnish in avoiding white spot lesions in orthodontics.

Materials: A thorough search was conducted on PubMed/Medline, Scopus, and Google Scholar databases using advanced search strategies, appropriate operators, and tags based on the title and abstract. Two reviewers worked independently to extract data and ensure accuracy and consistency.

Results: Eight randomised control trial articles involving 654 individuals were included. The findings revealed that fluoride varnishes significantly reduced white spot lesions on teeth. Patients who were treated with this substance had visibly reduced lesions (weighted mean difference = -0.54, 95% confidence interval = [-1.01 and -0.07], P < 0.001, I2 = 85.9%).

Conclusion: Fluoride varnish significantly reduces the incidence of white spot lesions, but high heterogeneity among studies suggests cautious interpretation of the results.

Keywords: Fluoride; meta-analysis; orthodontic treatment; varnish; white spot lesions.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Cariostatic Agents* / therapeutic use
  • Dental Caries* / etiology
  • Dental Caries* / prevention & control
  • Fluorides, Topical* / administration & dosage
  • Fluorides, Topical* / therapeutic use
  • Humans

Substances

  • Fluorides, Topical
  • Cariostatic Agents