PART I: THE PROBLEM
How many times have dental professionals heard something like this from a patient:
“I came in to have my teeth cleaned, and now I’m leaving with them feeling fuzzier than they did when I walked in!”
This “fuzzy feeling” comes from the application of conventional fluoride varnishes that produce an unpleasant gritty sensation, which occurs after the product interacts with saliva. Perhaps most unfortunately, the fuzzy aftermath from these traditional varnishes diminishes the benefits of fluoride in the minds of the patients. Who could really blame them, though? The thick, gritty consistency leaves a displeasing coating on the teeth that would irritate most anyone.
Clinicians can see that traditional varnish products are not a uniform, well-mixed consistency. Upon opening the varnish packet, one often observes a brownish film floating atop a thicker whitish paste. What is that stuff?
- The brown liquid consists of the resin and solvent components of the varnish
- The white paste material contains the fluoride and remaining ingredients
To use these varnishes correctly, the separate components must first be mixed together into a uniform mixture with an even distribution of fluoride.This is much like shaking up oil and vinegar in a cruet before pouring it on your salad.
If it’s not mixed well, it tastes funny. The same thing happens with these types of fluoride varnishes – if they are not mixed well, they won’t work properly.
PART II: THE SOLUTION
Now that we know the issue, we can move on to learning how to achieve a properly uniform dose, how much fluoride is ideal, and more!
Achieving a Uniform Dose
To get a uniform dose, the clinician should mix the varnish with the handle of the brush before dipping the brush head in. If this step is omitted, the brush will become saturated with resin, rendering it unable to pick up fluoride and resulting in the patient not getting the proper dose or the full benefit of the fluoride application.
The Facts About Fluoride
Ideally, fluoride release from varnish should occur between 3-4 hours after treatment. This is a reasonable amount of time to expect the varnish to remain in contact with the teeth, taking both the nature of the material and patient behavior into consideration.
In addition to fluoride, calcium and phosphate release is known to be important in the remineralization process. Several varnishes available in today’s market do not contain or release a significant amount of these favorable ions during the anticipated treatment period. There are, however, varnishes available that deliver the full benefit of fluoride and other important minerals to patients.
Embrace Varnish 5% Sodium Fluoride w/CXP – Shop
Embrace Varnish has been shown to demonstrate sustained optimal release of fluoride over a 4-hour period. It boasts a unique bioactive formula that provides multiple benefits and addresses many of the common issues that arise with other varnishes.
Let’s get “sciencey” for a moment: This product contains bioavailable calcium and phosphate salts that are nano-coated with xylitol. The xylitol-coating prevents the calcium and phosphate salts from reacting while stored in the package. They only become active when exposed to saliva. Saliva dissolves the xylitol and releases the calcium and phosphate ions, which can then react with the fluoride ions to form a protective fluorapatite precipitate on the enamel!
Furthermore, there is no separation of the resin and the fluoride in Embrace, so mixing is not required prior to placement – you can save those skills for your salad’s vinaigrette this evening! Lastly, Embrace Varnish has a pleasant, fruity taste, spreads to a thin film without clumping up, has a smooth, non-gritty texture, and contains no gluten or soy-based products. These patient pleasing attributes ensure patient compliance, and best of all, the full benefits of the fluoride varnish.
Have you had close encounters of the gritty kind, when attempting to mix up a batch of conventional fluoride varnish? Has your practice tried Embrace’s product? Feel free to share your experience with us in the comments below!
Author Credit: Karen L. Comisi, RDA