Nick Barker, BDS MSc MFGDP (UK) PGCertMedEd discusses the benefits of fluoride varnish in the treatment of hypersensitivity
Hypersensitivity is a common complaint of many of my patients and has a number of underlying causes including caries, gingival recession or when fillings start to leak. This chronic oral pain condition can significantly impact on the quality of patients’ lives and is one of the most common reasons for visiting a dentist or hygienist.
If there are any concerns in relation to restorative or periodontal treatment or anything in the mouth that looks suspicious and could be causing the sensitivity, the application of fluoride varnish is a valued solution and is particularly good for repeated treatments. Patients complaining of sensitivity tend to have more than one sensitive tooth, so they often return for treatment in different areas of the mouth.
Fluoride varnish can be applied wherever it is needed, to anterior or posterior teeth and to any tooth surface, both above and below gum level. If there is exposed root above the gum level fluoride varnish is applied using a brush in exactly the same way as for a regular tooth surface. For sub gingival treatment, varnish should be applied using either a scaling or periodontal instrument to place the varnish into the pocket or by using a brush to work it around the sensitive area.
The use of fluoride varnish contributes to better oral health because it holds so many advantages. Its ability to hold a high concentration of fluoride in close contact with the teeth for several hours, effectively seals the dentinal tubules and so reduces sensitivity. This minimally invasive approach to dentistry is particularly effective for younger patients as it reduces the need for future fillings or other procedures as well as acting as a good behaviour management tool to introduce them to dentistry.
One of the disadvantages of older, conventional varnishes is that they have caused aesthetic challenges by leaving a yellow tone on patients’ teeth which takes time to fade, causing embarrassment especially when applied in the anterior region. However, one of the joys of the latest generation of fluoride varnish such as NUPRO® 5% White Varnish (Dentsply Sirona) is that it is white in colour during application, making it easily visible, but when cured the varnish is clear. This vastly improves the aesthetics and allows patients to resume normal life immediately after leaving the surgery.
When treating hypersensitivity, we are looking for a fluoride varnish that is easy to handle, comfortable to apply for the patient and delivers fast aesthetic results. Dentsply Sirona’s NUPRO Varnish can be applied to a wet tooth surface, which eliminates the often painful need to dry the tooth surface, and does not require prophylaxis treatment before application. In comparison to other fluoride varnishes its handling characteristics are good, it is easy to apply, effective inn reaching hard to access interproximal areas and spreads evenly on the tooth surface, leaving a uniform layer. It’s helpfully thixotropic and once applied it stays in place with minimal or no stringing or clumping. Less viscous varnishes do not adhere as well and have a tendency to run, but NUPRO Varnish spreads easily without going gloopy like some other varnishes I have used.
Eliminating the time needed to dry the tooth quickens the entire procedure, and the fast-curing nature of the material means patients can eat and drink again within just two hours, half the time of some other varnishes and a particular advantage when treating children*. A nice touch that helps with patient acceptability is that the varnish is available in a range of flavours that appeal to both adults and children. Patients can choose the flavour they prefer along with a warning from me not to enjoy it too much and try to lick it off!
I use fluoride varnish routinely as a fast, easy and effective treatment to prevent hypersensitivity for all patients. It slows down the development of decay by stopping demineralisation and makes enamel more resistant to acid attack from plaque bacteria, providing long-lasting relief to the problem of tooth sensitivity during and after dental treatment. Incorporating this procedure into your treatment offering can provide significant benefits and ensures that your patients are receiving the highest standard of care.
It should be appreciated that NUPRO Varnish is not classed as a ‘Prescription Only Medicines’, unlike some of the fluoride varnishes and, therefore, is not governed by the rules governing the use of such when applied in the fashion recommended by the manufacturer. What this means is that any dental professional can apply the fluoride varnish provided they can demonstrate appropriate training and the requisite, current skills and competencies to do so. This would include both Dental Nurses and Orthodontic Therapists with Extended Duties training who are following the prescription from a dentist, whereas Dental hygienists and Dental therapists can provide fluoride applications direct to the patient under the 2013 rules from the General Dental Council under Direct Access.
To find out more about NUPRO 5% White Varnish contact Dentsply Sirona on 0800 072 3313 or visit www.dentsplysirona.com or visit them on Stand K40 at Dental Showcase.
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*Data available on request