Consider this: Approximately half of US adults experience tooth sensitivity. Ninety-one percent of US adults with dental decay are between the ages of 20 and 64. More than four million people in the United States wear braces, and of those, 25% are adults.
Now, consider these things we know as dental professionals: Long-term benefits can be realized when fluoride varnish treatment is used for patients with sensitive teeth or dental decay. Despite this, practices still struggle to convince adults they should undertake fluoride varnish treatment. How many times have you heard patients say that they don't want fluoride treatments following their hygiene visits?
Fortunately, it doesn't have to be this way. You and your dental hygienists have a tremendous opportunity to change how adults perceive the use of fluoride varnish. Following is a three-pronged approach that is effective for introducing fluoride varnish treatment to adults who have risk factors for sensitivity, enamel erosion, and decay. But first, here's a brief look at the benefits of fluoride varnish treatment.
We've known for years that individuals with diabetes, acid reflux, heart disease, or autoimmune disease are more likely to have compromised dental health. The same is true for people who undergo radiation treatment, take medication that causes dry mouth, vape, smoke tobacco products, or use a hookah. If you combine these risk factors with the nutritional deficiency we see among our patients, it is easy to see why there is a prevalence of tooth decay, enamel erosion, and sensitivity.
Fluoride varnish treatment has long been known to help reduce hypersensitivity along the cervical margins, improve enamel resistance against acid, provide long-term caries prophylaxis, reduce the incidence of caries among high-risk patients, and treat sensitivity after tooth whitening. In fact, the American Dental Association recommends fluoride applications up to every three months for high-risk patients.
Today's fluoride treatments
To ensure easy delivery, today's fluoride varnish products are conveniently packaged for immediate use. Fluor Protector and Fluor Protector S (Ivoclar Vivadent) are two such products that I will use as examples.
Modern fluoride varnish products provide instant fluoride availability and protection. Fluoride varnish can be applied in a single appointment (Fluor Protector) or over the course of several appointments (Fluor Protector S).
Targeted options, discussions
Many factors contribute to the decision to recommend fluoride varnish treatment to a patient. These include ease of application, patient comfort, convenience, effectiveness, and the willingness of patients to pay when insurance will not.
Today's products enable applications (multi- or single-dose) in hard-to-reach areas . For example, Fluor Protector, a protective 0.1% fluoride varnish, will spread easily, flow readily into complex surface structures, dry quickly, and show excellent adhesion to teeth. The product has been shown to be effective in numerous international studies. Similarly, Fluor Protector S features 7,700 ppm fluoride in a homogeneously dissolved solution to ensure immediate fluoride availability. Its low viscosity contributes to optimum flow and wetting properties. This enhances ease of use and application efficiency.
Considering the number of adults who could benefit, it's more important than ever to talk it. Focus on long-term oral health goals because many adults believe fluoride varnish treatment is "just for kids." Moreover, patients don't know that dental insurance hasn't caught up with the times. Clinicians can emphasize that good oral health can depend on preventive treatments such as fluoride varnish.
Explaining the risks of not using fluoride varnish treatment is one thing. Convincing patients to accept it is another. Here are three ways you can team up with your hygienists to successfully discuss fluoride treatments with patients.
First, review health history
Although some patients might be reticent with health histories and habits, compassionately ask questions—as well as ask permission to do so. No one is better suited to this than hygienists, who often know patients the best. Asking the right questions will establish a foundation of trust and understanding.
Consider patients who require maintenance medications. They may be prone to dry mouth and its related consequences, and unaware of its harmful effects over time. Help them they understand that the consequences occur through no fault of their own, even when they practice meticulous oral hygiene.
Hygienists are in a great position to understand patient needs and concerns. By explaining that fluoride varnish delivers superior protection against erosion, caries, and sensitivity, patients will be more receptive.
Second, discuss lifestyle
Remember, most patients are unaware that consuming highly acidic beverages and foods erodes enamel. If dietary changes are not in a patient's future, then your hygienist can take the opportunity to explain how fluoride varnish treatment will help in the long run. Your hygienist can explain how erosion ultimately leads to the need for costly restorations.
Talking about the convenience of today's products can also help. For example, Fluor Protector is clear, colorless, and fast-drying. It can be applied in one appointment, twice yearly (such as during routine hygiene appointments) for superior protection.
Keep in mind that previous generations of fluoride varnish left an undesirable sheen on teeth. Patients were also restricted from normal activities until the varnish dried. But with modern options, patients will not feel embarrassed when they smile after receiving treatment. What's more, because today's varnishes are designed to stay in place, patients will get superior protection from 1,000 ppm fluoride uptake into their teeth.
Third, explain benefits
Your hygienist can nonjudgmentally provide patients with facts about how fluoride varnish will help in three key areas: preventing caries, relieving sensitivity, and protecting against acid erosion. If patients still seem reluctant, mention that today's options have a mild flavor and smell, unlike many previous varnishes, and that they deliver about four times the concentration of fluoride after setting. Moreover, because their enamel will be directly supplied with fluoride, patients will definitely be getting their money's worth in protection.
As advocates, hygienists can guide their patients toward understanding the "why" behind recommendations. When hygienists incorporate health histories and habits into conversations, they can better engage patients in personal stories of ongoing preventive care. Products such as Fluor Protector and Fluor Protector S that are easy to apply and maximize fluoride benefits are welcome additions to our armamentarium. It all adds up to greater adult patient acceptance of fluoride varnish treatment, a win-win for practices and patients.
Article first published in 2016. Updated July 2022.
Anastasia Turchetta, RDH, is a registered dental hygienist of many years. Her brand is America's Dental Hygienist. She is a speaker, author, and video blogger. A recipient of the Top 25 Women in Dentistry award, Anastasia delivers an empowering message of health in a fun way across the country.