PDF: Effect of Fluoride Varnish in Caries Prevention on Permanent First Molars: A 36-Month Cluster Randomized Controlled Trial


The purpose of this study was to evaluate the effect of fluoride varnish in preventing dental caries of permanent first molars (PFMs).


Dental caries is among the most prevalent chronic diseases worldwide. The prevalence of dental caries varies among countries.

In China, data from the fourth National Oral Health Survey showed that the mean decayed, missing, and filled permanent teeth (DMFT) scores for 12-year-olds was 0.86 and the prevalence of dental caries was 38.5 percent.


Though the DMFT level at 12 years old was very low in China, the increasing rate of dental caries was 59.3 percent from 2005 to 2015.

“The Healthy China Plan for 2030,” issued by the General Office of the State Council of China, stated that the objective of this plan was to reduce the prevalence of dental caries in 12-year-olds to under 30 percent by 2025 and to 25 percent by 2030 which presents a significant challenge to dental professionals and the public. 

Previous studies found that over 90 percent of dental caries occurred on permanent first molars (PFMs) among schoolaged children, mainly affecting pit and fissures.



The time of tooth eruption for PFMs of children is approximately six years of age, with a mean 15-month duration of eruption. 

The eruption process is more caries susceptible due to dental plaque accumulation. Therefore, PFMs should be protected from the very beginning of tooth emergence.

The purpose of the present study was to evaluate the caries-preventive effect of the semi-annual application of fluoride varnish on permanent first molars in a 36-month study course, with a focus on the effect after 24 months. 

The null hypothesis was that there was no significant difference in the caries-preventive effect on PFMs between the test group and the control group over 36 months.

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