Effectiveness of School Fluoride Delivery Programs: A Community Guide Systematic Review

Details

• Personal Author:
  Alexander T ; Black VA ; Clark E ; Cofano LK ; Garcia RI ; Goddard A ; Griffin SO ; Grover J ; Hopkins DP ; Jones AA ; Kansagra SM ; Kottke TE ; Lense EC ; Lin M ; Naavaal S ; Scherrer CR ; Zokaie T
• Corporate Authors:
  Community Preventive Services Task Force
• Description:
  Introduction: Although preventable, dental caries remains highly prevalent. Many children do not receive preventive dental services routinely in clinical settings. This review examined the effectiveness of school (preschool through high school) fluoride varnish delivery programs (SFVDP) in preventing caries. Methods: Community Guide systematic review methods were followed. In 2024, databases were searched for studies published through December 2023 on SFVDP effectiveness in increasing fluoride varnish (FV) receipt and decreasing caries. Included studies had to be written in English, published in peer-reviewed journals, and conducted in upper-middle or high-income countries. Data synthesis conducted in 2024 used median RR and interquartile interval (IQI) to summarize findings across studies. Results: Of 31 included studies with 60,780 students, 25 were randomized controlled trials-20 with good quality of execution. Most studies were conducted in low socioeconomic status (SES) areas among students at elevated caries risk. SFVDP reduced caries initiation by 32% (IQI: 21%, 37%) in permanent teeth (19 studies, 25,826 students) and by 25% (IQI: 4%, 37%) in primary teeth (12 studies, 4,304 students). Stratified assessments indicated findings were largely applicable to different settings, populations, and intervention characteristics. Two studies found SFVDP significantly increased the number of annual FV applications and two found that SFVDP effectiveness was inversely related to SES. Discussion: About 30% of states report having no SFVDPs. Possible barriers to implementation include that Medicaid in some states only reimburses dental and medical professionals and does not reimburse non-dental providers for FV delivered to children older than 6 years. [Description provided by NIOSH]
• Subjects:
  Community Health Services Occupational Health Preventive Medicine Safety
• Keywords:
  Children Community Health Dental Disorders Dental Health Fluoride Preventive Medicine Systematic Reviews
• ISSN:
  0749-3797
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Atlanta Region [OSHA] ; Boston Region [OSHA] ; Chicago Region [OSHA] ; Connecticut ; District of Columbia ; Georgia ; Illinois ; Maryland ; Massachusetts ; Minnesota ; Nevada ; North Carolina ; Philadelphia Region [OSHA] ; San Francisco Region [OSHA] ; Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• NIOSHTIC Number:
  nn:20070813
• Citation:
  Am J Prev Med 2025 Apr; :[Epub ahead of print]
• Contact Point Address:
  Susan O Griffin PhD, Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA
• Email:
  susanandpaulgriffin@hotmail.com
• CAS Registry Number:
  Fluoride (CAS RN 16984-48-8)
• Federal Fiscal Year:
  2025
• Peer Reviewed:
  True
• Source Full Name:
  American Journal of Preventive Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3b6998ccbed8d7ad15d0dd52a9c09fc5b8b9a8efa73a207c3c03c7b189b8a55e1ba6475e84ff4b9207e8a0483f9005de826e36933fe747b95829c647ac2f425a
• Download URL:
  https://stacks.cdc.gov/view/cdc/208963/cdc_208963_DS1.pdf
• File Type:
  [PDF - 975.65 KB ]