Therapeutic fluoride varnishes: There has to be a better way

An inside look at Pulpdent’s Embrace Varnish and what it can do for your patients and your practice.

Fluoride varnish: when we think of this type of product as oral health professionals, we think of the gritty sensation many of the varnishes create once they are applied and interact with saliva.

How often have you heard a patient say, “I came in to have my teeth cleaned, and now I’m leaving with them feeling more ‘fuzzy’ than they were when I walked in”?

It seems that the benefit of applying a fluoride varnish gets put on the back burner by our patients because of this “fuzzy” feeling from our conventional varnishes.

Until now, the resin in these products has been very thick, and when applied it left a thicker coating than we would like. That’s just the way it has been. You can see this when you open the fluoride varnish. In the “tub” that contains the varnish there is often a brownish film floating on top of a thicker whitish paste.

The brown liquid is the resin and solvent components of the varnish, and the white paste-like material is the fluoride and other ingredients. 

To use those varnishes correctly, you must first mix the two materials together into a uniform mixture so the fluoride component is remixed into the resin varnish. This is 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.

Often times you must mix the varnish with the handle of the brush before you dip the brush into the varnish; otherwise, the brush will become saturated with resin and leave behind the fluoride, and you will not get the benefit of the fluoride application on the teeth. For those varnishes to work well, they must be placed on thick to allow the fluoride to eventually be released from the varnish.

How much fluoride is really released? Can it be released effectively to really be therapeutic? Ideally, fluoride release from our varnishes should occur between 3-4 hours after dental cleaning for optimal uptake by enamel.

However, independent studies have shown that many of these fluoride varnishes release little fluoride. Additionally, calcium and phosphate release has been shown to be important in the remineralization process as well. Many varnishes available today do not contain or release these ions to a great extent. Where can we turn for help and to bring a benefit to our patients?

One option today is provided by Pulpdent’s Embrace™ Varnish 5% Sodium Fluoride with cXp™. This bioactive material is unique in many ways.

First, it contains calcium and phosphate salts that are nano-coated with xylitol. This nano-coating prevents the calcium and phosphate salts from reacting while stored in the package. They only become active and bioavailable 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.

Second, Embrace Varnish with cXp has been shown to demonstrate sustained optimal release of fluoride over a 4-hour period.

Third, there is no separation of the resin and the fluoride in this product, so there is no need for mixing prior to placement. This means there is a consistent dosage of therapeutic material every time you reach for Embrace Varnish with cXp.

Finally, the product tastes good, spreads to a thin film without clumping up, has a smooth, non-gritty texture, and contains no gluten or soy-based products. This material truly is a patient pleaser.

Want more tips to help grow your practice? Check out this Morning Huddle video from Jameson Management: