Fluoride Varnish and Gel
Is applying a fluoride varnish or gel on teeth with plaque and calculus effective or should the tooth surface be cleaned prior to the application?
Great question! All calculus should be removed, but it is not necessary to remove plaque biofilm before a professional fluoride application. The recent American Dental Association Report on Topical Fluorides concluded that there is no added caries control benefit from performing a prophylaxis prior to topical fluoride application.1 In fact, the presence of biofilm provides a physical retentive factor allowing the fluoride to remain in the oral cavity for an extended period. So, if you have a patient who may need to return a week or two after his or her prophylaxis for a fluoride application, it is not necessary to remove the biofilm before the application.
Reference 1. Weyant RJ, Tracy SL, Anselmo T, et al. Topical fluoride for caries prevention: Executive summary of the updated clinical recommendations and supporting systemic review. J Am Dent Assoc. 2013;144:1279–1291.