Urinary fluoride excretion after application of fluoride varnish and use of fluoride toothpaste in young children.

BACKGROUND: The efficacy and safety of combined use of topical fluoride products are essential issues that must be monitored. AIM: To assess urinary excretion of fluoride after application of two different dental varnishes containing 2.26% fluoride in 3- to 4-year-old children and to compare the levels with and without parallel use of fluoride toothpaste. DESIGN: Fifteen healthy children were enrolled to a randomized crossover trial that was performed in two parts: Part I with twice-daily tooth brushing with fluoride toothpaste and Part II with twice-daily brushing with a non-fluoride toothpaste. After a 1-week run-in period, 0.1 mL of the two fluoride varnishes (Duraphat and Profluorid Varnish) was topically applied in a randomized order. Baseline and experimental urine was collected during 6-h periods. The fluoride content was determined with an ion-sensitive electrode. RESULTS: There was a statistically significant increase in the 6-h fluoride excretion after application of both experimental varnishes, with and without parallel use of fluoride toothpaste (P < 0.01). When fluoridated toothpaste was used, the mean fluoride excretion was 0.20 mg/6 h after application of Duraphat and 0.29 mg/6 h after application of Profluorid Varnish (P = 0.18). CONCLUSIONS: Topical applications of 0.1 mL of fluoride varnish significantly increased the 6-h fluoride excretion. As some individuals displayed excretion levels exceeding the optimal fluoride exposure, a restricted use of fluoride toothpaste in connection with the varnish applications would decrease fluoride exposure.