138 THE EFFECTIVENESS OF A FLUORIDE VARNISH IN PREVENTING THE DEVELOPMENT OF WHITE SPOT LESIONS A prospective examination of 10 consecutively treated orthodontic patients was undertaken to examine the effectiveness of fluoride var- nish in reducing enamel demineralization. Pairs of dental quadrants for each patient’s mouth (ie, maxillary right and mandibular left; max- illary left and mandibular right) were randomly assigned to an experi- mental or control group. After placement of resin-bonded orthodontic brackets, fluoride varnish was applied to the 2 experimental dental quadrants for each patient. Subsequent applications were done every 3 months during 12 months of orthodontic treatment. A double- blinded examination of intraoral photographs of the 100 experimental and 100 control teeth was done. The presence of white spot lesions was registered using the enamel decalcification index and the 2 groups were compared using paired Student t tests with a signifi- cance level of 5% (P < .05). There was no statistically significant dif- ference between the mean enamel decalcification index for the con- trol and experimental groups before or after treatment, since demineralization increased for both groups. Most importantly, the change in mean enamel decalcification index was significantly smaller for the experimental group (0.34), compared to the control group (0.51). In other words, there was 44.3% (P < .05) less deminer- alization noted for teeth that had been treated with fluoride varnish during orthodontic treatment. World J Orthod 2006;7:138–144. Gustavo Vivaldi-Rodrigues, DDS 1 Carina Faleiros Demito, DDS 2 S. Jay Bowman, DMD, MSD 3 Adilson L. Ramos, DDS, Msc, PhD 4 I t is accepted knowledge that orthodon- tic treatment with fixed appliances pre- disposes patients to a larger accumula- tion of bacterial plaque and, therefore, to enamel demineralization lesions. This is due to the mechanical interference imposed by the orthodontic appliances, making adequate oral hygiene more dif- ficult. Consequently, enamel demineral- ization lesions, resulting from the disso- lution of the enamel, can appear within only a few weeks after appliance place- ment. 1–3 These enamel scars can vary from microscopic alterations to visible “white spot lesions” that may reach cavi- tation. 2 The presence of these lesions is not typically noted until the removal of orthodontic appliances and has been reported to be a frequent event. 4,5 As a consequence, these scars present a dis- couraging result for a specialty whose objectives are to improve facial and den- tal esthetics. Several authors have suggested pre- ventive methods to combat these dental scars. For example, patient motivation and oral hygiene instruction, as well as home use of fluoride supplements have been demonstrated to be effective. 6,7 The prescription of a 0.05% solution of 1 Private practice of Orthodontics, Curitiba, Brazil. 2 Graduate student, Orthodontics, Dentistry Department, State Univer- sity of Maringá, Maringá, Brazil. 3 Adjunct Associate Professor, Depart- ment of Orthodontics, Saint Louis University, Saint Louis, Missouri, USA. 4 Adjunct Professor, Orthodontics, Dentistry Department, State Univer- sity of Maringá, Maringá, Brazil. CORRESPONDENCE Dr Adilson Luiz Ramos Arthur Thomas St., 831 Maringá-PR, Brazil 87013-250 Email: alramos@uem.br COPYRIGHT © 2005 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART OF THIS ARTICLE MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER.