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.

Copyright © 2025. Published by Elsevier Inc.

简介：尽管可以预防，龋齿仍然普遍存在。许多儿童在临床环境中并未常规接受预防性牙科服务。本综述评估了学校（从幼儿园到高中）氟化物漆项目（SFVDP）在防止龋齿方面的有效性。

方法：遵循社区指南系统审查的方法。2024年，数据库搜索截止至2023年12月发布的关于SFVDP有效性的研究，这些研究旨在增加氟化物漆的接受度并减少龋齿的发生。纳入的研究必须用英语撰写，并发表在同行评审期刊上，且研究应在中高收入或高收入国家进行。2024年的数据分析使用中位数相对风险（RR）和四分位区间（IQI）来总结各研究的结果。

结果：31项纳入的研究共涉及60,780名学生，其中25项为随机对照试验，其中20项执行质量良好。大多数研究在低社会经济状态区域进行，并且参与者具有较高的龋齿风险。SFVDP使恒牙的龋齿发生率降低了32%（IQI：21%，37%），涉及19项研究和25,826名学生；对乳牙的影响则降低了25%（IQI：4%，37%），涉及12项研究和4,304名学生。分层评估表明，这些发现大多适用于不同的环境、人群和干预特性。两项研究表明SFVDP显著增加了年度氟化物漆的应用次数，而另外两项研究则指出，SFVDP的效果与社会经济地位呈负相关。

讨论：大约有30%的州报告没有实施SFVDP项目。可能的障碍包括一些州的医疗补助计划仅向牙科和医学专业人士支付费用，并不对非牙科人员为6岁以上儿童提供的氟化物漆服务进行补偿。

版权 © 2025. Elsevier Inc.出版。