Cheap tooth sensitivity liquid combats dental caries

Dental Tribune International

Wed. 10. April 2024

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NEW YORK, US: Silver diamine fluoride (SDF) has clearance by the US Food and Drug Administration for treatment of tooth sensitivity, and there is strong research interest in its off-label use to arrest dental caries. A study at the New York University College of Dentistry has now compared the efficacy of SDF with that of dental sealants as a primary intervention for the prevention and control of caries and found that it achieved comparable results in school-based caries prevention. According to the study authors, SDF presents a faster, less expensive treatment option that could reduce the need for invasive tooth preparation.

The four-year study focused on the local school population with the highest risk of caries, which was low-income minority children at primary schools where at least half of the enrolled students were Black or Hispanic. Participants were randomly assigned to receive either SDF or dental sealant and atraumatic restorative treatment, and a total of 4,100 children completed follow-up observation and were included in the final analysis. The baseline prevalence of caries was 27.2%, and decay prevalence was found to decrease over time across the study group. All participants were found to have a comparable crude incidence of caries, indicating that the rate at which new carious lesions occurred was similar across the study population.

Discussing the results, the authors pointed out that the demonstrated efficacy of school sealant programmes was undermined by their burdensome cost. “We conclude that SDF is an effective alternative for community-based prevention that may help address these existing barriers,” they wrote.

The research follows a two-year study by the same research team that was published in February 2023 in JAMA Network Open. It found that a single dose of SDF or dental sealant prevented 80% of caries and stopped 50% of existing caries from progressing.

Senior author of the study Dr Richard Niederman, professor of epidemiology and health promotion at the dental school, commented in a university press release: “A growing body of research shows that SDF—which is quicker to apply and less expensive than sealants—can prevent and arrest cavities, reducing the need for drilling and filling.” Co-author Dr Tamarinda Barry Godín, the research project’s associate director and supervising dentist, emphasised: “Most research shows that SDF can stop a cavity from progressing further. Our study demonstrated that SDF can prevent cavities from happening in the first place.”

Lead author Dr Ryan Richard Ruff, associate professor of epidemiology and health promotion at the dental school, said: “Our longitudinal study reaffirms that both sealants and SDF are effective against cavities. SDF is a promising alternative that can support school-based cavity prevention—not to replace the dental sealant model, but as another option that also prevents and arrests decay.”

At least 25% of the study participants who received SDF were treated by registered nurses, and Dr Ruff commented that the health professionals may be an untapped resource for addressing inequalities in oral care. “Our results suggest that nurses can effectively provide this preventive care, which could dramatically improve access, given the role of school nurses and the size of the nursing workforce,” he said.

The study, titled “Noninferiority of silver diamine fluoride vs sealants for reducing dental caries prevalence and incidence: A randomized clinical trial”, was published in the April 2024 issue of JAMA Pediatrics.

Topics:

Preventive Dentistry

Tags:

Caries management Dental research Paediatric dentistry Prevention

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