Study shows silver diamine fluoride helps children's teeth

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School dental programme prevents 80% of cavities with one-time, non-invasive treatment

Thu. 2 March 2023

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A study of nearly 3,000 school children has found that silver diamine fluoride, as well as sealants, protected against cavities. The liquid brushed onto the surface of teeth was as effective against cavities as dental sealants, the current standard of care. A single dose of either topical treatment given to primary school aged children was found to prevent around 80% of cavities, and kept 50% of cavities from worsening when the children were seen two years later.

Research conducted by experts at New York University explored caries prevention in children between the ages of four and nine. The findings, published in JAMA Network Open, presents an efficient and cost-effective approach to improving children’s oral health.

Dental cavities are the most common chronic disease in children, and children from low-income families are at higher risk than those from higher-income families. The randomised trial of 2,988 children in schools in New York City compared the effectiveness of two cavity prevention techniques: A ‘simple’ treatment using silver diamine fluoride (SDF) and fluoride varnish, and a ‘complex’ treatment using traditional glass ionomer sealants and fluoride varnish. Both are non-invasive and applied to the surface of teeth to prevent and arrest cavities in children, but for the same time and cost, dental professionals can treat more children with the simpler SDF therapy.

Upon visiting each school, the clinical research team, which included a supervising dentist, dental hygienists, registered nurses, and assistants, did baseline exams to measure any tooth decay, and then applied fluoride varnish and either sealants or SDF, depending on whether the school was assigned to receive the complex or simple treatment.

The researchers found that both the simple and complex treatments were successful. Just one cavity prevention treatment prevented more than 80% of cavities (81% for SDF and 82% for sealants) and stopped half of cavities from progressing (56% for SDF and 46% for sealants).

"Without prevention, dental cavities grow continuously if not treated. One cavity prevention treatment was remarkably effective over the following two-year period," said Richard Niederman, DMD, professor in the Department of Epidemiology & Health Promotion at NYU College of Dentistry, co-principal investigator and the study's senior author. "I know of no other dental preventive intervention that had this great a beneficial impact across the pandemic."

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