Preventing and arresting root caries through silver diammine fluoride applications

Abstract

Objectives: To describe the effectiveness of application of silver diammine fluoride (SDF) solution in preventing and arresting root caries in elders. Method: This study was conducted among community-dwelling elders aged over 55 years in Hong Kong. Elders having self-care ability for normal daily activities and at least 5 teeth with exposed root surfaces were randomly allocated into 3 groups to receive interventions as follows: Gp1 –oral hygiene instruction (OHI) only; Gp2 – OHI and annual application of SDF solution; Gp3 – OHI and annual application of SDF solution followed immediately by potassium iodide solution. Fluoridated toothpaste (1000 ppm) was provided to all subjects. Status of root surfaces was assessed at baseline and thereafter every 6 months by the same independent examiner.

Results: A total of 323 elders aged 56-87 years (mean=72.1) with 13676 exposed root surfaces were examined at baseline. After 12 months, 297 (92%) of the elders were reviewed. The mean numbers of root surface with new caries in Gp1 to Gp3 were 0.47, 0.18, 0.23, respectively (ANOVA, p<0.05). Elders received SDF and SDF followed by potassium iodide solution developed fewer new root surface caries than those only received OHI (Scheffe’s multiple comparison, p<0.05). The numbers of surface with active caries at baseline were 40, 54 and 62, in Gp1 to Gp3, respectively. The proportions of them been arrested 12 months after treatment were 22.5%, 44.4%, 66.1% in Gp1 to Gp3, respectively (X2 test, P<0.001). Pairwise comparisons showed statistically significant differences among all the pairs (P<0.05).

Conclusions: The initial 12-month results support that SDF solution is effective in preventing and arresting root caries. This clinical trial is on-going and longer term results will be reported later.

(Supported by Hong Kong Research Grants Council, grant #HKU773711M)

This abstract is based on research that was funded entirely or partially by an outside source: Hong Kong Research Grants Council, grant #HKU773711M