Dentists are turning to silver diamine fluoride (SDF) to prevent caries in children and adults alike. Fortunately, researchers at the University of California, San Francisco (UCSF), found that topical SDF was safe and effective in arresting dental caries in preschool children. Meanwhile, researchers at Rio de Janeiro State University agree that SDF is efficacious for caries prevention, compared to fluoride varnish.
The UCSF study was a Phase III multi-site double-blinded randomized placebo-controlled trial with a pair of parallel groups and primary endpoint of caries inactivity 14 days after the intervention. Conducted in community settings in Oregon, 36 subjects were treated with a placebo, while 30 were treated with SDF. The researchers completed follow-up evaluations of 64 of the subjects.
The subjects treated with SDF showed a 0.72 mean fraction of arrested caries, while those who received a placebo only showed a 0.05 mean fraction, which the researchers called a significant difference. While there were 4 adverse events in each group, none were attributed to the SDF. The researchers then concluded that topical SDF was effective and safe in arresting dental caries in preschool children.
The Brazilian researchers reviewed 9 electronic databases, 4 registers of ongoing trials, and the reference lists of identified review articles to examine if SDF application results in caries prevention. They found 49 publications addressing randomized or quasi-randomized trials on SDF for caries prevention in primary teeth with at least 12 months of follow-up. After further review for potential bias, 4 trials met their inclusion criteria.
Two trials compared SDF to a placebo, one compared SDF to a placebo and to a sodium fluoride varnish, and one compared SDF to high-viscosity glass ionomer cement. After 12 months, glass ionomer cement was more effective than SDF, but the difference was not seen as statistically significant. After 24 months, SDF was more effective than the placebo and the sodium fluoride varnish. The researchers concluded, then, that SDF is an effective preventive treatment.
Jeremy Horst, DDS, PhD, of UCSF presented “RCT of Silver Diamine Fluoride for Caries Arrest in Children” and Branca Oliveira, DDS, of Rio de Janeiro State University presented “SDF for Caries Prevention in Primary Teeth: A Systematic Review” at the 95th General Session & Exhibition of the International Association for Dental Research at Moscone West in San Francisco in March.
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