A large US trial has found that silver diamine fluoride can arrest tooth decay in more than half of affected baby teeth when applied every six months.
The Phase III study, published online in JAMA Pediatrics, included 830 children under the age of six with severe early childhood caries. Researchers tested 38% silver diamine fluoride (SDF), a low-cost liquid applied directly to cavities without drilling, injections or sedation.
At six months, 54.0% of lesions treated with SDF had arrested, compared with 22.5% in the placebo group. At eight months, arrest rates were 50.2% for SDF and 17.4% for placebo.
The authors said the findings provided evidence that could support a future Food and Drug Administration (FDA) application for SDF as a treatment for dental caries in children.
Margherita Fontana, professor of dentistry at the University of Michigan School of Dentistry and lead investigator, said the treatment was effective and safe, including in children as young as one.
Researchers said SDF could be particularly useful for very young children, patients with dental anxiety, people with developmental or physical disabilities and those with limited access to conventional dental care.
However, SDF has a visible drawback, with the silver permanently turning the decayed part of the tooth dark.
SDF usage in UK dentistry
While the study was designed to support a US FDA application, the findings will also be of interest to UK clinicians using SDF as part of minimally invasive caries management, particularly for young children and patients who may struggle with conventional restorative treatment.
Amr Moursi, professor of paediatric dentistry at New York University College of Dentistry and co-principal investigator, said: ‘Our results support FDA approval of SDF for managing arrest of tooth decay in young children.’
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