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The New Tooth Decay Treatment that Prevents Cavities and Keeps Existing Ones From Worsening

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An effective new treatment for tooth decay that fights decay-causing bacteria and remineralizes teeth to prevent further decay, according to a new study presented by researchers at NYU College of Dentistry today.

A new study conducted by researchers at NYU College of Dentistry unveils the efficacy of an affordable, cavity-fighting solution known as silver diamine fluoride (SDF) in preventing tooth decay, rivaling the effectiveness of dental sealants.

The research, which tracked over 4,000 primary school pupils for four years and was published in JAMA Pediatrics, found that SDF is an effective alternative to sealants that may improve access to dental treatment while lowering expenses.

Silver diamine fluoride, initially FDA-approved for treating tooth sensitivity, has emerged as a promising cavity-fighting treatment. Applied by brushing onto the tooth surface, this economical solution not only kills decay-causing bacteria but also facilitates remineralization, effectively preventing further decay.

This innovative approach holds promise in broadening access to preventive dental care and safeguarding the oral health of children, especially those with limited access to regular dental services.

“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,” remarked senior author Richard Niederman.

CariedAway, the biggest school-based cavity prevention project in the country, was spearheaded by researchers at NYU College of Dentistry to evaluate the use of SDF versus traditional sealants. Approximately 4,100 students from primary schools in New York City participated in the research; at the beginning of the trial, more than 25% of the students had untreated cavities.

Depending on which therapy the school was randomly allocated to receive, a team of medical experts evaluated children’s teeth at each visit and administered either sealants or SDF followed by fluoride varnish. Dental hygienists applied sealants, and registered nurses or dental hygienists applied SDF, all under the direction of a dentist.

The team began visiting each school twice a year in 2018, however, due to school closures and the COVID-19 epidemic, several trips were missed.

One application of sealants or SDF, according to a study published last year in the journal JAMA Network Open, prevented 80% of cavities and stopped 50% of already-existing cavities from becoming worse after two years. After two more years of research, the team’s findings were published in JAMA Pediatrics. They discovered that, after four years of follow-up with the kids, the number of cavities prevented by SDF and sealants was about equal. Furthermore, at every follow-up appointment, the risk of decay was decreased by both sealants and SDF.

“Our longitudinal study reaffirms,” said first author Dr. Ryan Richard Ruff, “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.”

“Most research,” according to co-author Tamarinda Barry Godín, “shows that SDF can stop a cavity from progressing further. Our study demonstrated that SDF can prevent cavities from happening in the first place.”

Adopting SDF in schools to prevent and treat cavities might avoid children from having fillings, saving money on families and the healthcare system. However, the success of these initiatives depends on the availability of sufficient medical personnel to provide treatment.

The NYU researchers discovered that children who had SDF application from registered nurses and dental hygienists saw comparable results, indicating that nurses, particularly school nurses, may be essential in cavity prevention initiatives.

“Nurses may be an untapped resource for addressing oral health inequities,” commented Ruff. “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.”

Source: 10.1001/jamapediatrics.2023.6770

Image Credit: ©Sorel: Courtesy of NYU Photo Bureau

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