Topical solution halts tooth decay in children


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Friday, March 8, 2024

Research funded by the National Institutes of Health found that a non-invasive application of diamine silver fluoride was better than a placebo.

A topical liquid, silver diamine fluoride (SDF), can stop tooth decay in young children, according to a large clinical trial funded by the National Institutes of Health.Preliminary results were published in pediatric dentistry, Studies have shown that 54% of cavities stopped progressing after SDF treatment, compared to 21% with placebo. The research was funded by the National Institute of Dental and Craniofacial Research (NIDCR), a division of the National Institutes of Health (NIH).

SDF is approved by the U.S. Food and Drug Administration to treat tooth sensitivity and off-label to treat cavities (also called cavities or cavities). It can be easily and painlessly wiped onto cavities and has been widely used in other countries for decades to treat cavities. Research shows that the silver in SDF helps stop tooth destruction by killing cavity-causing microorganisms, while the fluoride helps rebuild and strengthen teeth.

“Current treatment for severe early childhood caries relies on restoration and tooth extraction, which may require general anesthesia,” said lead researcher Dr. Margherita Fontana of the University of Michigan. “These interventions are expensive, cavities often recur, and anesthesia can have long-term effects on the developing brain. Until recently we didn’t really have any other options – SDF is a game changer.

The researchers recruited children ages 1 to 5 with severe tooth decay. An interim analysis of 599 children assessed the proportion of cavity lesions in which decay progression stopped six months after a single treatment with SDF or placebo.

To document SDF's effectiveness, researchers measured the hardness of cavities before and after treatment. When decay is ongoing, the affected part of the tooth becomes soft, and hardening of the area indicates that the decay has stopped. The team reported no safety concerns with the treatment. The trial was stopped early after a planned interim analysis showed the study had met its primary endpoint, showing that SDF was effective in halting the progression of tooth decay. Ending trials early allows particularly effective interventions to be approved by the FDA and made available to patients more quickly.

“FDA approval of SDF for the treatment of dental cavities may result in SDF being more widely used; more readily accepted by providers, patients, and parents; and more likely to be covered by insurance. “Increasing patient access to dental caries treatment will be most helpful Children in need are vital. “

Researchers are currently analyzing final data from more than 800 children, including assessing the impact of SDF on dental pain and quality of life, as well as potential side effects. Because SDF darkens cavities, which may be unsightly, researchers are also evaluating patient and parent satisfaction and acceptability. Although SDF appears to be quite effective, not every cavity responds to treatment. Scientists will use future research to find out why.

“Oral health problems, such as untreated tooth decay, can have many public health consequences for children and adults,” said NIDCR Director Rena D'Souza, DDS, PhD, MS. “This study provides evidence that SDF can A powerful tool in the fight against tooth decay to help improve children's health and well-being.

According to the Centers for Disease Control and Prevention, tooth decay is the most common chronic disease in children, affecting nearly 46% of children in the United States. It disproportionately affects Hispanic and non-Hispanic black children, as well as children from low-income families. If left untreated, tooth decay puts children at risk for chronic pain, impaired development, and long-term oral and overall health problems. In severe cases, tooth-infected bacteria can even spread throughout the body and cause death.

This research was supported by NIDCR grant UH3-DE027372. For more information about the trial, visit ClinicalTrials.gov and search for identifier NCT 03649659.

About the National Institute of Dental and Craniofacial Research: NIDCR is the leading funder of oral, dental, and craniofacial health research in the United States.

About the National Institutes of Health (NIH):NIH is a medical research agency in the United States, with 27 institutes and centers and is affiliated with the U.S. Department of Health and Human Services. NIH is the premier federal agency that conducts and supports basic, clinical, and translational medical research that is investigating the causes, treatments, and cures for common and rare diseases. For more information about the NIH and its programs, visit www.nih.gov.

NIH…translating discoveries into health®

refer to

Fontana M, Khera D, Levy S, Eckert G, Katz B, Yanca E, González-Cabezas C, Mours A. Pediatric Dentistry. 2024 Jan 15;46(1):8-12. Phone number: 38449039

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