A simple treatment, applied directly to the cavity, could reduce the number of dental interventions for young children. Researchers say the method is safe and could prevent many procedures that involve drilling, injections or anesthesia.
Most of the time, many small children reach the dentist only when the caries are so advanced that the treatment involves burs, local anesthesia or even sedation. In serious cases, some are operated under general anesthesia, which entails some risks, and in Romania there have already been several cases resulting in the death of children.
However, a study carried out in the United States shows that there is a much simpler alternative, which could stop the evolution of caries before such interventions are needed, informs medicalxpress.
It is silver diamine fluoride (SDF), a solution that has been used for several decades in many countries and is applied directly to the cavity. The treatment, whose role is to stop the evolution of caries, is practically carried out in just a few seconds and does not involve removing the affected tissue with a bur, anesthesia injections or sedation of the child.
The solution is applied with a small sponge-tipped applicator, and the procedure only takes a few seconds for each affected tooth. Unlike conventional treatment, the doctor does not remove the affected part of the tooth before application, and there is no need for a filling at that time.
Promising results
Although dentists have been using this treatment for decades in many states, in the US it has only been used “off-label” since 2014, that is, outside of the officially approved indications for treating caries.
The product was originally licensed to reduce tooth sensitivity, but until now there was not enough clinical evidence obtained in the American population for the Food and Drug Administration (FDA) to approve its use in the treatment of cavities.
The new data comes from a phase III clinical trial led by the University of Michigan and published in the journal JAMA Pediatrics.
The research included 830 children under the age of six recruited through dental and pediatric practices, as well as Head Start and Early Head Start programs in the states of Michigan, New York, and Iowa.
The results show that the application of a solution of silver diamine fluoride in a concentration of 38%, repeated every six months, was able to stop the development of caries in more than half of the affected baby teeth.
Advantages and disadvantages
“This is a very effective and safe treatment, even at children of only 1 year“, said Margherita Fontana, a professor at the University of Michigan School of Dentistry and the study’s coordinator.
According to her, the benefits of the treatment are not limited to young children. The solution can also be an option for the elderly, patients with physical or developmental disabilities, those who suffer from severe anxiety about dental treatments, but also for people who have difficult access to dental services.
However, the treatment also has a downside. The silver in the composition of the solution permanently colors the area affected by caries in black, which can be an inconvenience from an aesthetic point of view.
For some children, the researchers say, reapplying the solution every few months may be enough to keep decay under control until the baby tooth falls out naturally. For adults, treatment can be either a long-term solution or a temporary solution until a dental restoration becomes possible.
“For almost anyone, this can stop the decay, the infection and the pain it causes. This could benefit a lot of people.” concluded Margherita Fontana.
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