Two topical treatments applied to kids’ cavities can stop the majority of them from progressing for years, according to a US study.
Treating more than 10,000 cavities in New York City elementary school students, researchers at NYU College of Dentistry found that both atraumatic restorations (ART) and silver diamine fluoride (SDF) kept most dental decay from worsening, supporting the use of non-surgical approaches for managing cavities.
They published their findings in JAMA Network Open.
In school-based dental programs, health professionals often use sealants—thin, protective coatings applied to the surface of children’s back teeth—to safeguard against tooth decay. But few programs address existing cavities.
ART can be used to stop the progression of cavities by removing tooth decay with hand instruments and applying the same protective material as sealants. SDF has also emerged as a promising tool for cavity prevention and treatment. The liquid is brushed onto teeth to kill decay-causing bacteria and remineralise teeth to prevent further decay.
To compare the use of SDF and ART, the team led a large clinical trial in New York City elementary schools as part of their CariedAway cavity prevention program. At twice-yearly school visits, health professionals examined children’s teeth and applied either ART or SDF followed by fluoride varnish to any existing cavities, depending on which treatment the school was randomly assigned to receive.
In a previous analysis of the CariedAway study, NYU researchers reported that a single treatment of either ART or SDF kept approximately 50 per cent of cavities from worsening over two years.
Their latest analysis focused on more than 1600 children ages five to 13 who had cavities on one or more teeth. SDF or ART were applied to the children’s teeth—including more than 10,000 cavities—during biannual school visits. The students were followed for up to four years to see if their tooth decay worsened or stayed the same.
The researchers found that SDF and ART had similar results when applied to cavities: SDF kept 62 per cent of decayed surfaces from worsening over four years, while ART controlled 55 per cent.
“Offering ART or SDF in schools can help avoid the need for more invasive dental treatment and improve access to preventive care,” Dr Tamarinda J. Barry Godín said.
