NIH Record - National Institutes of Health

Topical Solution Stops Tooth Decay in Kids

A female dentist in white lab coat looks into a child's mouth in the clinic.
A clinical trial participant receives an oral exam at school from a dental clinician on the study.

Photo:  University of Michigan

In a large clinical trial, a topical liquid, silver diamine fluoride (SDF), stopped tooth decay in young children. Preliminary results from this NIDCR-funded study, published in Pediatric Dentistry, showed that 54% of cavities stopped progressing after SDF treatment, compared to 21% of those treated with a placebo.

Tooth decay is the most common chronic disease of childhood. Left untreated, cavities can put children at risk for chronic pain, impaired development and long-term oral and overall health problems. 

SDF can be easily, painlessly swabbed onto cavities. It is cleared by the FDA for treating dental sensitivity and is used off label to treat tooth decay, also known as cavities. Studies suggest that the silver in SDF kills cavity-causing microbes and helps stop destruction of the tooth, while the fluoride helps to rebuild and strengthen the tooth.

Researchers recruited children between ages 1 and 5 with severe tooth decay. Interim analysis of 599 children evaluated the proportion of cavity lesions in which decay progression was stopped six months after a single treatment with SDF or a placebo. To determine effectiveness of SDR, researchers measured the hardness of cavities before and after treatment. 

“Current treatments for severe early childhood caries rely on restoration and tooth extraction, which can involve general anesthesia,” said lead investigator Dr. Margherita Fontana of the University of Michigan. “These interventions are expensive, cavities often return and anesthesia can have long-term effects on a developing brain. We didn’t really have any other options until recently. SDF is a game-changer.”

Researchers are now analyzing the final data on more than 800 children, including assessing SDF’s effects on tooth pain and quality of life, as well as potential side effects. One concern is that not every cavity responded to the treatment. Scientists will use future studies to figure out why.

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