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27-08-2012 | Oral medicine | Article

Frequency of fluoride solution application impacts caries arrest in children


Free abstract

medwireNews: Applying silver diamine fluoride (SDF) solution every 6 months rather than yearly increases the rate of caries arrest in preschool-age children, show study results.

A biannual application protocol significantly increased the odds of caries arrest after 2 years of treatment, report the researchers.

"Use of simple caries arrest treatment in outreach community health services will be of great significance in the control of the prevalent dental caries problem in many child populations," say Edward Lo (Prince Philip Dental Hospital, Hong Kong Special Administrative Region) and co-investigators, whose study population included 212 children aged a mean 4 years with a total of 719 dental caries lesions.

The children were randomly assigned to receive one of three treatment interventions and those that remained in the study after 24 months were followed up. This included 60 children treated with SDF solution application every 12 months (group 1), 59 children treated with SDF solution application every 6 months (group 2), and 62 children who received glass ionomer application every 12 months (group 3).

Caries arrest rates at follow up were highest in group 2 children, at 91%, compared with 79% in group 1 and 82% in group 3 children, report the researchers.

Indeed, adjusted analysis confirmed that lesions treated with the biannual treatment protocol (group 2), those in anterior teeth, and those in the buccal or lingual tooth surfaces were a significant 2.98, 5.55, and 15.6 times more likely to have caries arrest compared with group 1 lesions, those located posteriorly, and those on occlusal or approximal surfaces, respectively.

"This is probably because these teeth and surfaces are easier to be cleaned by young children," comment the authors in the Journal of Dentistry.

Lo and team questioned the children's parents at follow up about their satisfaction with the appearance of their child's teeth, since SDF can blacken the color of lesions while glass ionomer is white. However, there were no significant differences in responses between treatment groups and glass ionomer involves higher cost, a more skillful operator, and longer treatment time, remarks the team.

Applying SDF on a 6-monthly basis coincides with the commonly recommended frequency of recall visits for high-risk patients, say Lo and colleagues. "Better results... can be expected if SDF solution is applied onto the carious lesions every time a child visits a dentist at this recall frequency," they conclude.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Sarah Guy, medwireNews Reporter