1
|
AlMady F, Abogazalah N, Dehalian LA, Capin O, Hara AT, Eckert GJ, Lippert F. The effect of silver diammine fluoride on In Vitro Enamel caries lesion remineralization and staining as a function of lesion baseline mineral distribution. J Dent 2024; 147:105139. [PMID: 38897540 DOI: 10.1016/j.jdent.2024.105139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/14/2024] [Accepted: 06/17/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES to investigate whether baseline mineral distribution modulates the ability of silver diammine fluoride (SDF) to remineralize and stain enamel caries lesions. METHODS This laboratory study followed a 3 [treatment: SDF/fluoride varnish (FV)/deionized water (DIW)] ×3 [lesion protocol: methylcellulose (MeC)/hydroxyethylcellulose (HEC)/Carbopol 907 (C907)] factorial design. Lesions were created in bovine enamel specimens (n = 20). Treatments were applied and lesions remineralized in artificial saliva. Digital transverse microradiography (TMR-D) was used to analyze lesions. Lesion color was monitored spectrophotometrically. The effects of lesion protocol and treatment on changes in lesion depth (ΔLD), mineral loss (ΔΔZ), maximum mineral density at the surface zone (ΔSZmax), and color changes related to remineralization (ΔL*remin) were analyzed using two-way ANOVA. RESULTS The treatment×lesion protocol interaction was significant for ΔΔZ (p < 0.01) and ΔL*remin (p < 0.01), however not for ΔLD (p = 0.23) or ΔSZmax (p = 0.91). There were no differences in ΔΔZ between treatments in HEC and C907 lesions. However, DIW resulted in more remineralization than both SDF (p < 0.01) and FV (p = 0.01) in MeC lesions. Considering changes from lesion baseline after remineralization in MeC lesions, SDF treatment resulted in the highest mineral gain in the surface zone. However, DIW revealed the highest mineral gain after remineralization in the lesion body. SDF stained lesions with the intensity increasing after remineralization in C907 lesions, whereas staining decreased in MeC and HEC lesions. CONCLUSION High fluoride treatments can interfere with continuous remineralization of caries lesions due to partial arrest. Baseline lesion mineral distribution affects SDF's ability to enhance remineralization and the staining caused by SDF. CLINICAL SIGNIFICANCE SDF is being used to arrest active caries lesions extending into dentin and to treat dentin hypersensitivity. This study shed light on SDF's effect on an isolated process in dental caries only, remineralization. It achieved this by examining enamel caries lesions with differing mineral distributions and assessing their staining properties.
Collapse
Affiliation(s)
- Fahad AlMady
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA; King Faisal University, Restorative Department, School of Dentistry AlAhsa, Saudi Arabia
| | - Naif Abogazalah
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA; Department of Restorative Dental Sciences, King Khalid University College of Dentistry, Abha, Saudi Arabia
| | - Laila Al Dehalian
- Department of restorative dental sciences, college of dentistry, Imam Abdulrahman bin Faisal university, Dammam, Saudi Arabia
| | - Oriana Capin
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Anderson T Hara
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - George J Eckert
- Department of Biostatistics and Health Data Science. Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Frank Lippert
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA.
| |
Collapse
|
2
|
Quritum M, Abdella A, Amer H, El Desouky LM, El Tantawi M. Effectiveness of nanosilver fluoride and silver diamine fluoride in arresting early childhood caries: a randomized controlled clinical trial. BMC Oral Health 2024; 24:701. [PMID: 38890627 PMCID: PMC11184862 DOI: 10.1186/s12903-024-04406-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND One of the most prevalent health problems affecting children worldwide is untreated caries in primary teeth. Agents to arrest caries are used to manage untreated decay in children in disadvantaged communities. Nano Silver Fluoride (NSF) overcomes the staining problems of Silver Diamine Fluoride (SDF). This study compared the clinical cariostatic effect of NSF to 38% SDF for arresting caries lesions. METHODS The study included 360 children younger than 4 years, with at least one active lesion, ICDAS score ≥ 3, recruited from nurseries in a rural area in Alexandria, Egypt, in 2022. They were randomly assigned to receive a single application of NSF at baseline, or two applications of SDF at baseline and after 6 months. The arrest of active carious lesions was assessed after 6 and 12 months using ICDAS criteria, and parents' satisfaction with child appearance was also assessed. Chi-Square test was used to compare the groups and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest at lesion level and binary logistic regression was used to assess the effect at patient level. RESULTS 1853 active lesions were included in children whose mean (SD) age was 42.3 (8.2) months. The arrest rate was significantly higher in the NSF than the SDF group at lesion level (78.4% and 65.0% at 6 months and 71.3% and 56.3% at 12 months, p < 0.001). In regression analysis, NSF had significantly higher odds of caries arrest than SDF at lesion level (at 6 months, AOR = 2.57, 95% CI: 1.55, 4.26 and at 12 month, AOR = 3.27, 95% CI: 1.89, 5.67). Parents of children receiving NSF had significantly greater satisfaction with their children's dental appearance than those receiving SDF: (97.2% and 76.1%, respectively, p < 0.001). CONCLUSION NSF demonstrated greater effectiveness in arresting caries in preschool children without inducing black staining of teeth and with greater parental satisfaction than SDF. NSF can be an alternative to SDF in arresting caries especially in underprivileged communities. TRIAL REGISTRATION The trial was registered in the clinicaltrials.gov registry (#NCT05255913)-16/02/2022.
Collapse
Affiliation(s)
- Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, 21527, Azarita, Alexandria, Egypt.
| | - Ahmed Abdella
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, 21527, Azarita, Alexandria, Egypt
| | - Hala Amer
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, 21527, Azarita, Alexandria, Egypt
| | - Lubna M El Desouky
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, 21527, Azarita, Alexandria, Egypt
| |
Collapse
|
3
|
Sun IG, Duangthip D, Chai HH, Luo BW, Lo ECM, Chu CH. Postoperative instructions for silver diamine fluoride therapy: A scoping review of current evidence and practice. J Dent 2024; 145:105029. [PMID: 38679132 DOI: 10.1016/j.jdent.2024.105029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVES Silver diamine fluoride (SDF) has gained popularity in dentistry as an anti-hypersensitive and anti-caries agent. This study aims to review the postoperative instructions for SDF therapy and examine the evidence supporting these instructions in treating dentine hypersensitivity and caries control. DATA AND SOURCES Two independent reviewers searched three electronic databases (EMBASE, PubMed, and Web of Science) to identify clinical studies that used SDF to treat dentine hypersensitivity and dental caries. Additionally, they searched Google Chrome for information from manufacturers, the department of health, national dental organisations, authoritative dental organisations, and universities regarding SDF therapy for these conditions. Data on postoperative instructions were extracted, and their impact on the treatment of dentine hypersensitivity and caries control was investigated. STUDY SELECTION This review included 74 clinical studies, 11 sets of instructions from SDF manufacturers, and six recommendations from national dental organisations, departments of health and universities. Amongst the included records, 50 clinical studies, two manufacturers, and one department of health mentioned postoperative instructions for SDF therapy. The recommendations varied, from suggesting no specific instructions, immediate rinsing, refraining from eating or drinking for 30 to 60 min, and even avoiding brushing until the next day after SDF therapy. Notably, no clinical studies reported the effects of these postoperative instructions on the SDF treatment of dentine hypersensitivity or dental caries. CONCLUSIONS This scoping review highlights the presence of inconsistent postoperative instructions for SDF therapy in the treatment of dentine hypersensitivity and caries control. Furthermore, there is a lack of evidence supporting the effectiveness of these instructions. CLINICAL SIGNIFICANCE No evidence supports the postoperative instructions for SDF therapy for managing dentine hypersensitivity and dental caries. Studies are necessary to provide guidance for clinicians using SDF in their clinical practice.
Collapse
Affiliation(s)
- Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Duangporn Duangthip
- Division of Pediatric Dentistry, The Ohio State University, Columbus, United States
| | | | - Bella Weijia Luo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
4
|
Cifuentes-Jiménez C, Bolaños-Carmona MV, Enrich-Essvein T, Rodríguez-Navarro AB, González-López S, Yamauti M, Álvarez-Lloret P. Green synthesis of chitosan- and fluoride-functionalized silver nanoparticles using Camellia sinensis: Characterization and dental applications. Int J Biol Macromol 2024; 268:131676. [PMID: 38641271 DOI: 10.1016/j.ijbiomac.2024.131676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/06/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
The development of new biocompatible and eco-friendly materials is essential for the future of dental practice, especially for the management of dental caries. In this study, a novel and simple method was applied for the green synthesis of silver nanoparticles (AgNPs) from the aqueous extract of Camellia sinensis (WT) and functionalized with chitosan (CHS) and NaF. The effects of WT_AgNPs application on demineralized dentin were evaluated for potential dental applications. The WT_AgNPs showed molecular groups related to organic compounds, potentially acting as reducing and capping agents. All AgNPs presented spherical shapes with crystal sizes of approximately 20 nm. Forty human molars were assigned to control: sound (SD) and demineralised dentine (DD), and experimental groups: WT_AgNPs, WT_AgNPs_NaF, and WT_AgNPs_CHS. Then, the NPs were applied to DD to evaluate the chemical, crystallographic, and microstructural characteristics of treated-dentine. In addition, a three-point bending test was employed to assess mechanical response. The application of WT_AgNPs indicated a higher mineralisation degree and crystallites sizes of hydroxyapatite than the DD group. SEM images showed that WT_AgNPs presented different degrees of aggregation and distribution patterns. The dentine flexural strength was significantly increased in all WT_AgNPs. The application of WT_AgNPs demonstrated remineralising and strengthening potential on demineralised dentine.
Collapse
Affiliation(s)
| | | | | | | | | | - Monica Yamauti
- Department of Restorative Dentistry, Graduate School of Dental Medicine, Hokkaido University, Japan
| | | |
Collapse
|
5
|
Varughese A, Janakiram C, Karuveettil V, James A. Effectiveness of silver diamine fluoride application with atraumatic restorative treatment in arresting the progression of dental caries: a systematic review protocol. JBI Evid Synth 2024:02174543-990000000-00300. [PMID: 38655633 DOI: 10.11124/jbies-23-00376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This review aims to evaluate the effectiveness of silver diamine fluoride application along with atraumatic restorative treatment in arresting the progression of dental caries when compared with other caries-arresting treatments in children and adults. INTRODUCTION A combination of silver diamine fluoride with atraumatic restorative treatment is a minimally invasive and cost-effective method to treat dental caries. It offers a solution for the progression of caries and restoration of cavitated lesions in both primary and permanent teeth. A comprehensive summary of the evidence will assist dental clinicians and guide subsequent clinical research. INCLUSION CRITERIA Randomized controlled trials involving human participants of any age with cavitated dental caries lesions will be included. The intervention arm will evaluate the effectiveness of silver diamine fluoride application with atraumatic restorative treatment in dental caries arrest with a control arm of either atraumatic restorative treatment (ART) or silver diamine fluoride (SDF) application; or composite restoration; or sodium fluoride varnish or a placebo; or a study group with no intervention. METHODS Systematic searches for relevant studies will be conducted across multiple databases, including MEDLINE, Scopus, Cochrane CENTRAL, Dentistry and Oral Sciences Source, CINAHL, and Web of Science. ProQuest Dissertations and Theses and Google Scholar will also be searched for gray literature. The databases will be searched from January 2016 to the present. No restrictions will be imposed on the country of publication. Data appraisal, extraction, and synthesis will follow JBI guidance for systematic reviews of effectiveness. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system will be used to grade the certainty of evidence, and a Summary of Findings will be prepared. REVIEW REGISTRATION PROSPERO CRD42023426766.
Collapse
Affiliation(s)
- Anju Varughese
- Department of Conservative Dentistry and Endodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
- Amrita Centre for Evidence Based Oral Health: A JBI Affiliated Group, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Chandrashekar Janakiram
- Amrita Centre for Evidence Based Oral Health: A JBI Affiliated Group, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Vineetha Karuveettil
- Amrita Centre for Evidence Based Oral Health: A JBI Affiliated Group, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Anju James
- Amrita Centre for Evidence Based Oral Health: A JBI Affiliated Group, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| |
Collapse
|
6
|
Muntean A, Mzoughi SM, Pacurar M, Candrea S, Inchingolo AD, Inchingolo AM, Ferrante L, Dipalma G, Inchingolo F, Palermo A, Bordea IR. Silver Diamine Fluoride in Pediatric Dentistry: Effectiveness in Preventing and Arresting Dental Caries-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:499. [PMID: 38671716 PMCID: PMC11049537 DOI: 10.3390/children11040499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/04/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Tooth decay is considered a global scourge by the World Health Organization (WHO) starting at an early age. In recent years, silver diamine fluoride (SDF) has regained interest, particularly in pediatric dentistry, used to prevent the development of carious lesions or arrest their progression. OBJECTIVE The aim of this study was to assess, through a systematic review of the literature, the effectiveness of SDF, used in pedodontics, in temporary teeth, in preventing or arresting dental caries. MATERIAL AND METHODS An electronic search was conducted on PubMed, Web of Science and Scopus. The effect of SDF on both temporary and permanent teeth has been considered. RESULTS The inclusion criteria identified 16 randomized controlled trials involving patients aged 18 months to 13 years and followed over a period of 12-30 months. CONCLUSIONS SDF is a practical, accessible and effective non-invasive way to prevent and arrest caries in temporary and permanent teeth. Its application requires regular monitoring. The resulting black spot is diminished by immediate application of potassium iodide but this may affect its effectiveness.
Collapse
Affiliation(s)
- Alexandrina Muntean
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Soundouss Myriam Mzoughi
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Mariana Pacurar
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine, Pharmacy Science and Technology “G. E. Palade” Targu Mures Romania, Gheorghe Marinescu Street, nr. 38, 540139 Târgu Mureș, Romania;
| | - Sebastian Candrea
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Ioana Roxana Bordea
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 15 V. Babes Street, 400012 Cluj-Napoca, Romania;
| |
Collapse
|
7
|
Mulder R, Noordien N, Potgieter N. Comparing cytocompatibility of two fluoride-containing solutions and two resin-based restorative materials-a pilot study. FRONTIERS IN ORAL HEALTH 2024; 5:1330944. [PMID: 38650760 PMCID: PMC11033402 DOI: 10.3389/froh.2024.1330944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/15/2024] [Indexed: 04/25/2024] Open
Abstract
Background Cytocompatibility should always be considered, especially if the surface of treated carious lesions is close to soft tissue or is accidentally exposed to the oral soft tissue by the clinician. Methods The aim of the present study was to compare the cytocompatibility of two fluoride-containing liquids and two resin-containing restorative materials with buccal mucosa fibroblasts. The fluoride-containing materials were silver diamine fluoride and water-based silver fluoride. Results The statistical analysis was completed by comparing the positive control growth of the buccal mucosa fibroblasts to the growth of cells exposed to various materials. The one-way ANOVA with Tukey's HSD result was completed. All the assessed materials compared to the control wells for both the 24 and 48 h time intervals indicated a significant cytocompatibility result, except for the test wells with Stela (SDI) at the 24 h time interval. There was no significant difference between the step 2 liquids and the two dental materials in cytocompatibility at the 24 h interval. All four materials indicated no significant differences between the cytocompatibility of any dental materials for 48 h. Conclusion The cytocompatibility assessment for Riva Star and Riva Star Aqua with the direct method in a full dispensing drop is not viable for step 1 of the fluoride-containing liquids. The use of Stela Light Cure is a suitable material that will be in contact with buccal mucosa as it showed potential for increased cytocompatibility compared to Riva Light Cure. Riva Star Aqua is more cytocompatible than Riva Star.
Collapse
Affiliation(s)
- Riaan Mulder
- Department of Prothodontic Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Naeemah Noordien
- Department of Orthodontics and Paediatric Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Nicoline Potgieter
- Department of Orthodontics and Paediatric Dentistry, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
8
|
Abdellatif EB, El Kashlan MK, El Tantawi M. Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial. BMC Oral Health 2023; 23:875. [PMID: 37978488 PMCID: PMC10656986 DOI: 10.1186/s12903-023-03597-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS. METHODS Children aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents' satisfaction with their children's appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated. RESULTS The study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children's appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23). CONCLUSION SDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC. TRIAL REGISTRATION This trial was registered in the clinicaltrials.gov registry (#NCT05642494).
Collapse
Affiliation(s)
- Enas B Abdellatif
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt.
| | - Mona K El Kashlan
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt
| |
Collapse
|
9
|
Yassin R, Amer H, Tantawi ME. Effectiveness of silver diamine fluoride versus sodium fluoride varnish combined with mother's motivational interviewing for arresting early childhood caries: a randomized clinical trial. BMC Oral Health 2023; 23:710. [PMID: 37789300 PMCID: PMC10548636 DOI: 10.1186/s12903-023-03456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Silver Diamine Fluoride (SDF) has gained attention as one of the minimally invasive modalities to manage ECC although it causes black staining of treated carious lesions. A possible affordable alternative may be Sodium Fluoride (NaF) varnish combined with good oral hygiene promoted by parental Motivational Interviewing (MI). The study compared the effectiveness of 38% SDF solution and 5% NaF varnish supported by parental MI in arresting ECC. MATERIALS AND METHODS Children aged ≤ 4 years old with at least one active carious lesion (ICDAS score ≥ 3) were randomly assigned to treatment by a single application of 38% SDF solution or a single application of 5% NaF varnish supported by two MI sessions for mothers at baseline and after three months. Chi-Squared test was used to compare groups and multilevel logistic regression analysis was used to assess the effect of the interventions on ECC arrest adjusting for confounders. The interaction between the type of intervention and baseline lesion severity, moderate (ICDAS 3/4) or advanced (ICDAS 5/6), was also assessed. RESULTS The study included 165 children with 949 active lesions. After 6 months, there were no significant differences between SDF and NaF/MI groups in overall caries arrest (63.7% and 58.1%, p = 0.08), and in moderate lesions (72.9% and 69.6%, p = 0.52). However, in advanced lesions, the arrest rate was significantly higher in the SDF than the NaF/ MI group (60.3% and 50.0%, P = 0.01). Multilevel multiple logistic regression showed no significant differences between the interventions (AOR = 1.56, P = 0.27) with significant interaction between the intervention and baseline lesion severity (p < 0.001). Moderate lesions treated with SDF (AOR = 3.69, P = 0.008) or NaF/MI (AOR = 3.32, P < 0.001) had significantly higher odds of arrest than advanced lesions treated with NaF/ MI with no difference between advanced lesions treated with SDF or NaF/ MI (AOR = 1.85, P = 0.155) in arrest rate. CONCLUSION NaF/ MI can be an alternative to SDF in arresting advanced and moderate ECC lesions without staining with stronger effect on moderate lesions (ICDAS 3/4). TRIAL REGISTRATION The trial was retrospectively registered at clinicaltrial.gov registry (#NCT05761041) on 9/3/2023.
Collapse
Affiliation(s)
- Randa Yassin
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Hala Amer
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
10
|
Zheng FM, Lo ECM, Chu CH. Outreach Service Using Silver Diamine Fluoride to Arrest Early Childhood Caries. Int Dent J 2023; 73:598-602. [PMID: 37612156 PMCID: PMC10509413 DOI: 10.1016/j.identj.2023.07.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023] Open
Abstract
Early childhood caries (ECC) is prevalent and affects more than half of 5-year-old children in Hong Kong. This study aims to report the development of an outreach dental service using silver diamine fluoride (SDF) to arrest ECC amongst kindergarten children in Hong Kong. A pilot outreach service was initiated in 2008 in 14 kindergartens. The pilot service provided screening to 1,749 3- to 5-year-old children. SDF was applied to 3,262 carious teeth of 786 children with parental consent. No significant complications were reported. The pilot service's success allowed the service to expand to 100 kindergartens in 2013. From 2010 to 2019, the service delivered 161,354 dental screenings and SDF therapy on 218,333 carious primary teeth in 53,821 children. ECC prevalence amongst the participating children declined from 43% in 2010 to 34% in 2019. A follow-up of 222 3-year-old children revealed that annual SDF therapy arrested 67% of ECC over 3 years. The children's participation rate and their parents' satisfaction rate with the service were greater than 90% each year. Moreover, the acceptance rate of SDF therapy to control ECC was 88%, although SDF stained carious lesions black. No adverse effects of SDF therapy were reported. A cross-sectional survey on a sample of 498 3- to 5-year-old children showed that 96% of the participating children had no dental fear or anxiety in this service, with encouragement and support from their peers and teachers. In 2019, the service was made available to all 1,024 kindergartens in Hong Kong. This kindergarten outreach dental service (Case Study HKU/04/003) was selected as an Impact Case Study in the thematic report "Health & Healthcare" by the Hong Kong University Grant Council (UGC). The UGC publishes thematic reports to give members of the public some concrete idea on what contributions academic research has brought to the society.
Collapse
Affiliation(s)
| | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| |
Collapse
|
11
|
Rinsathon J, Wiriyasuebpong S, Thariya K, Jiradechochai P, Phetsuk P, Bouanil S, Saikaew P, Pawaputanon Na Mahasarakham C. Bonding performance of glass ionomer cement to carious dentin treated with different surface treatment protocols using silver diamine fluoride. Sci Rep 2023; 13:14233. [PMID: 37648840 PMCID: PMC10468524 DOI: 10.1038/s41598-023-41511-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023] Open
Abstract
This study investigated the influence of silver diamine fluoride (SDF) on the shear bond strength (SBS) to artificial carious dentin and GIC restorations with various SDF application protocols. Artificial caries were prepared on human dentin discs using bacteria model. These samples were randomly allocated to five groups (n = 10/group) according to the following treatment: (1) control group (CD): no treatment (2) CSR: dentin conditioner, SDF, and rinsing (3) CS: dentin conditioner and SDF (4) SRC: SDF, rinsing and dentin conditioner, and (5) SC: SDF and dentin conditioner. The treated-dentin surface was bonded with GIC and subjected to SBS test. Mean SBS was analyzed using one-way ANOVA. Surface morphology and elemental contents after surface treatment were examined (n = 3/group) by scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDX). There was no significant difference in the mean SBS among CD (2.45 ± 0.99 MPa), CSR (1.76 ± 0.65 MPa), and SRC (2.64 ± 0.95 MPa). Meanwhile, the mean SBS of CS (0.35 ± 0.21 MPa) was significantly lower than the control and SRC group. SEM/EDX demonstrated deeper silver penetration in CSR and CS groups when compared to SRC and SC groups. SDF-modified GIC restorations resulted in significantly lower bond strength in CS and SC groups. The findings suggested treating the carious dentin surface with CSR and SRC protocol. SDF-treated carious dentin should be rinsed off prior to restore with GIC.
Collapse
Affiliation(s)
| | - Suthinee Wiriyasuebpong
- Department of Restorative Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Kunwara Thariya
- Department of Restorative Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Panupong Jiradechochai
- Department of Restorative Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Porada Phetsuk
- Research Unit, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Sanit Bouanil
- Research Unit, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pipop Saikaew
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | |
Collapse
|
12
|
Sirivichayakul P, Jirarattanasopha V, Phonghanyudh A, Tunlayadechanont P, Khumsub P, Duangthip D. The effectiveness of topical fluoride agents on preventing development of approximal caries in primary teeth: a randomized clinical trial. BMC Oral Health 2023; 23:349. [PMID: 37268914 DOI: 10.1186/s12903-023-03045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/14/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND This 18-month randomized clinical trial aimed to compare the effectiveness of two topical fluoride applications versus placebo control on preventing development of approximal caries in primary teeth. METHODS Preschool children were recruited if they had at least one initial approximal carious lesion at the distal surface of the canines, both approximal surfaces of the first molars, or the mesial surface of the second molars assessed from bitewing radiographs. The participants were randomly allocated into 3 intervention groups: Group 1 (placebo control), Group 2 (5% sodium fluoride [NaF] varnish), and Group 3 (38% silver diamine fluoride [SDF]). All agents were applied semiannually. Two calibrated examiners evaluated the caries development from bitewing radiographs. Caries development was recorded when the baseline sound surface or initial approximal carious lesion surface developed dentin caries (beyond the outer one-third of dentine) at the follow-up examination. The intention-to-treat approach was adopted. The Chi-square test was used to analyze the effectiveness of topical fluoride agents in preventing approximal caries development and the effect of other variables. The multi-level logistic regression analysis was performed to assess the relative effectiveness of topical fluoride agents in preventing approximal caries development at the 18-month follow-up. RESULTS At baseline, 190 participants with 2,685 sound or initial carries at the approximal surfaces were recruited. No differences in participant demographic backgrounds, oral health related habits, or caries experience were observed among the 3 groups (P > 0.05). After 18 months, 155 (82%) participants remained in the study. The rates of developing approximal caries in Groups 1, 2, and 3 were 24.1%, 17.1%, and 27.2%, respectively (P < 0.001, χ2 test). After adjusting for confounding factors and clustering effect, the multilevel logistic regression analysis showed no differences in caries development rates between the 3 groups (P > 0.05). Tooth type and the extent of a carious lesion at baseline were the significant factors for caries development. CONCLUSION At 18-month follow-up, after adjusting for confounding factors and clustering effect, there were no statistically significant differences in preventing of approximal caries development between the semiannual application of 5%NaF, 38%SDF, or placebo. TRIAL REGISTRATION The study was registered in the Thai Clinical Trials Registry under the number TCTR20190315003 on 15/03/2019.
Collapse
Affiliation(s)
- Parach Sirivichayakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Varangkanar Jirarattanasopha
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand.
| | - Araya Phonghanyudh
- School of Dentistry, King Mongkut's Institute of Technology Ladkrabang, 1 Chalongkrung St, Ladkrabang, Bangkok, 10520, Thailand
| | - Pitchaya Tunlayadechanont
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Ploychompoo Khumsub
- Dental department, Pakkred hospital, 33 Moo 5 Saphan Nonthaburi - Bang Bua Thong Rd., Pakkret district, Nonthaburi, 11120, Thailand
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Prince Phillip Dental Hospital, 34 Hospital Rd., Sai Ying Pun, Hong Kong SAR, China
| |
Collapse
|
13
|
Zhang JS, Chen Z, Chu CH, Yu OY. Effect of silver diamine fluoride upon the microbial community of carious lesions: A scoping review. J Dent 2023; 134:104554. [PMID: 37220834 DOI: 10.1016/j.jdent.2023.104554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/03/2023] [Accepted: 05/15/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVES To explore the effects of silver diamine fluoride (SDF) on the microbial community of carious lesions. DATA Original studies evaluating the effect of SDF treatment on the microbial community of human carious lesions were included. SOURCES A systematic search of English-language publications was performed in PubMed, EMBASE, Scopus, and Web of Science. Gray literature was searched in ClinicalTrials.gov and Google Scholar. STUDY SELECTION/RESULTS This review included seven publications reporting the effects of SDF on microbial community of dental plaque or carious dentin, including the microbial biodiversity, relative abundance of microbial taxa, and predicted functional pathways of the microbial community. The studies on microbial community of dental plaque reported that SDF did not have a significant effect on both the within-community species diversity (alpha-diversity) and inter-community microbial compositional dissimilarity (beta-diversity) of the plaque microbial communities. However, SDF changed the relative abundance of 29 bacterial species of plaque community, inhibited carbohydrate transportation and interfered with the metabolic functions of the plaque microbial community. A study on the microbial community in dentin carious lesions reported that SDF affected its beta-diversity and changed the relative abundance of 14 bacterial species. CONCLUSION SDF showed no significant effects on the biodiversity of the plaque microbial community but changed the beta-diversity of the carious dentin microbial community. SDF could change the relative abundance of certain bacterial species in the dental plaque and the carious dentin. SDF could also affect the predicted functional pathways of the microbial community. CLINICAL SIGNIFICANCE This review provided comprehensive evidence on the potential effect of SDF treatment on the microbial community of carious lesions.
Collapse
Affiliation(s)
- Josie Shizhen Zhang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China
| | - Zigui Chen
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China; Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China.
| |
Collapse
|
14
|
Influence of salivary acquired pellicle on colour changes and minerals content of dentine after application of silver diamine fluoride followed by potassium iodide. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00791-5. [PMID: 36929510 DOI: 10.1007/s40368-023-00791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE This study evaluated whether the presence of the salivary acquired pellicle (AP) had any effect on the dentin's darkening and on the caries arresting effect after the use of SDF + KI, in a cariogenic challenge. METHODS Human dentin specimens were standardised, submitted to artificial caries lesion formation, and divided into five groups (n = 20): C: control group-no treatment, SDF: 38% SDF, APSDF: SDF 38% and AP, KISDF: 38% SDF and KI, and APKISDF: 38% SDF, KI and AP, that were submitted to pH cycling. Colour evaluation (CIE L*a*b* system) and surface hardness were performed before and after the treatments/pH cycling. RESULTS SDF and APSDF groups showed no difference in colour. KISDF and APKISDF groups showed significantly different colours than the groups without KI. SDF, APSDF, and APKISDF groups had less mineral loss than C and KISDF. SDF, APSDF, and APKISDF revealed significantly greater mineral recovery, compared to KISDF and C. CONCLUSION The AP did not influence the dentin´s colour after SDF + KI, but had a protective role in modulating the dentin´s mineral gain/loss. KI used after SDF decreased the dentin´s darkening, and did not interfere with the dentin de/remineralization process.
Collapse
|
15
|
Asghar M, Omar RA, Yahya R, Yap AU, Shaikh MS. Approaches to minimize tooth staining associated with silver diamine fluoride: A systematic review. J ESTHET RESTOR DENT 2023; 35:322-332. [PMID: 36628650 DOI: 10.1111/jerd.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To the effectiveness of different strategies to overcome silver diamine fluoride (SDF)-mediated tooth staining. MATERIALS AND METHODS Four online databases (PubMed, ScienceDirect, Scopus, and Web of Science) were searched using different MeSH terms and Boolean Operators to retrieve the articles (until June 2021), followed by a hand-search of the reference list of the included articles. All full-text, original studies in English that evaluated SDF staining and at least one SDF modification/alternative were included. RESULTS Among the assessed studies, nine studies explored the stain-minimization effect of potassium iodide (KI) post-application following SDF treatment. Among these, eight concluded that KI application after SDF treatment significantly reduced tooth staining, while one showed marginal staining following glass ionomer restoration of the SDF-treated dentine. Additionally, one study applied potassium fluoride (KF) and silver nitrate (AgNO3 ) concurrently to mitigate SDF-mediated staining. One study compared SDF staining with polyethylene glycol (PEG)-coated nanoparticles containing sodium fluoride (NaF), and another used nanosilver fluoride (NSF) for staining comparison with SDF. CONCLUSIONS Within the limitations of this study, the addition of different materials to SDF has proven to be a beneficial strategy for overcoming tooth staining associated with SDF. Future studies are warranted, particularly clinical trials, to validate these findings. CLINICAL SIGNIFICANCE SDF-mediated tooth staining is a serious concern that limits its clinical use. A review of various strategies to overcome this problem will help clinicians enhance its clinical use and patient acceptance.
Collapse
Affiliation(s)
- Mehmood Asghar
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.,Department of Dental Materials, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Ros Anita Omar
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Rosiyah Yahya
- Department of Chemistry, Faculty of Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Adrian Ujin Yap
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.,Department of Dentistry, Faculty of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.,National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
| | - Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| |
Collapse
|
16
|
Almuqrin A, Kaur IP, Walsh LJ, Seneviratne CJ, Zafar S. Amelioration Strategies for Silver Diamine Fluoride: Moving from Black to White. Antibiotics (Basel) 2023; 12:antibiotics12020298. [PMID: 36830209 PMCID: PMC9951939 DOI: 10.3390/antibiotics12020298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Topical cariostatic agents have become a reasonable alternative for managing dental caries in young children. Silver diamine fluoride (SDF) is a practical topical approach to arrest caries and avoid extensive and risky dental treatment. However, the literature demonstrates a parental hesitation towards accepting SDF because of black unaesthetic tooth discolouration following application. The rapid oxidation of ionic silver darkens demineralised tooth structure permanently. In this regard, nano-metallic antimicrobials could augment or substitute for silver, and thereby enhance SDF aesthetic performance. Recently, biomedical research has drawn attention to selenium nanoparticles (SeNPs) due to their antimicrobial, antioxidant, and antiviral potencies. Various in vitro studies have examined the effect of SeNPs on the virulence of bacteria. This narrative review explores practical issues when using SDF and suggests future directions to develop it, focusing on antimicrobial metals. Several methods are described that could be followed to reduce the discolouration concern, including the use of nanoparticles of silver, of silver fluoride, or of selenium or other metals with antimicrobial actions. There could also be value in using remineralising agents other than fluoride, such as NPs of hydroxyapatite. There could be variations made to formulations in order to lower the levels of silver and fluoride in the SDF or even to replace one or both of the silver and fluoride components completely. Moreover, since oxidation processes appear central to the chemistry of the staining, adding SeNPs which have antioxidant actions could have an anti-staining benefit; SeNPs could be used for their antimicrobial actions as well. Future research should address the topic of selenium chemistry to optimise how SeNPs would be used with or in place of ionic silver. Incorporating other antimicrobial metals as nanoparticles should also be explored, taking into account the optimal physicochemical parameters for each of these.
Collapse
|
17
|
Zhang Q, Guan L, Guo J, Chuan A, Tong J, Ban J, Tian T, Jiang W, Wang S. Application of fluoride disturbs plaque microecology and promotes remineralization of enamel initial caries. J Oral Microbiol 2022; 14:2105022. [PMID: 35923900 PMCID: PMC9341347 DOI: 10.1080/20002297.2022.2105022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The caries-preventive effect of topical fluoride application has been corroborated by a number of clinical studies. However, the effect of fluoride on oral microecology remains unclear. Objective To monitor the effect of fluoride on dental plaque microecology and demineralization/remineralization balance of enamel initial caries. Methods Three-year-old children were enrolled and treated with fluoride at baseline and 6 months. International Caries Detection and Assessment System II indices of 52 subjects were measured at baseline, 3, 6, and 12 months. Supragingival plaque samples of 12 subjects were collected at baseline, 3 and 14 days for 16S rRNA sequencing. Results Changes in microbial community structure were observed at 3 days after fluoridation. Significant changes in the relative abundance of microorganisms were observed after fluoride application, especially Capnocytophaga, unidentified Prevotellaceae and Rothia. Functional prediction revealed that cell movement, carbohydrate and energy metabolism were affected significantly after fluoride application. Fluoride significantly inhibited enamel demineralization and promoted remineralization of early demineralized caries enamel at 3 months. Conclusion Fluoride application significantly inhibited the progression of enamel initial caries and reversed the demineralization process, possibly by disturbing dental plaque microecology and modulating the physicochemical action of demineralization/remineralization. This deepened our understanding of caries-preventive effects and mechanisms of fluoride.
Collapse
Affiliation(s)
- Qianxia Zhang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
| | - Lingxia Guan
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Jing Guo
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Aiyun Chuan
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
| | - Juan Tong
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Jinghao Ban
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Tian Tian
- Department of VIP Dental Care, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Wenkai Jiang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
| | - Shengchao Wang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
| |
Collapse
|
18
|
Hafiz Z, Allam R, Almazyad B, Bedaiwi A, Alotaibi A, Almubrad A. Effectiveness of Silver Diamine Fluoride in Arresting Caries in Primary and Early Mixed Dentition: A Systematic Review. CHILDREN 2022; 9:children9091289. [PMID: 36138602 PMCID: PMC9497160 DOI: 10.3390/children9091289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022]
Abstract
Dental caries is a painful condition that could lead to nutritional problems which affects the overall health of the child, as well it is expensive to treat. The effectiveness of silver diamine fluoride (SDF) in primary and early mixed dentition is systematically reviewed in this study. This systematic review utilized the Preferred Reporting Items for Systematic reviews and Meta- Analysis statement (PRISMA, 2020). A literature search conducted using the common electronic databases (from 2010–2021). Based on the inclusion and exclusion criteria, ten randomized clinical trials (RCT) have met the inclusion criteria and were considered for the qualitative assessment. Critical appraisal of these studies was done. This systematic review found that using SDF is a successful and effective method in arresting dentin carious process in the primary teeth and first permanent molars in children. Additionally, when compared to the commonly used topical fluoride products and materials, SDF showed to have better cariostatic effect. However, these findings must be cautiously viewed since more research is required to support them.
Collapse
Affiliation(s)
- Zain Hafiz
- Pediatric Dentistry and Orthodontics Department, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
- Correspondence:
| | - Rehab Allam
- Pediatric Dentistry and Orthodontics Department, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| | - Bdoor Almazyad
- Intern, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| | - Alya’a Bedaiwi
- Intern, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| | - Areej Alotaibi
- Intern, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| | - Alwateen Almubrad
- Intern, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| |
Collapse
|
19
|
Parental perspectives on the use of silver diamine fluoride therapy to arrest early childhood caries in kindergarten outreach dental services: A qualitative study. J Dent 2022; 125:104250. [DOI: 10.1016/j.jdent.2022.104250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/28/2022] [Accepted: 08/05/2022] [Indexed: 11/18/2022] Open
|
20
|
Phonghanyudh A, Duangthip D, Mabangkhru S, Jirarattanasopha V. Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158992. [PMID: 35897363 PMCID: PMC9331268 DOI: 10.3390/ijerph19158992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
Background: There is limited information on the effectiveness of 38% silver diamine fluoride (SDF) in managing enamel caries. Objective: This study aimed to compare effectiveness of 38% SDF and 5% Sodium fluoride (NaF) varnish in arresting enamel caries in young children when applied semiannually over 18 months. Methods: A randomized controlled trial was conducted on children aged 1−3 years who had at least one active carious surface. They were allocated into two groups: Group 1 (38% SDF) and Group 2 (5% NaF varnish). Visual-tactile examination was used to assess extent of carious lesions. Enamel caries that did not progress to dentin were classified as having caries arrest. Intention-to-treat analysis was performed. Results: At baseline, 290 children with 1974 tooth surfaces with enamel caries were recruited. Caries arrest rates at the tooth surface level in Group 1 and Group 2 were 59.1% and 58.8%, respectively (p = 0.873), at 18 months. The multilevel logistic regression analysis revealed that tooth position, tooth surface, extent of enamel caries at baseline, caries experience, and brushing with fluoride toothpaste influenced caries arrest (p < 0.05). Conclusion: The semiannual application of 38% SDF and 5% NaF varnish had comparable effectiveness in arresting enamel caries in primary teeth.
Collapse
Affiliation(s)
- Araya Phonghanyudh
- School of Dentistry, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
| | | | | | | |
Collapse
|
21
|
Cabalén MB, Molina GF, Bono A, Burrow MF. Nonrestorative Caries Treatment: A Systematic Review Update. Int Dent J 2022; 72:746-764. [PMID: 35879115 PMCID: PMC9676527 DOI: 10.1016/j.identj.2022.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/16/2022] [Accepted: 06/26/2022] [Indexed: 11/29/2022] Open
Abstract
Caries is the most prevalent chronic noncommunicable disease. Strategies to prevent its onset and early interventions to arrest the progression of early lesions have been emphasised throughout recent decades to avoid or delay the restorative spiral of the tooth. More individuals are retaining their natural teeth into old age, thereby necessitating ongoing restorative dentistry intervention for their maintenance. The aim of this systematic review was to update the state of the art regarding clinical studies reporting the effectiveness of different nonrestorative caries treatment options in the 5-year period from 2017 to 2022. Relevant articles were retrieved from 2 electronic databases, including randomised clinical trials (RCTs) published from January 2017 until April 2022, assessing effectiveness and secondary effects of at least one nonrestorative caries treatment option, carried out with adults and/or children with noncavitated or cavitated carious lesions on either primary or permanent teeth and diagnosed by radiographs or visual/tactile assessment. All 35 included articles presented the results of RCTs with a follow-up period ranging from 6 to 84 months. Most of these studies were considered high-quality articles with a low risk of bias. Sealants and fluoride gels and varnishes were mentioned in 12 studies as effective strategies to prevent the onset of caries lesions and to arrest them in the early stages. Resin infiltration reported high caries arresting rates in noncavitated proximal lesions in 10 publications. Silver diammine fluoride presented high caries-arresting rates in open dentin lesions, both in primary and permanent dentitions as well as in root caries lesions that were accessible for cleansing. New evidence has been published between 2017 and 2022 as the result of numerous clinical studies providing further evidence of the effectiveness of nonrestorative caries treatment options.
Collapse
Affiliation(s)
- María Belén Cabalén
- Cátedra de Materiales Dentales, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina
| | - Gustavo Fabián Molina
- Cátedra de Materiales Dentales, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina; Division of Restorative Dental Sciences, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR China.
| | - Alejandra Bono
- Cátedra de Periodoncia, Faculty of Dentistry, Universidad Nacional de Córdoba, Argentina
| | - Michael F Burrow
- Division of Restorative Dental Sciences, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR China
| |
Collapse
|
22
|
Jabin Z, Jain G, Jaiswal M, Vishnu Priya V. Top 100 cited articles on Silver diamine fluoride-A bibliometric analysis. J Oral Biol Craniofac Res 2022; 12:413-420. [DOI: 10.1016/j.jobcr.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
|
23
|
Mudusu SP, Jampanapally SR, Konda S, Inguva H, Achaladi SB, Kancharidasu VK. Prevalence of Arrested Caries in Three Areas of South India with Different Groundwater Fluoride Levels: An Epidemiological Study. Int J Clin Pediatr Dent 2022; 15:S186-S190. [PMID: 35645515 PMCID: PMC9108833 DOI: 10.5005/jp-journals-10005-2148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Dental caries, though a progressive disease, if intervened early may become arrested, provided there is a change in the oral environment. One such factor which may lead to caries arrest is prolonged exposure to naturally available groundwater fluoride. Aim The aim of the study is to know the prevalence of arrested caries in three geographical areas with different levels of fluoride in groundwater and to attribute if there is any correlation between the natural high fluoride levels in groundwater and the prevalence of arrested caries. Design A cross-sectional study is conducted on schoolchildren residing in three geographical areas of south India with high, moderate, and low groundwater fluoride levels. A total of 5,982 children, from all the three regions between the age-groups 5-9 years, are examined and 1,514 children with caries are included in the study. The teeth and surfaces with active and arrested caries are identified and recorded in a structured pro forma. All the data obtained was tabulated and subjected to statistical analysis. Results The prevalence of arrested carious lesions is found to be significantly higher in areas with high groundwater fluoride level when compared to the other two areas. Conclusion It can be concluded that the progression of caries in children residing in areas with high groundwater fluoride level is slow and gets arrested early in the presence of a high amount of fluoride. How to cite this article Mudusu SP, Jampanapally SR, Konda S, et al. Prevalence of Arrested Caries in Three Areas of South India with Different Groundwater Fluoride Levels: An Epidemiological Study. Int J Clin Pediatr Dent 2022;15(S-2):S186-S190.
Collapse
Affiliation(s)
- Srujana P Mudusu
- Pedodontics and Preventive Dentistry, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | - Sharada R Jampanapally
- Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Suhasini Konda
- Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Hemachandrika Inguva
- Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Hyderabad, Telangana, India
| | | | - Vamshi K Kancharidasu
- Department of Prosthodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
| |
Collapse
|
24
|
Karami H, Farahat F, Davari A. Investigation of the effect of simultaneous use of silver diamine fluoride and potassium iodide on the shear bond strength of total etch and universal adhesive systems to dentin. Dent Res J (Isfahan) 2022; 19:6. [PMID: 35308443 PMCID: PMC8927945 DOI: 10.4103/1735-3327.336691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 03/12/2021] [Accepted: 06/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Applying silver diamine fluoride (SDF) is recommended to arrest and prevent dental caries. However, it may jeopardize the bond of the restorative materials to the tooth. The aim of the present in vitro study was to evaluate the effect of the simultaneous use of the SDF and potassium iodide (KI) on shear bond strength to the sound dentin. Materials and Methods: In this in vitro study, on the buccal and lingual surfaces of the 48 human third molar teeth, dentinal surfaces with a diameter of 6 mm were created by removing the enamel. Then, the specimens were divided into four groups based on applying or not applying the KI/SDF and adhesive type (etch and rinse [E and R] or universal adhesive). Afterward, cylindrical composite restoration was made on the surfaces. Half of the specimens were subjected to 1000 cycles of thermocycling. Subsequently, the shear bond strength was evaluated by Universal testing machine. Furthermore, the type of failure was determined by a stereomicroscope. Data were analyzed by t-test and Chi-square at a significance level of P < 0.05. Results: There were statistically significant differences in shear bond strength between Groups 1 and 3 (P < 0.05), whereas the bond strength difference between Groups 2 and 4 was not statistically significant (P = 0.609). Failures were predominantly of the mixed type in almost all groups. Conclusion: Based on the results of this study, the superiority of shear bond strength of universal adhesive to the sound dentin compared to E and R adhesive was confirmed. Thus, using this type of adhesive is recommended under the condition that KI/SDF anticaries material is applied.
Collapse
|
25
|
Desai H, Stewart CA, Finer Y. Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review. Dent J (Basel) 2021; 9:dj9120147. [PMID: 34940044 PMCID: PMC8700643 DOI: 10.3390/dj9120147] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
Collapse
Affiliation(s)
- Hetal Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Correspondence:
| |
Collapse
|
26
|
The Effectiveness of Early Childhood Caries Treatment with MI Varnish Fluor in Obese Subjects: A Study from Vietnam. CHILDREN 2021; 8:children8121151. [PMID: 34943346 PMCID: PMC8699859 DOI: 10.3390/children8121151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/04/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022]
Abstract
Objective: We conducted this work to evaluate the effectiveness of treatment for early childhood caries (ECC) using MI Varnish Fluor in obese children aged from 36 to 71 months. Methods: This study was conducted on 300 carious teeth of obese children and normal-weight children in Hanoi, Vietnam, over the period 2019–2020. Diagnodent KaVo 2190 laser equipment was used to diagnose ECC. The children in each group were selected on the basis of similarities in age, gender, and study location, and the teeth in the two groups were selected on the basis of similarities in damage level and jaw position. ECC treatment was performed once a week for four consecutive weeks with MI Varnish Fluor. The child, the child’s family, and the child’s teacher were consulted on diet and oral hygiene during the treatment. Children were examined and monitored throughout the treatment period. Children were re-examined after 3 and 6 months from the start time of treatment. The Mann–Whitney U test and Kruskal–Wallis tests were used, with statistical significance indicated at p < 0.05. Results: After six months of treatment with MI Varnish Fluor, the number of cases of code 0 damage recovery (D0) increased in both groups. The result showed that MI Varnish fluor was effective in ECC treatment. D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children were observed after six months of treatment, but there was no statistically significant difference between the two groups. Furthermore, there was no statistically significant difference between the two groups according to age, tooth position, or tooth surface position in D0 damage recovery. Conclusions: MI Varnish Fluor was effective in ECC treatment, with D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children after six months of treatment.
Collapse
|
27
|
Duangthip D, He S, Gao SS, Chu CH, Lo ECM. Effectiveness of Silver Diamine Fluoride in Preventing Occlusal Caries in Primary Teeth of Preschool Children: a Study Protocol for a Randomized Clinical Trial (Preprint). JMIR Res Protoc 2021; 11:e35145. [PMID: 35604758 PMCID: PMC9171591 DOI: 10.2196/35145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/21/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Tooth decay is a significant public health problem globally. The caries-arrest effectiveness of 38% silver diamine fluoride (SDF) has been well documented. However, information on the caries-preventive effect of SDF on primary teeth is insufficient. Objective The aim of this trial is to investigate the effectiveness of semiannual application of 38% SDF and that of 5% sodium fluoride (NaF) varnish when compared with placebo control for preventing occlusal caries in the primary molars of preschool children over 30 months. Methods This 3-arm, parallel design, double-blind, randomized controlled trial involves 791 preschool children. Children are randomly allocated to receive 1 of 3 interventions as follows: Group 1, 38% SDF; Group 2, 5% NaF varnish; and Group 3, placebo control (tonic water). The intervention and dental examination will be carried out every 6 months. A parent-administered questionnaire, including the children’s demographic background and oral health–related behaviors, has been collected at baseline. Follow-up examinations to detect new caries development will be conducted every 6 months by a masked examiner. Caries development will be diagnosed at the cavitation level. Chi-square tests and logistic regression analyses will be adopted. A 2-level logistic regression analysis will be performed to investigate the effects of the study interventions and other potential confounding factors on the development of occlusal caries. Results This study was started on September 1, 2020, and the recruitment process ended on September 30, 2021. At present, a total of 791 children are participating in the study. This 30-month clinical trial is expected to be completed in March 2024. Conclusions If SDF application is more effective than NaF varnish for preventing caries on occlusal surfaces of primary teeth, it can be a preferred choice for caries prevention in a kindergarten-based program. Results of this trial will provide valuable clinical evidence for the development of oral health strategies and policies on the promotion of child oral health. Trial Registration HKU Clinical Registry HKUCTR-2844, https://tinyurl.com/bdhz9yuk; ClinicalTrials.gov NCT05084001, https://clinicaltrials.gov/ct2/show/NCT05084001 International Registered Report Identifier (IRRID) DERR1-10.2196/35145
Collapse
Affiliation(s)
- Duangporn Duangthip
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Shuyang He
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Sherry Shiqian Gao
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - Chun Hung Chu
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Edward Chin Man Lo
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
28
|
Chan AKY, Tamrakar M, Jiang CM, Lo ECM, Leung KCM, Chu CH. A Systematic Review on Caries Status of Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010662. [PMID: 34682414 PMCID: PMC8535396 DOI: 10.3390/ijerph182010662] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/18/2022]
Abstract
The aim of this systematic review was to provide an update on caries prevalence in older adults aged 60 years or above around the globe. Two independent reviewers performed a systematic literature search of English publications from January 2016 to December 2020 using Pubmed, Scopus, Embase/Ovid and Web of Science. The MeSH terms used were “dental caries”, “root caries”, “DMF index”, “aged” and “aged 80 and over”. Further searches in Google Scholar retrieved eight additional publications. The epidemiological surveys reporting the prevalence of dental caries or root caries or caries experience using DMFT (decayed, missing and filled teeth) and DFR (decayed and filled root) in older adults aged 60 years or above were included. Quality of the publications was assessed using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. Among the 5271 identified publications, 39 articles of moderate or good quality were included. Twenty studies were conducted in Asia (China, India, Vietnam, Singapore and Turkey), ten in Europe (Ireland, Norway, Finland, Germany, Portugal, Poland, Romania and Kosovo), three in North America (USA and Mexico), one in South America (Brazil), two in Oceania (Australia) and three in Africa (Malawi, Egypt and South Africa). The prevalence of dental caries ranged from 25% (Australia) to 99% (South Africa), while the prevalence of root caries ranged from 8% (Finland) to 74% (Brazil) in community dwellers. The situation was even worse in institutionalised older adults of which the mean DMFT score varied from 6.9 (Malawi) to 29.7 (South Africa). Based on the included studies published in the last 5 years, caries is still prevalent in older adults worldwide and their prevalence varies across countries.
Collapse
Affiliation(s)
| | | | | | | | | | - Chun Hung Chu
- Correspondence: ; Tel.: +852-28590287; Fax: +852-28582532
| |
Collapse
|
29
|
The Current Strategies in Controlling Oral Diseases by Herbal and Chemical Materials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3423001. [PMID: 34471415 PMCID: PMC8405301 DOI: 10.1155/2021/3423001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/26/2021] [Indexed: 01/23/2023]
Abstract
Dental plaque is a biofilm composed of complex microbial communities. It is the main cause of major dental diseases such as caries and periodontal diseases. In a healthy state, there is a delicate balance between the dental biofilm and host tissues. Nevertheless, due to the oral cavity changes, this biofilm can become pathogenic. The pathogenic biofilm shifts the balance from demineralization-remineralization to demineralization and results in dental caries. Dentists should consider caries as a result of biological processes of dental plaque and seek treatments for the etiologic factors, not merely look for the treatment of the outcome caused by biofilm, i.e., dental caries. Caries prevention strategies can be classified into three groups based on the role and responsibility of the individuals doing them: (1) community-based strategy, (2) dental professionals-based strategy, and (3) individual-based strategy. The community-based methods include fluoridation of water, salt, and milk. The dental professionals-based methods include professional tooth cleaning and use of varnish, fluoride gel and foam, fissure sealant, and antimicrobial agents. The individual-based (self-care) methods include the use of fluoride toothpaste, fluoride supplements, fluoride mouthwashes, fluoride gels, chlorhexidine gels and mouthwashes, slow-release fluoride devices, oral hygiene, diet control, and noncariogenic sweeteners such as xylitol. This study aimed to study the research in the recent five years (2015–2020) to identify the characteristics of dental biofilm and its role in dental caries and explore the employed approaches to prevent the related infections.
Collapse
|
30
|
Ying Lam PP, Sardana D, Luo W, Ekambaram M, Man Lee GH, Man Lo EC, Yung Yiu CK. Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A Randomized Controlled Trial. Caries Res 2021; 55:322-332. [PMID: 34284374 DOI: 10.1159/000517390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3-4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0-1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group - application of 5% NaFV at 3-monthly intervals or GIS group - 1 single placement of GIS. A parental questionnaire was used to collect information on the children's sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (p = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.
Collapse
Affiliation(s)
- Phoebe Pui Ying Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China,
| | - Divesh Sardana
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Weijia Luo
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Gillian Hiu Man Lee
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| |
Collapse
|
31
|
Haiat A, Ngo HC, Samaranayake LP, Fakhruddin KS. The effect of the combined use of silver diamine fluoride and potassium iodide in disrupting the plaque biofilm microbiome and alleviating tooth discoloration: A systematic review. PLoS One 2021; 16:e0252734. [PMID: 34115788 PMCID: PMC8195348 DOI: 10.1371/journal.pone.0252734] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022] Open
Abstract
Silver diamine fluoride (SDF) is used in minimally invasive dentistry for arresting dental caries. However, discoloration of teeth is a significant side effect that has limited the use of SDF. Hence, the application of potassium iodide (KI) following SDF has been proposed to ameliorate the staining. Although antimicrobial activity is one of the major mechanisms of the caries-arresting effect of SDF, the antimicrobial potency of SDF/KI combination is unclear. Thus, the primary objective of this systematic review was to appraise the studies on the antimicrobial efficacy of SDF/KI combination on cariogenic microbes. The secondary objective was to summarize the evidence on the potential of KI in reducing the discoloration associated with the application of SDF. Electronic databases of Medline via PubMed, Cochrane Library, Web of Science, and EBSCO host were searched for English language manuscripts from January 2005 to 15th November 2020. The reference lists of these manuscripts were manually searched for additional studies. Twelve studies were included in the final analysis, seven of which have investigated the antimicrobial efficacy of SDF/KI, and the rest have examined the anti-staining potential of KI. The exploratory findings from the reviewed articles revealed the promising antimicrobial potential of SDF/KI on cariogenic microbes associated with dentine caries. There is, however, contradictory evidence on the effect of SDF/KI on tooth color. The reviewed in-vitro studies indicated significant effectiveness of KI in preventing staining. A clinical trial on primary dentition showed 25% reduction in the incidence of staining by SDF after applying KI, while a clinical study on root caries in adults showed no significant effect. Within the methodological limitations of this review, we conclude that for arresting dental caries, SDF could be combined with KI, as there may be a lower likelihood of staining. Further, well-designed clinical trials on the antimicrobial and anti-staining effect of SDF/KI are needed to obtain more robust evidence.
Collapse
Affiliation(s)
- Anahita Haiat
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
| | - Hien Chi Ngo
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
| | - Lakshman Perera Samaranayake
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
- Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - Kausar Sadia Fakhruddin
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
32
|
Chen J, Duangthip D, Gao SS, Huang F, Anthonappa R, Oliveira BH, Turton B, Durward C, El Tantawi M, Attia D, Heima M, Muthu MS, Maharani DA, Folayan MO, Phantumvanit P, Sitthisettapong T, Innes N, Crystal YO, Ramos-Gomez F, Medina AC, Lo ECM, Chu CH. Oral Health Policies to Tackle the Burden of Early Childhood Caries: A Review of 14 Countries/Regions. FRONTIERS IN ORAL HEALTH 2021; 2:670154. [PMID: 35048013 PMCID: PMC8757786 DOI: 10.3389/froh.2021.670154] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/07/2021] [Indexed: 12/05/2022] Open
Abstract
Aim: Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions. Method: Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country. Results: The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to population ratio was reported by Nigeria at 1:48,400, whereas the highest ratio was in Brazil (1:600). Out of 14, three (21%) countries namely India, Venezuela and Cambodia had no national oral health policies addressing ECC and four (29%) countries (Cambodia, China, India, Venezuela) had no publicly funded dental care program for 0-5-year-old children. Water fluoridation is available in four countries/regions (Australia, Brazil, Hong Kong, USA). Conclusion: ECC remains a global health challenge and dental workforce is limited. National/regional programs to tackle ECC are not yet prioritized in many countries/regions. Evidence to support demonstration projects is limited. Further research on the cost-effectiveness of interventions strategies is required for policymakers.
Collapse
Affiliation(s)
- Jieyi Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | | | | | - Fang Huang
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Robert Anthonappa
- Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
| | | | - Bathsheba Turton
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - Callum Durward
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - Maha El Tantawi
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Dina Attia
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Masahiro Heima
- Faculty of Dentistry, Kagoshima University, Kagoshima, Japan
| | - Murugan Satta Muthu
- Centre for Early Childhood Caries Research (CECCRe), Sri Ramachandra Institute of Higher Education and Research, Chennai, India
- Adjunct Research Associate, Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | | | | | | | | | - Nicola Innes
- School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - Yasmi O. Crystal
- College of Dentistry, New York University, New York, NY, United States
| | - Francisco Ramos-Gomez
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
33
|
Janakiram C, Ramanarayanan V, Devan I. Effectiveness of Silver Diammine Fluoride Applications for Dental Caries Cessation in Tribal Preschool Children in India: Study Protocol for a Randomized Controlled Trial. Methods Protoc 2021; 4:mps4020030. [PMID: 34064721 PMCID: PMC8162555 DOI: 10.3390/mps4020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Silver Diammine Fluoride (SDF) is an emerging caries preventive treatment option that is inexpensive, safe, and easily accessible. The evidence is clear that the use of SDF at concentrations of 38% is effective for arresting caries in primary teeth. However, the determination of an optimal SDF application frequency for a cavitated lesion in pragmatic settings is warranted especially among high dental caries risk groups. Hence, the primary objective of this clinical trial is to compare the effectiveness of annual, bi-annual, and four times a year application of 38% SDF application in arresting active coronal dentinal carious lesions on primary teeth among tribal preschool children aged 2–6 years. Methods and Analysis: This study is designed as a randomized, controlled trial consisting of three parallel arms with an allocation ratio of 1:1:1. The trial will enroll 480 preschool tribal children with a cavitated carious lesion (2–6 years) attending a primary health care Centre in Wayanad district, India. Each arm will receive 38% SDF application on an annual (baseline), bi-annual (baseline and 6 months), and four times a year (baseline, 2nd, 4th, and 8th week), respectively. The analysis will be performed both at the tooth- and person-level. Ethics and Dissemination: This trial will be conducted following the principles of the Declaration of Helsinki and local guidelines (Indian Council of Medical Research). The protocol has been approved by Institutional Review Committee (IRB). This trial has been registered prospectively with the Clinical Trial Registry of India [Registration No: CTRI/2020/03/024265].
Collapse
|
34
|
Contractor IA, M.S. G, M.D. I. Silver Diamine Fluoride: Extending the spectrum of Preventive Dentistry, a literature review. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
35
|
Caries arrest effectiveness of silver diamine fluoride compared to alternative restorative technique: randomized clinical trial. Eur Arch Paediatr Dent 2021; 22:575-585. [PMID: 33387347 DOI: 10.1007/s40368-020-00592-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/25/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This RCT study assessed and compared the effect of a biannual application of 38% silver diamine fluoride (SDF) with alternative restorative technique (ART) on arresting caries in primary dentition. METHODS The RCT was conducted over a period of 12 months and included 79 healthy children (237 primary teeth), aged 3-8 years, selected from the University Pediatric Dentistry outpatient clinics, with at least one primary asymptomatic tooth with active dentinal occlusal/labial lesions. Children were randomly assigned to SDF application or ART treatment. Visual and tactile examinations were used after 6 and 12 months to assess the activity of the carious lesions using the ICDAS II. RESULTS At 6- and 12-month-evaluation periods, no statistically significant differences in lesions arrest were found between SDF and ART groups (P = 1.000). Considering the frequency of arrested caries between the test groups at 6 and 12 months, no significant differences were observed between anterior and posterior lesions, as well as between the maxillary and mandibular lesions. When comparing the working time for the two treatments, the median time for those treated with SDF was 3.3 min, compared to 14.4 min for ART and was statistically significant (P < 0.0001). CONCLUSION Both SDF and ART are, indeed, effective for arresting caries. However, the chair-time management required for SDF is significantly shorter compared to ART. Taking into consideration the present evidence, the best decision regarding disease management and application of SDF or ART is to be made by the dentist and the patient/parent, recognizing individuals' differences and preferences.
Collapse
|
36
|
Jiang M, Fan Y, Li KY, Lo ECM, Chu CH, Wong MCM. Factors affecting success rate of atraumatic restorative treatment (ART) restorations in children: A systematic review and meta-analysis. J Dent 2020; 104:103526. [PMID: 33188846 DOI: 10.1016/j.jdent.2020.103526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Aim of this systematic review was to summarize the factors that affect the success rate of atraumatic restorative treatment (ART) restorations in children. DATA/SOURCES Two independent reviewers conducted a literature search in the databases PubMed, Medline and Web of Science until October 2019 with no initial time limit. Articles reporting on clinical outcomes of ART restorations placed in children were included. STUDY SELECTION A total of 67 articles were included in this review reporting on clinical outcomes of ART restorations placed in children in 47 studies. The overall estimated success rate and 95 % confidence interval (CI) of ART restorations were 0.71 (0.65-0.77) and 0.67 (0.56-0.78) at the 12-month and the 24-month follow-up, respectively. Operator was one of the significant factors associated with the success rate of ART restorations. ART restorations placed by dental students/therapists had a significantly lower success rate compared with those placed by dentists. Besides, type of restoration (single-surface vs. multiple-surface restoration) was also associated with the success rate of ART restorations. Other factors including dentition, restorative material, clinical setting, and moisture control method had no significant influence on the success rate of ART restorations in children. CONCLUSION It is concluded that ART approach can be used to manage cavitated caries lesions in children. Operator and type of restoration are significant factors influencing the success rate of ART restorations. CLINICAL SIGNIFICANCE This study provides valuable information on the factors that affect success rate of ART restorations in children, which helps clinicians to make informed decisions on provision of ART restorations in children.
Collapse
Affiliation(s)
- Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Yanpin Fan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Kar Yan Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - May Chun Mei Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| |
Collapse
|
37
|
Duangthip D, Chu CH. Challenges in Oral Hygiene and Oral Health Policy. FRONTIERS IN ORAL HEALTH 2020; 1:575428. [PMID: 35047981 PMCID: PMC8757757 DOI: 10.3389/froh.2020.575428] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/02/2020] [Indexed: 01/10/2023] Open
Affiliation(s)
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
38
|
Mei ML, Yan Z, Duangthip D, Niu JY, Yu OY, You M, Lo ECM, Chu CH. Effect of silver diamine fluoride on plaque microbiome in children. J Dent 2020; 102:103479. [PMID: 32950631 DOI: 10.1016/j.jdent.2020.103479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To investigate the microbiome profile and relative abundance changes of the plaque on silver diamine fluoride (SDF)-treated caries in children with early childhood caries. METHODS A single trained examiner assessed the caries as being arrested or active and then collected plaque samples from the caries lesions from fourteen 5-year-old children immediately before, 2 weeks after, and 12 weeks after a one-off application of 38 % SDF. We assigned 16S rRNA gene sequences to operational taxonomic units (OTUs) using a 98.5 % identity cut-off. We also used a variety of taxonomy- and phylogeny-based statistical approaches to compare the biodiversity and relative abundance among different groups. RESULTS The caries arrest rate were 90 % and 83 % after 2 and 12 weeks, respectively. We studied 46 plaque samples and identified 388 OTUs (254 identified at the species level, 129 identified at the genus level, and 76 identified at the family level). There was no significant change in the diversity in the arrested caries before and 12 weeks after SDF treatment (p = 0.71). The diversity in active caries reduced significantly 12 weeks after SDF treatment (p = 0.006). The relative abundance of certain caries-related species (e.g., Streptococcus mutans and Lactobacillus sp.) was reduced in arrested caries but was increased in active caries after SDF treatment. CONCLUSION There was no overall microbiome changes in the caries arrested by SDF. The relative abundance of some caries-related species is reduced in arrested caries, while increased in active caries. CLINICAL SIGNIFICANCE This study provides information on microbiome changes on SDF-treated caries of children.
Collapse
Affiliation(s)
- May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand; Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Zejun Yan
- Department of Research & Development, Aviagen Ltd, Edinburgh, United Kingdom
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Meng You
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| |
Collapse
|
39
|
Jiang M, Xie QY, Wong MCM, Chu CH, Lo ECM. Association between dental conditions, sliver diamine fluoride application, parental satisfaction, and oral health-related quality of life of preschool children. Clin Oral Investig 2020; 25:653-662. [PMID: 32895767 DOI: 10.1007/s00784-020-03542-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the associations between dental conditions, sliver diamine fluoride (SDF) application, parental satisfaction, and oral health-related quality of life (OHRQoL) of preschool children. MATERIALS AND METHODS In a clinical trial conducted in Hong Kong, preschool children who had carious lesions into dentine were randomly assigned to receive an application of SDF solution or placebo on their caries lesions 10 weeks before they received restorations. Additionally, a random sample of caries-free children was also recruited. Parents of the study children rated their satisfaction with their child's teeth using a 5-point scale (5 = very satisfied, 1 = very dissatisfied) 10 weeks after SDF or placebo application. Besides, the Chinese version of the Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to assess the children's OHRQoL. RESULTS There were 127, 133, and 154 children in the SDF, placebo, and caries-free groups, respectively. The parents whose child had 4 or more decayed teeth reported lower satisfaction scores (mean = 2.0 ± 0.7) with their child's dental health status compared with those of parents whose child had fewer (mean = 2.6 ± 0.9) or no (mean = 3.7 ± 0.7) decayed teeth (p < 0.001). These parents also reported higher C-ECOHIS scores. However, there was no significant difference in parental satisfaction and children's OHRQoL between the SDF and placebo groups (p > 0.05). CONCLUSIONS In this study population, parental satisfaction and children's OHRQoL were associated with children's dental caries status but not with SDF application. CLINICAL RELEVANCE This study provides valuable information about the factors, including SDF application, that can influence parental satisfaction and OHRQoL of preschool children.
Collapse
Affiliation(s)
- Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Qiu Yan Xie
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
- Prince Philip Dental Hospital, 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China.
| |
Collapse
|
40
|
Jiang M, Mei ML, Wong M, Chu CH, Lo E. Influence of Silver Diamine Fluoride Treatment on the Microtensile Bond Strength of Glass Ionomer Cement to Sound and Carious Dentin. Oper Dent 2020; 45:E271-E279. [PMID: 32502257 DOI: 10.2341/19-237-l] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2020] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE This study provides valuable information about the influence of silver diamine fluoride (SDF) treatment on the microtensile bond strength of glass ionomer cement (GIC) to dentin. SUMMARY Objectives: To investigate the influence of silver diamine fluoride (SDF) treatment on the microtensile bond strength (mTBS) of glass ionomer cement (GIC) to sound and artificial carious dentin.Methods: Thirty dentin blocks prepared from 30 noncarious human molars were randomly allocated into either the sound (Gp1) or artificial carious dentin (Gp2) groups. A microbiological method was adopted to create artificial dentin caries lesions in Gp2 specimens. Each dentin block was sectioned into two halves perpendicularly, and each pair of block halves was randomly assigned to two subgroups to receive topical application of SDF (Gp1-SDF, Gp2-SDF) or water as control (Gp1-water, Gp2-water). An encapsulated GIC was bonded to the exposed dentin surfaces 14 days after the SDF/water application. After immersion for 7 days in artificial saliva, the GIC-dentin specimens were sectioned into beams for mTBS testing. Failure mode was examined after the mTBS test.Results: There was no significant difference in the mean mTBS values between the SDF and control subgroups (Gp1-SDF vs Gp1-water, 10.57±1.6 MPa vs 10.20±1.8 MPa; Gp2-SDF vs Gp2-water, 6.14±2.2 MPa vs 5.97±2.3 MPa; paired t-test, p>0.05). However, the mean mTBS value of the sound dentin group was significantly higher than that of the carious dentin group, irrespective of whether SDF was applied prior to GIC bonding (independent t-test, p<0.001). Proportionally more cohesive failures occurred in the sound dentin groups (Gp1-SDF, 48.4%; Gp1-water, 42.9%) compared with the carious dentin groups (Gp2-SDF, 15.6%; Gp2-water, 9.8%; p<0.05).Conclusions: SDF treatment had no significant influence on the mTBS of GIC to dentin. Compared with sound dentin, dentin with caries had lower mTBS to GIC.
Collapse
|
41
|
A 24-month randomized controlled trial on the success rates of restoring untreated and SDF-treated dentine caries lesions in primary teeth with the ART approach. J Dent 2020; 100:103435. [PMID: 32712307 DOI: 10.1016/j.jdent.2020.103435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/10/2020] [Accepted: 07/18/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the success rates of restoring untreated and SDF-treated dentine caries lesions in primary teeth with atraumatic restorative treatment (ART) approach. METHOD Cavitated dentine caries lesions in preschool children were randomly allocated to two groups to be applied with either 38% silver diamine fluoride (SDF) solution or tonic water (control) ten weeks before being restored with the ART approach. Status of the restorations were assessed every six months by a blinded independent examiner. Multilevel logistic regression and multilevel survival analyses were conducted to assess the restoration success rates. RESULTS A total of 194 children (SDF group, 101; control group, 93) were included, with 260 and 249 ART restorations placed in the SDF and the control groups, respectively. At 24-month follow-up, 88 (87 %) and 84 (90 %) children remained in the SDF and the control groups, respectively. There was no significant difference between the ART restoration success rates of the two study groups (p > 0.05). The success rate of ART restorations was associated with the class of restorations. Class I restorations had the highest success rate (∼50 %), followed by Class V (∼35 %), Class II (∼15 %) and Class III (<10 %). Besides, the mean time used to place an ART restoration in a SDF-treated caries lesion was shorter than that in untreated lesion (4.8 vs. 5.1 min, p = 0.006). CONCLUSION Prior SDF application does not significantly affect the success rate of ART restorations placed in primary teeth. Besides, it is faster to place ART restorations in caries lesions that have been previously treated with SDF. CLINICAL SIGNIFICANCE Prior application of silver diamine fluoride solution on cavitated dentine caries lesions in primary teeth can shorten the average time required to place an ART restoration while not jeopardizing the success rate of the restorations.
Collapse
|
42
|
Turton B, Horn R, Durward C. Caries arrest and lesion appearance using two different silver fluoride therapies with and without potassium iodide: 6-month results. Heliyon 2020; 6:e04287. [PMID: 32715116 PMCID: PMC7369606 DOI: 10.1016/j.heliyon.2020.e04287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 04/21/2020] [Accepted: 06/19/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives to compare arrest rates and colour change in carious lesions in primary teeth using two different silver fluoride solutions with and without potassium iodide (KI). Methods The study was a four-armed, parallel-design randomised controlled trial and investigated four protocols for caries arrest at 6m. Children in Group 1 and Group 2 received Rivastar Silver Diammine Fluoride (SDF), and Children in Group 3 and Group 4 received an aqueous silver fluoride solution (AgF). Children in Group 2 and Group 4 received a two-step procedure where application of the AgF or SDF solution was followed by KI. Results At the six-month follow-up 446 (82.2%) children were re-examined. The arrest rate across the full sample was 51.4% and there were no significant differences in arrest rate by type of silver fluoride therapy. The lesion size, tooth type, surface type, presence of plaque on the carious lesion and caries increment all had an influence on caries arrest. Once clustering effects were accounted for, the use of KI was associated with a higher chance of arrest (OR 1.23; P-value 0.008) and a lower chance of the lesion darkening (OR 0.73; P-value <0.001). Conclusions The combination of AgF & KI was associated with the most favourable clinical outcomes in terms of caries arrest and lesion colour. Clinical significance The major draw-back of arrest of caries treatment with silver fluoride solutions is that it can create an appearance which may be aesthetically unacceptable. This study explores ways in which the base colour of lesions could be improved and as such provide the opportunity for better aesthetic outcomes for children afflicted with a severe burden of dental caries in their primary dentition, and in whom conventional treatment is not being provided.
Collapse
|
43
|
A randomized clinical trial to arrest dentin caries in young children using silver diamine fluoride. J Dent 2020; 99:103375. [PMID: 32428523 DOI: 10.1016/j.jdent.2020.103375] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The study aimed to compare the effectiveness of 38% silver diamine fluoride (SDF) solution, and 5% sodium fluoride (NaF) varnish applied semiannually in arresting dentin caries in young children with high caries risk. METHODS Children aged 1-3 years who had at least one active dentin carious lesion were randomly allocated into 2 groups as follows: Group 1 = 38% SDF (Topamine), and Group 2 = 5% NaF varnish (Duraphat). Both agents were applied every 6 months onto the carious surface. Lesion activity was assessed by the visual-tactile examination. Baseline and follow-up examinations were conducted by the same examiner. The children's demographic background, oral health-related habits, and oral hygiene practices, as well as parental satisfaction with children's dental appearance were collected at baseline and the 12-month follow-up. RESULTS At baseline, 153 and 149 children were recruited in Group 1 and Group 2, respectively. The mean dmfs scores in Groups 1 and 2 were 8.89 and 9.79, respectively. After 12 months, 87.1% remained in the study. The caries arrest rate of Group 1 (35.7%) was significantly higher than that of Group 2 (20.9%) (p < 0.001). The results of the multilevel logistic regression analysis confirmed that the treatment in Group 1 was more effective in arresting dentin carious lesions than that of Group 2 (OR = 2.04; 95% CI, 1.41-2.96). The presence of plaque on caries lesions, tooth type, tooth surface type, frequency of milk feeding, snack taking, and family income influenced on caries activity. Regardless of the intervention groups, there were no differences in parental satisfaction with on the child's dental appearance before and after receiving the intervention. CONCLUSION Based on the 12-month results, 38% SDF is more effective than 5% NaF varnish in arresting dentin carious lesions in young children. SDF has no negative impact on parental satisfaction with the child's dental appearance. CLINICAL SIGNIFICANCE To control dentin carious lesions in young children with high caries risk, 38% SDF is more effective than 5% NaF varnish.
Collapse
|
44
|
Mei ML, Yan Z, Duangthip D, Niu JY, Yu OY, You M, Lo ECM, Chu CH. WITHDRAWN: Effect of silver diamine fluoride on plaque microbiome in children. J Dent 2020; 103S:100016. [PMID: 34059301 DOI: 10.1016/j.jjodo.2020.100016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 02/05/2023] Open
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published in Journal of Dentistry, 102 (2020) article number 103479, https://doi.org/10.1016/j.jdent.2020.103479. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
Collapse
Affiliation(s)
- May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand; Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Zejun Yan
- Department of Research & Development, Aviagen Ltd, Edinburgh, United Kingdom
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Meng You
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| |
Collapse
|
45
|
Jiang M, Mei ML, Wong MCM, Chu CH, Lo ECM. Effect of silver diamine fluoride solution application on the bond strength of dentine to adhesives and to glass ionomer cements: a systematic review. BMC Oral Health 2020; 20:40. [PMID: 32024501 PMCID: PMC7003410 DOI: 10.1186/s12903-020-1030-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/30/2020] [Indexed: 11/25/2022] Open
Abstract
Background Silver diamine fluoride (SDF) solution gains increasing popularity in arresting dentine caries in clinical practice. The aim of this systematic review was to summarize the findings from laboratory studies on the influence of SDF application on the bond strength of dentine to various adhesives and to glass ionomer cements (GICs). Methods Two independent reviewers conducted a literature search in the databases Medline, Ovid, PubMed and Web of Science until 15th August 2019 using the search keywords [‘bond strength’] AND [‘silver diamine fluoride’ OR ‘silver diammine fluoride’ OR ‘SDF’ OR ‘silver fluoride’ OR ‘diamine silver fluoride’]. Articles investigating the effect of SDF application on the bond strength of dentine to various adhesives and to GICs were included in this review. Information on how SDF application influenced the bond strength was extracted from the included articles. Besides, related information, e.g. test method of bond strength, concentration and brand of SDF, type of adhesive system and GIC, testing dental substrate, protocol of specimen preparation, and failure mode was also reviewed. Results A total of 13 articles were included in this review, with 8 and 6 studies investigating the effect of SDF application on the bond strength of dentine to various adhesives and to GICs, respectively. Sound dentine as well as demineralized dentine created by chemical methods, e.g. immersing in a demineralizing solution, was commonly adopted as the testing dental substrate. The microtensile bond strength (mTBS) test was the predominant method employed. However, the bond strength values had large variations among studies, ranging from <10 to 162 Mpa. Regarding the bond strength to different adhesives, 4 studies indicated that SDF application followed by rinsing with water had no significant influence. However, another 4 studies reported reduced bond strength after SDF application. Regarding the bond strength to GICs, 4 studies concluded that SDF application had no adverse impact on the bond strength. Conclusions No solid conclusion can be drawn on the effect of SDF application on the bond strength of dentine to adhesives and to GICs due to the high degree of variation of the included studies.
Collapse
Affiliation(s)
- Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - May Lei Mei
- Faculty of Dentistry, The University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand
| | - May Chun Mei Wong
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong, China. .,Dental Public Health, The Prince Philip Dental Hospital, 3F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China.
| |
Collapse
|
46
|
Schmoeckel J, Gorseta K, Splieth C, Juric H. How to Intervene in the Caries Process: Early Childhood Caries – A Systematic Review. Caries Res 2020; 54:102-112. [DOI: 10.1159/000504335] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/24/2019] [Indexed: 11/19/2022] Open
Abstract
For an Organisation for Caries Research/European Federation of Conservative Dentistry consensus, this systematic review is aimed to assess the question of how to manage the caries process in the case of early childhood caries (ECC). Medline via PubMed was searched systematically regarding management of ECC. First priority was existing systematic reviews or randomized clinical trials otherwise cohort studies dealing with management of ECC, primarily with carious anterior teeth. After data extraction, the potential risk of bias was estimated depending on the study types, and the level of evidence was evaluated. Regarding management of ECC, results are presented for silver diamine fluoride (SDF, n = 5), nonoperative caries management (NOCM, n = 10), and restorative approaches (RA, n = 8) separately, as different kinds of studies with different levels of evidence were found for the different aspects in the management of ECC. The 5 systematic reviews on SDF showed a high potential for arrest of ECC on a high level of evidence. In NOCM, a low level of evidence for a moderate effect of fluoride varnish in arresting or remineralizing, especially non-cavitated lesions, was assessed. For RA in carious anterior upper primary teeth, a low level of evidence was found for higher failure rates of glass ionomer cement and composite fillings than composite strip crowns even if placed under general anaesthesia and especially compared to other crowns (stainless steel and zirconia). In conclusions, ECC may be managed successfully with nonoperative (SDF, regular fluoride application) and moderately well with operative approaches, but the decision is affected by many other variables such as pulpal involvement, the child’s cooperation, or a general anaesthesia setting.
Collapse
|
47
|
Fröhlich TT, Rocha RDO, Botton G. Does previous application of silver diammine fluoride influence the bond strength of glass ionomer cement and adhesive systems to dentin? Systematic review and meta-analysis. Int J Paediatr Dent 2020; 30:85-95. [PMID: 31419356 DOI: 10.1111/ipd.12571] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/24/2019] [Accepted: 08/11/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Silver diammine fluoride (SDF) applied before a restoration may prevent recurrent caries; therefore, its effect on the bonding of restorative materials is contradictory. AIM To assess through a systematic review and meta-analysis the influence of SDF on the bonding performance of adhesive materials to dentine. DESIGN A systematic search was carried out in PubMed, Web of Science, LILACS, and Scopus. Studies comparing bond strength of adhesive systems or glass ionomer cement to SDF-treated and -untreated (control) dentine were included. Global analysis comparing the bond strength data was performed, separately for adhesive systems and glass ionomer cement, using RevMan5.1, with a random-effect model, at a 5% significance level. RESULTS Eleven studies were included in the review and ten in the meta-analyses. Overall pooled effect for glass ionomer cement has shown no significant difference between the groups (Z = 0.47; P = .64). SDF treatment significantly impairs the bonding of adhesive systems to dentine (Z = 2.11; P = .03); this effect can be eliminated by the rinsing step (Z = 0.85; P = .40). CONCLUSIONS The previous application of SDF does not influence the dentine bond strength of glass ionomer cement, but compromises the bonding of adhesive systems.
Collapse
Affiliation(s)
| | | | - Graziela Botton
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| |
Collapse
|
48
|
Slayton RL, Urquhart O, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, Nový BB, Tinanoff N, Weyant RJ, Wolff MS, Young DA, Zero DT, Tampi MP, Pilcher L, Banfield L, Carrasco-Labra A. Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. J Am Dent Assoc 2019; 149:837-849.e19. [PMID: 30261951 DOI: 10.1016/j.adaj.2018.07.002] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults. TYPES OF STUDIES REVIEWED The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane database of systematic reviews to identify randomized controlled trials reporting on nonrestorative treatments for noncavitated and cavitated carious lesions. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions. RESULTS The expert panel formulated 11 clinical recommendations, each specific to lesion type, tooth surface, and dentition. Of the most effective interventions, the panel provided recommendations for the use of 38% silver diamine fluoride, sealants, 5% sodium fluoride varnish, 1.23% acidulated phosphate fluoride gel, and 5,000 parts per million fluoride (1.1% sodium fluoride) toothpaste or gel, among others. The panel also provided a recommendation against the use of 10% casein phosphopeptide-amorphous calcium phosphate. CONCLUSIONS AND PRACTICAL IMPLICATIONS Although the recommended interventions are often used for caries prevention, or in conjunction with restorative treatment options, these approaches have shown to be effective in arresting or reversing carious lesions. Clinicians are encouraged to prioritize use of these interventions based on effectiveness, safety, and feasibility.
Collapse
|
49
|
Meyer BD, Wang R, Steiner MJ, Preisser JS. The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia. JDR Clin Trans Res 2019; 5:146-155. [PMID: 31434532 DOI: 10.1177/2380084419870128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite early evidence touting the effectiveness of physician-provided oral health services (POHS), recent evidence suggests these services might have little impact on caries-related outcomes in children. General anesthesia (GA) is often used to treat early childhood caries and may be considered the most extreme utilization outcome. We sought to assess the impact of POHS utilization on dental GA utilization and expenditures. METHODS We used the Medicaid claims of a birth cohort of children born in 2008 in North Carolina (N = 32,558) to determine the impact of POHS on dental utilization and expenditures under GA for individual children. Children were followed until their eighth birthday. We analyzed the association of the number of prior POHS visits with visit-specific outcomes of dental treatment under GA using population-averaged models fit with generalized estimating equations with exchangeable working correlation structure. RESULTS Children with 2 or more previous POHS visits had reduced odds of GA (odds ratio [OR] = 0.93; confidence interval [CI], 0.87-0.99; P = 0.029) and expenditures ($114; CI,-$152.61 to -$75.19; P < 0.001) compared to those without physician-provided oral health visits, adjusting for age, sex, race/ethnicity, and geographic residence. Dental expenditures did not differ between POHS and non-POHS subjects at non-GA visits. CONCLUSIONS POHS decreased the odds of having dental GA treatment and dental expenditures at GA visits. The role of physicians in oral health care can reduce the impact on the most severe outcome-treatment under general anesthesia. KNOWLEDGE TRANSFER STATEMENT The results of this study have important financial implications for state Medicaid programs and disease management programs trying to mitigate the costs of treating early childhood caries under general anesthesia. Children who receive physician oral health care are less likely to use and more likely to save money on general anesthesia to complete dental treatment.
Collapse
Affiliation(s)
- B D Meyer
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R Wang
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M J Steiner
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J S Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
50
|
Effects of restoring SDF-treated and untreated dentine caries lesions on parental satisfaction and oral health related quality of life of preschool children. J Dent 2019; 88:103171. [PMID: 31325466 DOI: 10.1016/j.jdent.2019.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/10/2019] [Accepted: 07/14/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To find out the effects of placement of atraumatic restorative treatment (ART) restorations on parental satisfaction and oral health related quality of life (OHRQoL) of preschool children with SDF-treated or untreated dentine caries lesions. METHODS In a randomized controlled trial conducted in Hong Kong, preschool children who had cavitated dentine caries lesions were randomly assigned to receive application of silver diamine fluoride (SDF) solution or placebo (tonic water) on their caries lesions 10 weeks before receiving ART restorations. Parents were asked to rate their satisfaction with their child's teeth using a 5-point scale (5 = very satisfied, 1 = very dissatisfied) before and six months after the restorative treatment. Besides, the Chinese version of Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to assess the children's OHRQoL. RESULTS A total of 194 children participated in this study, with 101 and 93 children receiving SDF and placebo application before ART restorations, respectively. There was no significant difference in parental satisfaction and C-ECOHIS score between the SDF and placebo groups at baseline. At the 6-month follow-up, the mean parental satisfaction score regarding their child's dental health status increased significantly (p < 0.001) from 2.2 ± 0.7 to 2.8 ± 1.0 in the SDF group and from 2.3 ± 0.8 to 2.7 ± 0.9 in the placebo group. However, no significant changes (p > 0.05) in C-ECOHIS scores were found in either of the two groups after ART restoration placement. CONCLUSIONS Placement of ART restorations can improve parental satisfaction with the health and appearance of their child's teeth but has no significant effect on the OHRQoL. CLINICAL SIGNIFICANCE This study provides valuable information about the effects of ART restoration placement on SDF-treated or untreated dentine caries lesions regarding parental satisfaction and OHRQoL of preschool children.
Collapse
|