Simple, low-cost treatment prevents tooth decay in children

Scientists have discovered a simple, low-cost solution for it the most common chronic disease among children: tooth decay.

More than half of US children between the ages of 6 and 9 have had a cavity in at least one of their baby teeth, according to the US Centers for Disease Control and Prevention (CDC). And more than half of US teens ages 12 to 19 have had a cavity in at least one of their permanent teeth.

Tooth decay can be very painful and lead to problems with eating, speaking, playing and learning. Children in low-income families are twice as likely to develop tooth decay as those in higher-income households, so finding low-cost solutions is an essential public health goal.

Across the US, school sealant programs have dental professionals visit schools to apply a thin, protective coating to the surface of teeth to help harden them and protect them from decay. The CDC says these dental sealants can prevent 80 percent of cavities.

However, these sealants can be expensive and time-consuming to apply. Therefore, researchers are looking for lower-cost alternatives. One such alternative is silver diamine fluoride, a solution originally approved by the Food and Drug Administration for the treatment of tooth sensitivity.

“A growing body of research shows that silver diamine fluoride – which is applied more quickly and is less expensive than sealants – can prevent and stop cavities, reducing the need for drilling and fillings,” said Richard Niederman, professor of epidemiology and health promotion at the New York University College of Dentistry, in a statement.

The treatment is easy to apply and simply involves brushing the liquid over the surface of the teeth, which kills the bacteria that cause cavities and remineralizes the teeth to prevent further decay.

In a new study, published in the journal JAMA PediatricsNiederman and colleagues at NYU compared the use of silver diamine fluoride with standard sealants in a group of about 4,100 children in New York City elementary schools.

Each school was randomly assigned either traditional silver diamine fluoride sealants, followed by a fluoride varnish.

In 2023, the team said a single treatment of both treatments prevented 80 percent of cavities and kept 50 percent of existing cavities from getting worse two years later. For context, at the start of the project 25 percent of the children studied had untreated cavities.

Now, in March 2024, the team was able to confirm that silver diamine fluoride treatment is as effective in preventing tooth decay as a sealant in children after four years.

Ryan Richard Ruff, associate professor of epidemiology and health promotion at the NYU College of Dentistry and first author of the study, said in a statement: “Our longitudinal study confirms that both sealants and silver diamine fluoride are effective against dental caries. . a promising alternative that can support caries prevention in school – not to replace the dental sealant model, but as another option that also prevents and inhibits caries.”

Study co-author and Tamarinda Associate Program Director Barry Godin added: “Most research shows that SDF can stop a cavity from progressing further. Our study showed that SDF can prevent cavities from forming in the first place .”