Abstract
BackgroundUntreated dentin caries in primary teeth is commonly found in preschool children worldwide. Recently, the use of simple non-surgical approaches to manage the situation has been advocated.The aim of the study was to systematically review and evaluate the literature on effectiveness of non-surgical methods in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children.MethodsA systematic search of the main electronic databases (Pubmed, Cochrane Collaboration, EMBASE) was conducted to identify peer reviewed papers published in English in the years 1947–2014. Keywords and MeSH terms used in the search were “dental caries”, “primary dentition” and various non-surgical treatments (fluoride, sealant, resin infiltration, xylitol, chlorhexidine, CPP-ACP, ozone, etc.). The inclusion criteria were clinical studies conducted in children under 6 years old, and reported findings on caries arrest or caries progression in primary teeth. Retrieved papers were read by two reviewers independently to assess suitability for inclusion, and the final decision was made by consensus. Quality of the included studies was assessed and data were extracted for analysis.ResultsThe search identified 323 papers for screening. Among these, 290 papers did not satisfy the study inclusion criteria. Consequently, 33 full papers were retrieved and reviewed. Finally, 4 studies were included. Three studies reported that topical applications of silver diammine fluoride (SDF) solution could arrest dentin caries in preschool children. One study supported that having a daily toothbrushing exercise in kindergarten using toothpaste with 1000 ppm fluoride could stabilize the caries situation in young children.ConclusionsThere is limited evidence to support the effectiveness of SDF applications or daily toothbrushing with fluoride toothpaste in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children. More well-designed randomized controlled trials are required to confirm these findings.
Highlights
Untreated dentin caries in primary teeth is commonly found in preschool children worldwide
A number of studies in children have shown that silver diammine fluoride (SDF) solution is effective in preventing dental caries [11,12] and in arresting dental caries [13,14,15]
Five additional papers in English were identified using a combination of the Medical subject headings (MeSH) terms, “Silver Compounds” AND “Dental Caries” AND “Primary teeth”
Summary
Untreated dentin caries in primary teeth is commonly found in preschool children worldwide. The aim of the study was to systematically review and evaluate the literature on effectiveness of non-surgical methods in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children. Dental fillings or restorations have been used as a treatment option for the management of early childhood caries (ECC) [2]. This procedure requires sophisticated equipment and well trained dental personnel, especially when treating apprehensive young children. Caries arrest treatment with fluorides in various vehicles (toothpaste, gel, varnish, soluation, mouthrinse) has been shown to be a viable alternative to the traditional restorative approach. SDF has been used for more than four decades with no reported complications, adoption by clinicians is still limited, probably due to the black staining associated with the arrested caries lesions [16]
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