Caries Arrest Research Articles

Predicting Treatment Nonresponse in Hispanic/Latino Children Receiving Silver Diamine Fluoride for Caries Arrest: A Pilot Study Using Machine Learning.

Objectives: Silver diamine fluoride (SDF) is a nonsurgical therapy for the arrest and prevention of dental caries with demonstrated clinical efficacy. Approximately 20% of children receiving SDF fail to respond to treatment. The objective of this study was to develop a predictive model of treatment non-response using machine learning.Methods: An observational pilot study (N = 20) consisting of children with and without active decay and who did and did not respond to silver diamine fluoride provided salivary samples and plaque from infected and contralateral sites. 16S rRNA genes from samples were amplified and sequenced on an Illumina Miseq and analyzed using QIIME. The association between operational taxonomic units and treatment non-response was assessed using lasso regression and artificial neural networks.Results: Bivariate group comparisons of bacterial abundance indicate a number of genera were significantly different between non-responders and those who responded to SDF therapy. No differences were found between non-responders and caries-active subjects. Prevotella pallens and Veillonella denticariosi were retained in full lasso models and combined with clinical variables in a six-input multilayer perceptron.Discussion: The acidogenic and acid-tolerant nature of retained bacterial species may overcome the antimicrobial effects of SDF. Further research to validate the model in larger external samples is needed.

Caries lesion transition patterns of schoolchildren in a fluoridated community in Brazil.

To describe the caries lesion transition pattern in permanent tooth surfaces over 2years among a convenience sample of children in a fluoridated (0.8ppm F) low-socioeconomic community of Brazil. One hundred forty-nine schoolchildren (7-12years) were examined for caries using Nyvad criteria at baseline and after 2years. Descriptive analysis was used to evaluate caries lesion transition patterns. Less than 1% of sound surfaces and non-cavitated caries lesions at baseline progressed to cavitation stage within 2years. 12.7% of the active non-cavitated (ANC) lesions became inactive, 34.7% regressed to sound, 48.0% remained active, and 4.6% progressed to cavitated/filled stages at follow-up. Similarly, 55.2% of the inactive non-cavitated (INC) lesions at baseline remained inactive, 33.3% regressed to sound, 8.0% progressed to cavitated/filled lesions, while only 3.5% progressed to ANC lesions. The caries lesion transition pattern in this child population exposed to water fluoride and fluoride toothpaste showed that a low proportion of sound surfaces and non-cavitated lesions progressed to cavitation within the 2-year follow-up. Caries arrest was mainly ascribed to a high proportion of active non-cavitated lesions regressing to sound or inactive lesions. Caries activity can be controlled by regular exposure to fluoridated water and fluoridated toothpaste.

Arrest of root caries with an adjuvant chlorhexidine\u2013fluoride varnish over a 12-months observation period: a QLF-analyzed, placebo-controlled, randomized, clinical trial (RCT)

This study aimed at evaluating the effectiveness of an adjuvant chlorhexidine–fluoride varnish (Cervitec F) for prevention and arrest of root caries on elderly participants using quantitative light-induced fluorescence (QLF). 23 participants with two or three non-cavitated root carious lesions were included and assigned to three groups of different varnishes (CF: Cervitec F, P: placebo, DP: Duraphate). Agents were applied once to root surface at baseline and in follow-up after 3, 6 and 9 months. The lesions were assessed clinically and with QLF. QLF-images were analyzed regarding fluorescence loss (ΔF), lesion volume (ΔQ) and bacterial activity (ΔR) before (t0), after 14 days (t1), 6- (t2) and 12-months (t3). CF showed a significant difference between t0 and t3: ∆F (− 12.51 [15.41] vs. − 7.80 [16.72], p = 0.012), ∆Q (− 2339.97 (20,898.30) vs. − 751.82 (5725.35), p < 0.001), ∆R (23.80 [41.70] vs. 7.07 [37.50], p = 0.006). Independently of the varnish application, preventive care seems positively influence the root caries progress. Although within CF group the strongest effect was observed, no superiority of a specific varnish application was confirmed over a 12-months QLF observation period. Extra topical fluoride can help remineralise dentin lesions and QLF can be used as a measurement method to determine changes in the dentin lesions.

A Concise Review of Silver Diamine Fluoride on Oral Biofilm

Studies have shown that silver diamine fluoride (SDF) is an effective agent to arrest and prevent dental caries due to its mineralizing and antibacterial properties. While plenty of studies have investigated the mineralizing properties, there are few papers that have examined its antibacterial effect on oral biofilm. The objective of this study was to identify the effect of silver diamine fluoride on oral biofilm. Method: The keywords used were (silver diamine fluoride OR silver diammine fluoride OR SDF OR silver fluoride OR AgF AND biofilm OR plaque). Two reviewers screened the titles and abstracts and then retrieved the full text of the potentially eligible publications. Publications of original research investigating the effect of SDF on oral biofilm were selected for this review. Results: This review included 15 laboratory studies and six clinical studies among the 540 papers identified. The laboratory studies found that SDF could prevent bacterial adhesion to the tooth surface. SDF also inhibited the growth of cariogenic bacteria, including Streptococcus mutans, Lactobacillus acidophilus, Streptococcus sobrinus, Lactobacillus rhamnosus, Actinomyces naeslundii, and Enterococcus faecalis, thus contributing to its success in caries arrest. One clinical study reported a decrease in Streptococcus mutans and Lactobacillus sp. in arrested caries after SDF treatment, and another clinical study found that SDF inhibited the growth of periodontitis microbiota, including Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia/nigrescens. However, three clinical studies reported no significant change in the microbial diversity of the plaque on the tooth after SDF treatment. Moreover, one laboratory study and one clinical research study reported that SDF inhibited the growth of Candida albicans. Conclusion: Not many research studies have investigated the effects of SDF on oral biofilm, although SDF has been used as a caries-arresting agent with antibacterial properties. However, a few publications have reported that SDF prevented bacterial adhesion to the teeth, inhibited the growth of cariogenic and periodontal bacteria, and possessed antifungal properties.

Effectiveness and Parental Perception of Silver Diamine Fluoride toward Treatment of Dental Caries in Primary Teeth.

AimSilver diamine fluoride (SDF) is taken into account as one among the effective measures for caries arrest and prevention in youngsters, due to the fact it proffers marginally invasive but cost-effective alternative to time-commemorated restorative caries control. The study was carried out to appraise the effectiveness of SDF (38%) in arresting active carious lesions and to gauge parental perception toward the treatment of cavities with SDF in the primary teeth.Materials and methodsA total of 36 children in the age range 2–10 years, having active caries lésions, based on ICDAS criteria, in primary teeth were selected following the baseline examination. After four dropouts and refusal by two patients, 30 patients were treated with 1–2 topical applications of SDF (38%). Lesions were reassessed at 1 week and 3 months taking into account to assess the color and amend inconsistency (soft/hard). Parents have been mentioned regarding features of pain or infection and have been surveyed with regard to subjective feelings regarding SDF.ResultsQuantitative variables have been subjected to the Chi-square test. All the 30 participants within the present study at baseline were reported to possess active caries lesion. About 80% of carious lesions were found to be arrested at first recall and 93.3% after 3 months. No occurrence of pain or infection was documented. Parental perception for simple application, taste, and esthetics became statistically significant. Conclusion: Study outcomes endorse SDF to be effective in preventing active carious lesions in deciduous dentition in youngsters, and treatment outcomes were affirmative by the parents.Clinical significanceSDF has been a possible management option for a noninvasive remedy to inhibit active carious lesions in deciduous dentition without causing any psychological trauma to children.How to cite this articleShrivastava U, Barjatya K, AK BB, et al. Effectiveness and Parental Perception of Silver Diamine Fluoride toward Treatment of Dental Caries in Primary Teeth. Int J Clin Pediatr Dent 2021;14(6):790–794.

Silver Diamine Fluoride versus Bioactive Giomer Light-Curing Varnish: An In Vitro Study on Caries Arrest

Objective To compare the capacity of silver diamine fluoride (30%) and the bioactive giomer light-curing varnish for arresting ICDAS score 5 non-retentive caries lesions. Material and Methods An in vitro analytical study was conducted using 36 healthy primary teeth, in which a cavity was created, divided into 3 groups: control (distilled and deionized water), giomer-based light-curing varnish – Barrier Coat, and Silver Diamine Fluoride 30% – Cariestop (SDF). The samples were analyzed for mineral loss as measured by surface microhardness (SMH).The Knoop microhardness test was performed using the HVS-1000 microhardness tester. The data were compared by two-way analysis of variance – treatment and time (before and after treatment) followed by Tukey’s post-test. The significance level adopted in all analyzes was 5%. Results The specimens treated with giomer showed higher SMH compared to the untreated group but were similar to those of the SDF group. The SDF group, on the other hand, showed no statistically significant difference from the control group (p=0.010). Conclusion The giomer varnish had a remineralizing effect on artificial dentinal caries.

Caries arrest and lesion appearance using two different silver fluoride therapies on primary teeth with and without potassium iodide: 12-month results.

Globally, has been an increase in the use of silver fluoride products to arrest carious lesions and a variety of products are available. To examine differences in caries arrest and lesion colour of primary tooth carious lesions. A four-armed, parallel-design cluster-randomised controlled trial which investigated four protocols for caries arrest at 6m and 12m. Children in Group 1 and Group 2 received Rivastar Silver Diammine Fluoride (SDF), and children in Group 3 and Group 4 received a stabilised aqueous silver fluoride solution (AgF). Children in Group 2 and Group 4 received an additional application of KI immediately after the fluoride. Differences in caries arrest and lesion appearance were examined at 6m and 12m using two level logistic regression modelling. The arrest rate varied by group membership; group 1 and group 3 had higher arrest rates (77.3% and 75.3% respectively) than group 2 and group 4 (65.4% and 51.2% respectively). The use of KI was also associated with lower odds of arrest (12m OR 0.25; CI 0.19, 0.34) and higher odds of avoiding black discolouration (12m OR 6.08; 2.36, 15.67). Globally, has been an increase in the use of silver fluoride products to arrest carious lesions and a variety of products are available. This study demonstrated that both AgF and SDF can effectively arrest carious lesions on primary teeth. The use of KI is associated with poorer caries control but better aesthetic outcomes.

COVID-2019 – Time to Use Silver Diamine Fluoride for Caries Arrest in General Dental Practice?

Silver diamine fluoride (SDF) is applied topically to arrest caries and has an increasing evidence base to support its efficacy, both in the primary dentition and to arrest root caries in older patients. It can be used as a non-aerosol generating procedure and is a simple technique. It has a side-effect of discolouring caries black, a factor which requires discussion with patients and their carers prior to application. Due to its efficacy and simplicity, it is a useful intervention for the management of caries. CPD/Clinical Relevance: Caries is a common condition in the UK, and silver diamine fluoride offers a simple alternative management technique when case selection is appropriate.

Therapeutic Use of Silver Nanoparticles in the Prevention and Arrest of Dental Caries.

Dental caries is one of the major diseases of the oral cavity affecting humans worldwide. Different alternatives have been used for its control, but its incidence and prevalence are still high. On the other hand, silver has been used for centuries due to its antimicrobial properties. With advances in nanotechnology, the use and research in nanomaterials has increased, recently, and silver nanoparticles have become an essential part of the dental practice, giving materials physical and chemical improvements in their properties, used for their antibacterial capacity preventing and arresting dental caries. The objective of this review was to examine the use of silver nanoparticles, in the treatment of dental caries in the remineralization of teeth hard tissues, as well as the antimicrobial potential, cytotoxicity, and long-term effectiveness.

Caries arrest and lesion appearance using two different silver fluoride therapies with and without potassium iodide: 6-month results

Objectivesto compare arrest rates and colour change in carious lesions in primary teeth using two different silver fluoride solutions with and without potassium iodide (KI). MethodsThe 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. ResultsAt 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). ConclusionsThe combination of AgF & KI was associated with the most favourable clinical outcomes in terms of caries arrest and lesion colour. Clinical significanceThe 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.

EXPANDING HORIZON IN CARIES PREVENTION WITH SILVER DIAMINE FLUORIDE- A REVIEW

Dental caries is the most common pandemic on the globe, affecting various age bars in all countries with varying degree of severity. Silver diamine fluoride provides an alternative care path for those patients in whom traditional restorative treatment cannot be done. Application of SDF to arrest dental caries is a non-invasive procedure that is quick and simple to use. Reports of available studies found no severe pulpal damage after SDF application. However, it has drawbacks like black discoloration of the carious teeth and an unpleasant metallic taste. But, the low cost of SDF and its simplicity in application suggest that SDF is an appropriate therapeutic agent for use in community dental health projects.&#x0D; Keywords: Silver diamine fluoride; Dental caries; Caries arrest

Everyone else is using it, so why isn't the UK? Silver diamine fluoride for children and young people.

Silver diamine fluoride (SDF) is used to prevent and arrest caries across the globe, particularly in the developing world. Whilst its use in the Western World is increasing, it is not yet routinely used in the United Kingdom, nor is it advocated by our national guidelines. To explore the literature surrounding the use of SDF, and consider the reasons why SDF has not yet been widely adopted in the United Kingdom (UK). There is a growing evidence base for the use of SDF for the arrest and prevention of dental caries in the primary and permanent dentition. Potential side effects include staining of carious tooth structure, but in some cases this is acceptable to parents. There is no evidence for the cost effectiveness of SDF, although it may be a reasonably cost-effective option. SDF is perhaps not yet widely adopted in the UK due to a perceived parental concern about its staining effect. With a growing evidence base and reportedly higher efficacy than fluoride varnish for caries prevention and arrest, SDF has the potential to play an important role in managing dental disease in children and young people in both primary and secondary care.

Silver Diamine Fluoride in Arresting Dentinal Caries in School Children

Background: In recent years, remineralisation of caries lesions has gained acceptance in the practice ofminimally invasive dentistry and caries arrest treatment is being promoted as a part of basic oral health care.Silver diamine fluoride(SDF) has shown to be effective in arresting active caries in primary teeth. Whether ahigher caries arrest rate can be achieved through more frequent application is unknown, hence in our studywe had sought to explore this aspect. Aim: To evaluate the effectiveness of three different frequencies ofapplication of SDF in arresting active dentinal caries primary teeth.Methodology: 48 children aged 5-8 years were divided into three groups, group 1 who received monthlyapplications of SDF for three months, group 2 who received three monthly applications of SDF for 6 monthsand group 3 received 6 monthly applications. Active caries surfaces were recorded at baseline examinationand SDF was applied. No attempt was made to excavate caries. Active and arrested caries were recorded at6 months and one year for all the groups. Results: Allthree application protocols were effective in arrestingcaries at the end of 6 months and one-year. Inter-group comparison of active caries surfaces showed nostatistically significant differences at the end of 6 months. At one year follow up there were statisticallysignificant differences between the three groups, with caries arrest rate highest in group I, followed by groupII and then group III.Conclusion: Significant caries arrest was seen in all three application protocols of SDF at the end of sixmonths as well as one year follow up. The one monthly application of SDF was most effective in arrestingdentin caries in primary molars of children followed by the three monthly application and the 6 monthlyapplication. Increasing the frequency of application of SDF solution can increase the caries arrest rate.

Silver Diamine Fluoride and Fluoride Varnish May Halt Interproximal Caries Progression in the Primary Dentition

Objective: The study described the incidence of interproximal caries arrest following SDF and fluoride varnish application in the primary dentition. Study design: A retrospective analysis of dental records including radiographs was conducted for interproximal dental caries in pediatric patients treated with SDF applied with woven floss. Bitewing radiographs and ICCMS&trade; radiographic scoring criteria were used to assess caries depth in primary teeth at baseline and then at 12-month follow-up examination. Results: This study included 185 interproximal carious lesions in 131 patients treated with SDF. Mean baseline ICCMS&trade; score for all lesions was 1.50, with an average dmft of 2.9. The majority of carious lesions (n=155, 84.0%) showed radiographic evidence of non-progression at 12-month follow-up. There was no statistically significant difference in caries arrest among primary canines, primary first molars, and primary second molars (P=0.61). Furthermore, there was no statistically significant difference in caries arrest in patients with commercial insurance, Medicaid, or no insurance (P=0.27). Conclusions: SDF application with woven floss was associated with interproximal caries arrest in the primary dentition at 12-month follow-up in this sample of low caries risk children. Tooth type and insurance type were not associated with caries arrest.

A survey of caregiver acculturation and acceptance of silver diamine fluoride treatment for childhood caries

BackgroundInterest in aqueous silver diamine fluoride (SDF) has been growing as a treatment for caries arrest. A cross-sectional study was conducted to identify factors associated with caregiver acceptance of SDF treatment for children presenting with caries at 8 Federally Qualified Health Centers. The study purpose was to examine associations between caregiver acceptance of SDF treatment for children with caries and (1) sociodemographic and acculturation characteristics of caregivers and (2) clinical assessments of the children by dentists.MethodsA caregiver survey collected information on: sociodemographic characteristics; acculturation characteristics, measured using the validated Short Acculturation Scale for Hispanics (SASH); perceived benefits and barriers of SDF treatment, including caregiver comfort; and perceived health-related knowledge. Chart reviews were conducted to assess: the medical / dental insurance of pediatric patients; cumulative caries experience, measured using decayed, missing, filled teeth total scores (dmft / DMFT); whether operating room treatment was needed; and a record of caregiver acceptance of SDF treatment (the outcome measure). Standard logistic regression models were developed for caregiver acceptance of SDF treatment for their children as the binary outcome of interest (yes / no) to calculate unadjusted odds ratios (OR) and adjusted ORs for covariates of interest.ResultsOverall, 434 of 546 caregivers (79.5%) accepted SDF treatment for their children. A U-shaped relationship between caregiver odds of accepting SDF treatment and age group of pediatric patients was present, where caregivers were most likely to accept SDF treatment for their children who were either < 6 years or 9–14 years, and least likely to accept SDF treatment for children 6 to < 9 years. The relationship between acculturation and caregiver acceptance of SDF treatment depended upon whether or not caregivers were born in the United States: greater acculturation was associated with caregiver acceptance of SDF treatment among caregivers born in this country, and lower acculturation was associated with caregiver acceptance of SDF treatment among caregivers born elsewhere.ConclusionsCaregiver acceptance of SDF treatment is high; child’s age and caregiver comfort are associated with acceptance. Providers need to communicate the risks and benefits of evidence-based dental treatments to increasingly diverse caregiver and patient populations.

Silver diamine fluoride for caries prevention and arrest

Silver diamine fluoride for caries prevention and arrest

Silver diamine fluoride for managing carious lesions: an umbrella review

BackgroundThis umbrella review comprehensively appraised evidence for silver diamine fluoride (SDF) to arrest and prevent root and coronal caries by summarizing systematic reviews. Adverse events were explored.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, PubMed, Embase, Cochrane Library, PROSPERO register and Joanna Briggs Institute Database of Systematic Reviews were searched for systematic reviews investigating SDF for caries prevention or arrest (1970–2018) without language restrictions. Systematic reviews were selected, data extracted, and risk of bias assessed using ROBIS by two independent reviewers, in duplicate. Corrected covered area was calculated to quantify studies’ overlap across reviews.ResultsEleven systematic reviews were included; four focussing on SDF for root caries in adults and seven on coronal caries in children. These cited 30 studies (4 root caries; 26 coronal caries) appearing 63 times. Five systematic reviews were of “low”, one “unclear” and five “high” risk of bias. Overlap of studies was very high (50% root caries; 17% coronal caries). High overlap and heterogeneity, mainly comparators and outcome measures, precluded meta-analysis. Results were grouped by aim and outcomes to present an overview of direction and magnitude of effect. SDF had a positive effect on prevention and arrest of coronal and root caries, consistently outperforming comparators (fluoride varnish, Atraumatic Restorative Treatment, placebo). For root caries prevention, the prevented fraction (PF) was 25–71% higher for SDF compared to placebo (two systematic reviews with three studies) and PF = 100–725% for root caries arrest (one systematic review with two studies). For coronal caries prevention, PF = 70–78% (two systematic reviews with two studies) and PF = 55–96% for coronal caries arrest (one systematic review with two studies) with arrest rates of 65–91% (four systematic reviews with six studies). Eight systematic reviews reported adverse events, seven of which reported arrested lesions black staining.ConclusionSystematic reviews consistently supported SDF’s effectiveness for arresting coronal caries in the primary dentition and arresting and preventing root caries in older adults for all comparators. There is insufficient evidence to draw conclusions on SDF for prevention in primary teeth and prevention and arrest in permanent teeth in children. No serious adverse events were reported.

Randomized Trial of Silver Nitrate with Sodium Fluoride for Caries Arrest.

The aim of this noninferiority double-blind randomized clinical trial was to compare the effectiveness of the topical semiannual application of a 25% silver nitrate (AgNO3) solution followed by a 5% sodium fluoride (NaF) varnish with that of a 38% silver diamine fluoride (SDF) solution in arresting caries among preschool children. Healthy 3-y-old children with active dentine carious lesions were randomly allocated to 2 groups via computer-generated random numbers. Lesions in group A received applications of a 25% AgNO3 solution followed by a 5% NaF varnish semiannually (every 6 mo). Lesions in group B received semiannual applications of a 38% SDF solution followed by a placebo varnish. A trained examiner recorded the status of caries and oral hygiene at baseline and during follow-up examinations. The examiner, children, and their caretakers were blinded to the intervention allocation. This study adopted an intention-to-treat analysis. A noninferiority test was conducted for the data analysis. Group A's noninferiority was accepted if the lower limit of the 95% CI for the difference in the mean number of arrested surfaces was >-0.5. A total of 1,070 children were recruited at baseline, with 535 children in each group. After 18 mo, the mean ± SD number of arrested surfaces was 3.3 ± 3.4 in group A (n = 484) and 3.2 ± 3.5 in group B (n = 476; P = 0.664). The difference in the mean number of arrested surfaces between the groups was 0.092 (95% CI, -0.322 to 0.505). Apart from black staining on the arrested lesions, no other significant side effect was observed. A semiannual application of 25% AgNO3 followed by 5% NaF is no worse than a 38% SDF in arresting dentine caries among preschool children over 18 mo. The Hong Kong Research Grants Council (GRF 17107315) funded this trial, which was registered at ClinicalTrials.gov (NCT02019160). This randomized clinical trial found that silver nitrate solution followed by sodium fluoride varnish is effective in arresting dentine caries among preschool children. As silver nitrate followed by sodium fluoride is a noninvasive and simple protocol, it can be an alternative strategy to manage dental caries among young children, especially in countries where silver diamine fluoride is not available.

Silver and fluoride content and short-term stability of 38% silver diamine fluoride

BackgroundAs silver diamine fluoride (SDF) gains popularity for caries arrest, the authors aimed to investigate the content of fluoride and silver in 38% SDF produced for the US market and its short-term stability. MethodsFive samples of 38% SDF were evaluated when the bottle was first opened, and at 7 and 28 days. Fluoride concentrations were determined with a fluoride ion-selective electrode, and silver concentrations were determined with a simultaneous inductively coupled plasma mass spectrometer. pH was measured with a pH probe. Weight and volume of individual drops were measured. ResultsAt day 0, 40% of individual measured values were above the expected fluoride concentration, and at day 28, 93% were above the expected fluoride concentration (P = .005). At day 0, 19% of individual measured values were below the lowest expected silver concentration, and at day 28, 93% were below (P < .001). Acidity (pH 10) was consistent over the 3 periods. Mean (standard deviation) weight of a drop was 40 (4.0) milligrams, and mean (standard deviation) volume was 32.55 (1.89) microliters, 30% more than the reported value of 25 μL. ConclusionOver 28 days, the product pH is stable, whereas the fluoride content tends to increase and the silver content tends to decrease. Drops were larger than expected when dispensed from the bottle. Practical ImplicationsDrops are larger than expected, so each delivers higher than expected quantities of silver and fluoride. Clinicians should exercise caution when using this product on young children, replace the cap immediately, and use as soon as dispensed.

Nanosilver Fluoride&amp;mdash;A Paradigm Shift for Arrest in Dental Caries in Primary Teeth of Schoolchildren: A Randomized Controlled Clinical Trial

ABSTRACTBackgroundDue to limited financial resources, poor access to basic oral care, and the high cost of restorative treatment, children of low-income nations have their general health, social well-being, and education opportunities affected by untreated dental caries. Arresting caries treatment (ACT) has been proposed to manage untreated dental caries in children of disadvantaged communities.Aims and objectivesThe purpose of the present controlled clinical trial is to investigate the effectiveness of a new anticaries agent, nanosilver fluoride (NSF), preventing and arresting caries in children.Materials and methodsA total of 100 deciduous molars both maxillary and mandibular are randomly selected from 60 children of 4–9 years of age group, which were randomly divided into NSF experimental group and saline control group. Teeth were clinically diagnosed and treated by one masked examiner and followed up at 7 days, 5 months and 12 months by another calibrated examiner who was blinded to the type of treatment. The criteria of the ICDAS II were followed to determine the activity of lesion and the diagnosis of caries. The Pearson's Chi-square test was used to compare the groups during different follow-up examinations.ResultsSeventy-eight percent of decayed teeth showed hard arrested dentine at 7 days; after 5-month analysis in the NSF group, 72.91% of the teeth showed arrested caries; and in the control group, only 34% of teeth showed arrest of caries. At 12-month analysis in the NSF group, 65.21% of teeth showed arrested cavities, and in the control group, 28.88% of teeth showed arrest of caries.ConclusionThe present study proves that NSF is an anticaries agent and presents a noninvasive option for caries arrest and treatment when applied directly to dentin caries lesions.How to cite this articleNagireddy VR, Reddy D, Kondamadugu S, et al. Nanosilver Fluoride—A Paradigm Shift for Arrest in Dental Caries in Primary Teeth of Schoolchildren: A Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent 2019;12(6):484–490.