The use of silver diamine fluoride in school-based programs has demonstrated effectiveness in preventing the formation of dental caries and slowing the progression of existing ones.
By Genni Burkhart, DOCS Incisor Editor
According to the National Institute of Dental and Craniofacial Research (NIH), 57% of adolescents 12 to 19 have dental caries in their permanent teeth. (1) The NIH also estimates that the same age group has approximately one missing or decayed permanent tooth per child.
While these numbers have decreased since the NIH’s 2004 survey, the number of children with dental caries and tooth decay still requires significant improvement.
Oral Health Impacts on Learning
Dental caries are one of the most common chronic childhood diseases and often result in pain and missed school days. Untreated cavities can also lead to more severe complications such as infection and abscesses.
In addition, cavities can significantly affect a child's ability to concentrate, affecting their academic performance and creating a perpetual cycle of oral health issues and negative educational impact.
As a result, the Centers for Disease Control and Prevention (CDC) recommends school sealant programs to mainly target children who are less likely to visit a dentist.
Is SDF Cost-Effective?
Researchers at NYU College of Dentistry have discovered an inexpensive liquid to fight dental carries called silver diamine fluoride (SDF). Their study followed more than 4,000 elementary school students for four years and showed SDF as an effective, cheaper alternative to dental sealants while also increasing access to oral healthcare.
Richard Niederman, DMD, professor of epidemiology and health promotion at NYU College of Dentistry and the study’s senior author, is quoted in NYU’s press release as stating, “A growing body of research shows that SDF—which is quicker to apply and less expensive than sealants—can prevent and arrest cavities, reducing the need for drilling and filling.”
SDF vs. Traditional Sealants
NYU College of Dentistry researchers piloted CariedAway™ (developed by NYU Dentistry and supported by Northeast Delta Dental), the most comprehensive school-based cavity prevention program, to assess the effectiveness of SDF and traditional sealants.
The study was conducted in elementary schools in New York City and involved approximately 4,100 children, of whom a significant percentage (over 25%) had untreated cavities at the beginning. The study compared SDF and traditional sealants to evaluate their impact on cavity prevention.
Depending on whether the school had been randomly assigned sealants or SDF followed by fluoride varnish, a team of health professionals examined and treated children's teeth. Dental hygienists applied sealants, while registered nurses applied SDF, all under the supervision of a dentist. In 2018, the team visited each school twice a year, but school closures and the COVID-19 pandemic caused some visits to be missed.
In the journal JAMA Network Open, researchers reported last year that a single treatment of either SDF or sealants prevented 80% of dental carries and 50% from worsening two years later.
In their study published in JAMA Pediatrics (2), the team concluded that after following children for four years, SDF and sealants prevented roughly the same number of dental caries. Additionally, both sealants and SDF proved to be effective in reducing the ability of teeth to decay at each follow-up appointment.
In Conclusion
This longitudinal study confirms that sealants and SDF are effective tools for fighting adolescent dental caries. Furthermore, due to SDF's cost-effectiveness, it can prove effective as an option (not a replacement) to dental sealants in halting tooth decay. This study also shows that sealants are equally effective in treating tooth decay and vital to school-based cavity prevention programs.
Tamarinda Barry Godín, DDS, MPH, associate program director and supervising dentist for CariedAway™, research scientist at NYU College of Dentistry, and the study’s coauthor, is quoted in NYU’s press release as stating, “Most research shows that SDF can stop a cavity from progressing further. Our study demonstrated that SDF could prevent cavities from happening in the first place.”
Implementing SDF cavity prevention and treatment programs in schools can revolutionize children's dental health. Addressing cavities early can reduce and perhaps even eliminate the need for costly fillings, saving families from financial burden and improving countless adolescents' systemic health and academic achievements.
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Author: With over 14 years as a published journalist, editor, and writer, Genni Burkhart's career has spanned politics, healthcare, law, business finance, technology, and news. She resides in Northern Colorado, where she works as the editor in chief of the Incisor at DOCS Education.
References:
- https://www.nidcr.nih.gov/research/data-statistics/dental-caries/adolescents
- Ruff RR, Barry Godín TJ, Niederman R. Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence: A Randomized Clinical Trial. JAMA Pediatr. 2024;178(4):354–361. doi:10.1001/jamapediatrics.2023.6770
