Lifestyle & Healthresearch summary
Trial finds a painless liquid stops decay in more than half of treated baby teeth
Silver diamine fluoride takes seconds to apply and needs no drill, and a large U.S. trial now supplies the evidence for FDA review.
This article is general information, not medical advice. Talk to a doctor or another qualified professional about your own situation.
The finding
In a U.S. clinical trial, 38% silver diamine fluoride (SDF) stopped tooth decay in more than half of the affected baby teeth when applied every six months [1]. The result matters for children, since tooth decay is the most common chronic disease among them and affects more than 40% of children in the United States [1].
Margherita Fontana, the study's lead investigator, said the treatment is very effective and safe, even in children as young as 1 [1]. Reported adverse events were similar between the SDF group and the placebo group [2].
How the treatment works
SDF is a low-cost liquid that dentists apply directly to a cavity with a small sponge-tipped applicator, a process that takes only a few seconds for each tooth [1]. The treatment requires no drilling, injections, or sedation [1].
The liquid works through two ingredients. Silver helps combat bacteria associated with tooth decay, and fluoride helps strengthen the mineral structure of teeth [3].
Unlike a traditional filling, SDF does not replace lost tooth structure. It helps prevent existing decay from progressing [3]. For some children, reapplying SDF every few months may control the cavity until the baby tooth falls out naturally [1].
Why untreated cavities matter
Untreated cavities can lead to intense pain, infections, difficulty sleeping or eating, missed school days and repeated medical appointments [1]. They also send thousands of young children in the United States to emergency departments each year [1].
Hospital doctors usually cannot repair the underlying dental problem. Some children keep suffering pain and infection, while others eventually need surgery under general anesthesia [1].
How the study was run and funded
The research began in 2018 and continued despite disruptions caused by the COVID-19 pandemic [1]. The National Institute of Dental and Craniofacial Research provided more than $12 million to support the study [1]. Elevate Oral Care supplied Advantage Arrest 38% SDF, the product tested [1].
Where SDF stands with regulators
SDF has been used successfully in many countries for decades [1]. In the United States, dentists have used it off-label since 2014, when the product was approved as a medical device for reducing tooth sensitivity [1].
Large U.S. clinical trials were needed to show SDF's safety and effectiveness as a cavity treatment. That evidence would be necessary for the FDA to approve SDF as a drug for treating tooth decay [1]. The trial generated the clinical evidence the manufacturer needs to submit a dental caries drug application to the FDA [1].
Amr Moursi, co-principal investigator at NYU, said the results support FDA approval of SDF for managing arrest of tooth decay in young children [1].
The visible drawback
SDF permanently turns the decayed part of the tooth dark, which is the treatment's visible drawback [1].
What it means for you
If you have a young child with a cavity, SDF is a treatment that needs no drilling, injections, or sedation [1]. Application takes only a few seconds for each tooth [1]. The main trade-off to weigh is that the decayed part of the tooth turns permanently dark [1].
Fontana said SDF could be particularly useful for very young children, older adults, people with developmental or physical disabilities, and patients with severe dental anxiety [1]. Because SDF does not replace lost tooth structure, it helps prevent existing decay from progressing [3]. In the trial, it was applied every six months [1].
Sources
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