Arresting root caries through SDF in fluoridated and non-fluoridated areas

Abstract

OBJECTIVES: To describe the effectiveness of application of silver diammine fluoride (SDF) solution on arresting root caries in elders living in fluoridated and non-fluoridated areas. METHODS: This study was conducted in 2 sites, one in Hong Kong (HK) with water fluoridation and one in low fluoride areas, Guangzhou (GZ). Elders living in community, aged over 55 years with good general health, and having at least 5 teeth with exposed root surfaces were recruited and randomly allocated into 2 intervention groups as followed: Gp1 – oral hygiene instruction (OHI) only; Gp2 – OHI and annual applications of SDF solution. Fluoridated toothpaste (1000 ppm) was provided to all subjects. The subjects were clinically examined by calibrated examiners at baseline and thereafter to assess their root surface caries status. RESULTS: A total of 533 elders were recruited in HK (260) and GZ (273) at baseline. After 12-month, 237 elders (91%) and 222 elders (81%) were reviewed in HK and GZ, respectively. There were 81 root surfaces with active caries in Gp2 at baseline, 54 and 27 in HK and GZ, respectively. At 12-months, 58 of these lesions were reviewed. The proportions of them that had become arrested were 65% and 83% in HK and GZ, respectively (X2 test, P>0.05). After 18-month, 210 elders (81%) were reviewed in HK. There were 84 active carious root surfaces at baseline. At 18-months, 51 of these lesions were reviewed. The proportions of them that had become arrested were 32% and 66% in Gp1 to Gp2, respectively (X2 test, P<0.05). CONCLUSIONS: Topical applications of SDF solution can arrest root. Based on 12-month result, the effectiveness of arresting root caries through SDF was no significant difference between fluoridated and non-fluoridated areas. The current clinical trial is still ongoing and further results will be reported later.