Arresting root caries through fluoride applications: 2-year result

Abstract

OBJECTIVES: To describe the effectiveness of application of silver diammine fluoride (SDF) solution in arresting active root caries in elders and to assess the color of arrested root caries lesions. METHOD: This study was conducted among community-dwelling elders aged over 55 years in Hong Kong. Elders who had at least 5 teeth with exposed root surfaces and no serious medical problem were randomly allocated into 3 intervention groups as follows: Gp1 – oral hygiene instruction (OHI) only; Gp2 – OHI and annual application of SDF solution; Gp3 – OHI and annual application of SDF solution followed immediately by potassium iodide (KI) solution. Color of arrested root caries lesion was assessed using PANTONE color sheets and recorded using the following codes: yellow (7401U); light brown (1245U); dark brown (4635U); and black (Black U). Status of root surfaces was assessed every 6 months by the same independent examiner. RESULTS: 323 elders were examined at baseline. After 24 months, 258 elders (80%) were reviewed. There were 156 root surfaces with active caries at baseline, 40, 54 and 62 in Gp1 to Gp3, respectively. At 24-months, 97 of these lesions were reviewed. The proportions of them that had become arrested were 29%, 83%, 85% in Gp1 to Gp3, respectively (X2 test, P<0.001). Pairwise comparisons showed elders who received OHI only had a lower proportion of the active root caries changed to arrested (P<0.001) and the proportion of arrested root caries was similar in SDF and SDF+KI groups (P>0.05). The color distribution of arrested carious lesion was similar in SDF and SDF+KI groups (X2 test, P>0.05). CONCLUSIONS: SDF solution is effective in arresting root caries. Blackening of arrested root caries was not reduced by immediate application of KI after the application of SDF in this study.