Effect of silver diamine fluoride on oral microflora, growth and oral health-related quality of life of preschool children with early childhood caries

Abstract

Early childhood caries (ECC) is a disease of multi-factorial origin causing destruction of the tooth structure in children aged 5 or below. It affects more than half of the 5-year old population in Hong Kong. Early childhood caries causes a multitude of problems in those children affected by the disease, that extend beyond the repair of tooth tissue, such as changes in growth and a detrimental effect on quality of life. Treatment may be complicated by factors such as young age of the patients and therefore alternatives, such as silver diamine fluoride (SDF) are sought to manage the disease. The first study is a longitudinal study carried out over 6 months on 28 patients and their caregivers aiming to evaluate the changes in Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) counts after application of 38% SDF via quantitative real time polymerase chain reaction (qRT-PCR). The dental caries and oral hygiene status of the patients, along with their oral health behaviours and dietary habits were also compared. An increase in the dmft score at the 6-month review was noted. Streptococcus mutans counts were significantly higher than Streptococcus sobrinus counts at both baseline and 6 months but there no changes in S. mutans and S. sobrinus counts observed between the two time periods.

The second study was also a longitudinal study carried out over 6 months that aimed to evaluate the changes in height, weight, body mass index (BMI) and oral health related quality of life (OHRQoL) in the same 28 children from the first study, and their caregivers, after application of 38% SDF. Changes in height, weight and BMI were calculated according to the WHO 2007 standards and the OHRQoL was measured by the Early Childhood Oral Health Impact Scale (ECOHIS). Results showed that application of 38% SDF had a significant effect on the height, weight, and height-for-age (HAZ) scores at the 6-month review. No significant changes in ECOHIS scores were noted.

In conclusion, the application of 38% SDF did not have significant effect on the bacterial counts of S. mutans and S. sobrinus but did lead to a significant increase in the height, weight and HAZ scores of the patients.