No More Drilling: There's a New Cavity Treatment

Silver diamine fluoride, a drilling-free cavity treatment, may be as effective as dental sealants, a study finds.

Silver diamine fluoride (SDF) is a clear liquid that is applied to the teeth. It contains silver, which kills decay-causing germs, and fluoride, which prevents, slows down, or stops decay.

SDF also appears to be a promising alternative to dental sealants and can improve access to dental care while reducing costs, according to a new study published in JAMA Pediatrics.

The study included approximately 4,100 children in New York City elementary schools. A quarter of them had untreated cavities at the beginning of the study.

A team of health professionals examined children's teeth and applied either sealants or SDF followed by fluoride varnish, depending on which treatment the school was randomly assigned to.

After a four-year follow-up, SDF and dental sealants were found to prevent roughly the same number of cavities and reduce the risk of decay.

Researchers say SDF should not replace the dental sealant model but is another option to prevent and arrest decay.

"Most research shows that SDF can stop a cavity from progressing further. Our study demonstrated that SDF can prevent cavities from happening in the first place," said Tamarinda Barry Godín, DDS, MPH, associate program director and supervising dentist for CariedAway, a research scientist at NYU College of Dentistry, and the study's coauthor.

The findings suggest treatments are similarly effective but do not conclude that one is superior to the other, according to Ryan Richard Ruff, Ph.D., MPH, associate professor of epidemiology and health promotion at NYU College of Dentistry and the study's first author.

"However, there may be certain scenarios in which SDF is preferred. There are studies indicating that SDF is more affordable and efficient to use than sealants, so it may be attractive for low-resource, low-access areas," Ruff tells Healthnews.

Known complications with SDF application include potential oral soft tissue irritation, temporary staining of the oral mucosa, and permanent staining of porous tooth structure, according to the study.

Better access to dental treatment

More than 50% of Americans aged six to eight have experienced caries. Among some racial and ethnic minority groups, the rate exceeds 70%

Using SDF for cavity prevention and treatment in schools could reduce the need for fillings, saving money for both families and the healthcare system. However, programs can only be implemented if there are enough health professionals to provide care.

"Our research suggests that SDF can be effectively applied by nurses, which increases the availability of healthcare professionals that can provide caries prevention," Ruff adds.

Ruff says the new study results are only for children, therefore, it should not be generalized to adults. However, early evidence suggests that SDF is effective in arresting and preventing caries in older adults, and more studies are ongoing.