Now, the results of a pilot program in New York indicate that an alternative treatment that can be applied by nurses is as effective as dental sealants – and could prevent about 80 percent of cavities and stop half from getting worse.
Writing in JAMA Network Open, researchers report on CariedAway, a study that compared dental sealants with an application of silver diamine fluoride (SDF), a colorless liquid that is brushed onto molars.
The Food and Drug Administration classifies SDF as a medical device used to treat tooth sensitivity, but dentists increasingly using to prevent cavity formation or worsening. In 2018, the American Dental Association approved Use of SDF for cavity prevention in both children and adults.
In 2019 and early 2020, researchers from the NYU College of Dentistry visited 47 New York City elementary schools, where they examined the teeth of about 3,000 students in kindergarten through third grade and gave them either sealants or an SDF application.
When the researchers visited the schools again in 2021 and 2022 after the program was suspended during the early days of the pandemic, they again examined the children’s teeth. While 82 percent of children treated with sealants did not develop new cavities, 81 percent treated with SDF also did not develop new cavities. SDF was even more effective than sealants for students with existing cavities: 56 percent of those with SDF had no worsening of their cavity, compared with 46 percent of children treated with sealants.
Although not associated with significant adverse effects, the treatment may darken existing cavities. A 2018 study of 888 preschool children found that 36.7 percent of children who used SDF annually had black holes, with the number increasing to 76.3 percent for children who had a higher concentration of SDF dose applied each year.
In the new study, the researchers note that SDF could help address some of the limitations of school sealant programs because it is cheaper and faster to implement and can be administered by registered nurses rather than just dentists.
This could particularly benefit children from lower income families: According to the CDCthese children are 15 percent less likely to get sealants and twice as likely to have untreated tooth decay than their counterparts in higher-income homes.
Researchers in the new study call SDF an “attractive alternative” that could reduce oral health problems worldwide.
