Effectiveness of Silver Diamine Fluoride in Preventing Occlusal Caries in Primary Teeth of Preschool Children: a Study Protocol for a Randomized Clinical Trial (Preprint)

2021 ◽  
Author(s):  
Duangporn Duangthip ◽  
SHUYANG HE ◽  
Sherry Shiqian Gao ◽  
Chun Hung Chu ◽  
Edward Chin Man Lo
Keyword(s):  
Logistic Regression ◽  
Preschool Children ◽  
Oral Health ◽  
Primary Teeth ◽  
Controlled Trial ◽  
Public Health Problem ◽  
Placebo Control ◽  
Occlusal Caries ◽  
Silver Diamine Fluoride ◽  
Occlusal Surfaces

BACKGROUND Tooth decay is a significant public health problem globally. The caries-arrest effectiveness of 38% silver diamine fluoride (SDF) has been well documented. However, information on the caries preventive effect of SDF on primary teeth is insufficient. OBJECTIVE The aim of this trial is to investigate the effectiveness of semi-annual application of 38% SDF and that of 5% sodium fluoride (NaF) varnish when compared to placebo control in preventing occlusal caries in primary molars of preschool children over 30 months. METHODS This three-arm, parallel design, double-blind, randomised controlled trial involves 791 preschool children. Children are randomly allocated to receive one of the three interventions as follows; Group 1) 38% SDF, Group 2) 5% NaF varnish, and Group 3) placebo control with tonic water. The intervention and dental examination will be carried out every 6 months. A parent-administered questionnaire including the children’s demographic background and oral health-related behaviours has been collected at baseline. Follow-up examinations to detect new caries development will be conducted every 6 months by a masked examiner. Caries development will be diagnosed at the cavitation level. Chi-square tests and logistic regression analyses will be adopted. A two-level logistic regression analysis will be performed to investigate the effects of the study interventions and other potential confounding factors on the development of occlusal caries. RESULTS Result: To date, a total of 791 children are participating in the study. CONCLUSIONS If SDF application is more effective than NaF varnish in preventing caries on occlusal surfaces of primary teeth, it can be a preferred choice for caries prevention in a kindergarten-based program. Results of this trial will provide valuable clinical evidence for the development of oral health strategies and policy on promotion of child oral health CLINICALTRIAL ClinicalTrials.gov NCT05084001

scholarly journals Dye-enhanced laser fluorescence detection on natural caries lesions in primary teeth

2015 ◽  
Vol 21 (3) ◽  
pp. 145
Author(s):  
Fausto Medeiros Mendes ◽  
Victor Moreira Leamari ◽  
Márcia Turolla Wanderley ◽  
Mariana Minatel Braga ◽  
Juliana Mattos-Silveira ◽  
...  
Keyword(s):  
Primary Teeth ◽  
Fluorescent Dyes ◽  
Protoporphyrin Ix ◽  
Polarized Light ◽  
Laser Fluorescence ◽  
Primary Molars ◽  
Smooth Surfaces ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Caries Lesions

Objective: This study aimed to investigate the association of two fluorescent dyes and Laser Fluorescence (LF) device in detecting smooth and occlusal natural caries in primary teeth in vitro.Methods: Measurements were performed with the LF and with LF associated with tetrakis (N-methylpyridyl)porphyrin (LF TMPyP) and protoporphyrin IX (LF PPIX) in 72 smooth (63 primary molars) and 134 occlusal sites (81 primary molars). For validation, surfaces were sectioned and sections obtained were evaluated under stereomicroscope. Smooth surfaces were also evaluated using polarized light microscopy and Knoop microhardness. For both smooth and occlusal surfaces, ROC analyses were performed, and sensitivities, specificities and accuracies were assessed. In smooth surfaces, Pearson’s correlation coefficients between LF values and lesions hardness or lesions depth were calculated.Results: LF TMPyP presented higher correlation with hardness and lesion depth than other methods in smooth surfaces. No differences were observed in other parameters among the methods, in both smooth and occlusal surfaces.Relevance: The LF TMPyP might improve performance in quantifying smooth-surface caries lesions in primary teeth. However, the sensitivity is improved at D2 (caries extending into inner half of the enamel but not to amelodentinal junction) threshold when using PPIX in smooth caries lesions. The association of LF with fluorescent dyes does not improve the performance on occlusal caries.

scholarly journals Inequalities In Caries Among Pre-School Italian Children With Different Background

2021 ◽  
Author(s):  
Guglielmo Campus ◽  
Fabio Cocco ◽  
Laura Strohmenger ◽  
Thomas Gerhard Wolf ◽  
Araxi Balian ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preschool Children ◽  
Negative Binomial ◽  
Public Health Problem ◽  
Assessment System ◽  
Social Gradient ◽  
Caries Detection ◽  
Caries Prevalence ◽  
Explanatory Variables ◽  
Immigrant Background

Abstract Background: The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient. Methods: The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.76% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) and behavioral habits of children/parents/caregivers were estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated as the weighted sum of the worst circumstances deriving from social explanatory variables. Children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic regression in children with European background and a logistic regression in children with non-European background) were used to elucidate the associations between all explanatory variables and health outcome (namely the caries prevalence). Mantel Haenszel trend of odds adjusted by immigrant background and area of living were calculated to study the existence, dimensions and direction of a social gradient in oral health. Results: Overall, 54.37% (95%CI 46.71–58.28%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.59% vs 41.62% p<0.01). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z=5.24, p<0.01). Conclusions: Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background. The proposed gradient was clearly able to identify children with the worst dental conditions.

The Effect of a Bi-annual Professional Application of APF Foam on Dental Caries Increment in Primary Teeth: 24-month Clinical Trial

2005 ◽  
Vol 84 (3) ◽  
pp. 265-268 ◽  
Author(s):  
H. Jiang ◽  
Z. Bian ◽  
B.J. Tai ◽  
M.Q. Du ◽  
B. Peng
Keyword(s):  
Dental Caries ◽  
Primary Teeth ◽  
Controlled Trial ◽  
Control Group ◽  
Double Blind ◽  
Republic Of China ◽  
Caries Increment ◽  
Occlusal Surfaces ◽  
Cluster Randomized ◽  
Experimental Group

The purpose of this study was to evaluate the effect of a bi-annual professional application of acidulated phosphate fluoride (APF) foam on caries increment in the primary dentition over a two-year period in the People’s Republic of China. In a double-blind, cluster-randomized, placebo-controlled trial, 392 children aged 3–4 years from 15 classes were randomly assigned to two groups on a school class basis. The experimental group (8 classes) received a bi-annual APF foam application, and the control group (7 classes) received the placebo. The mean increment of dmfs in the experimental group was 24.2% lower than that in the control group (p < 0.05). The significant caries reduction was observed on approximal surfaces in the experimental group compared with the control group (p < 0.01), but there were no differences on occlusal surfaces (p > 0.05). A bi-annual professional application of APF foam was effective in reducing the increment of dental caries in the primary teeth.

scholarly journals Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A Randomized Controlled Trial

2021 ◽  
pp. 1-11
Author(s):  
Phoebe Pui Ying Lam ◽  
Divesh Sardana ◽  
Weijia Luo ◽  
Manikandan Ekambaram ◽  
Gillian Hiu Man Lee ◽  
...  
Keyword(s):  
Preschool Children ◽  
Assessment System ◽  
Fluoride Varnish ◽  
Caries Detection ◽  
Caries Experience ◽  
Primary Molars ◽  
Glass Ionomer ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Significant Difference

Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3–4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0–1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group – application of 5% NaFV at 3-monthly intervals or GIS group – 1 single placement of GIS. A parental questionnaire was used to collect information on the children’s sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (<i>p</i> = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.

scholarly journals Arresting Dentine Caries with Different Concentration and Periodicity of Silver Diamine Fluoride

2016 ◽  
Vol 1 (2) ◽  
pp. 143-152 ◽  
Author(s):  
M.H.T. Fung ◽  
D. Duangthip ◽  
M.C.M. Wong ◽  
E.C.M. Lo ◽  
C.H. Chu
Keyword(s):  
Primary Teeth ◽  
Low Cost ◽  
Kindergarten Children ◽  
Limited Information ◽  
Treatment Protocols ◽  
Silver Diamine Fluoride ◽  
Therapeutic Decisions ◽  
Occlusal Surfaces ◽  
Tooth Surfaces ◽  
Annual Application

Different regimens of silver diamine fluoride (SDF) have been used to manage early childhood caries. So far, there is limited information regarding the concentrations and frequency of applications for effective caries control in primary teeth. This study aimed to compare the efficacy of 2 commercially available SDF solutions at preprepared concentrations of 38% and 12% when applied annually or biannually over 18 mo in arresting dentine caries in primary teeth. This randomized double-blinded clinical trial recruited kindergarten children aged 3 to 4 y who had at least 1 tooth with dentine caries. The children were randomly allocated to receive 4 treatment protocols: group 1, annual application of 12% SDF; group 2, biannual application of 12% SDF; group 3, annual application of 38% SDF; and group 4, biannual application of 38% SDF. Clinical examinations at 6-mo intervals were conducted to assess whether active carious lesions became arrested. Information on the children’s background and oral hygiene habits was collected through a parental questionnaire at baseline and follow-up examinations. A total of 888 children with 4,220 dentine carious tooth surfaces received treatment at baseline. After 18 mo, 831 children (94%) were examined. The caries arrest rates were 50%, 55%, 64%, and 74% for groups 1, 2, 3, and 4, respectively ( P < 0.001). Lesions treated with SDF biannual application had a higher chance of becoming arrested compared with those receiving SDF annual application (odds ratio, 1.33; 95% confidence interval, 1.04–1.71; P = 0.025). The interaction between concentration and lesion site was statistically significant ( P < 0.001). Compared with 12% SDF, the use of 38% SDF increased a chance of becoming arrested ( P < 0.05), except lesions on occlusal surfaces. Based on the 18-mo results, SDF is more effective in arresting dentin caries in the primary teeth of preschool children at 38% concentration than 12% concentration and when applied biannually rather than annually. Knowledge Transfer Statement: The results of this study can be used by clinicians and dental public health professionals when deciding which concentrations and frequency of application of silver diamine fluoride solution should be adopted for arresting dentine caries. With consideration of caries arrest treatment with silver diamine fluoride, which is painless, simple, and low cost, this information could lead to more appropriate therapeutic decisions for caries control in young children or those who lack access to affordable conventional dental care.

Oral health-related quality of life of preschool children receiving silver diamine fluoride therapy: A prospective 6-month study

2019 ◽  
Vol 81 ◽  
pp. 27-32 ◽  
Author(s):  
Duangporn Duangthip ◽  
Sherry Shiqian Gao ◽  
Kitty Jieyi Chen ◽  
Edward Chin Man Lo ◽  
Chun Hung Chu
Keyword(s):  
Quality Of Life ◽  
Preschool Children ◽  
Oral Health ◽  
Health Related Quality ◽  
Silver Diamine Fluoride ◽  
Related Quality ◽  
Health Related
Sign in / Sign up

Export Citation Format

Share Document