A Randomized Trial on Root Caries Prevention in Elders

Abstract

Root caries is common in institutionalized elders, and effective prevention methods are needed. This clinical trial compared the effectiveness of four methods in preventing new root caries. From 21 residential homes, 306 generally healthy elders having at least 5 teeth with exposed sound root surfaces were randomly allocated into one of four groups: (1) individualized oral hygiene instruction (OHI); (2) OHI and applications of 1% chlorhexidine varnish every 3 months; (3) OHI and applications of 5% sodium fluoride varnish every 3 months; and (4) OHI and annual applications of 38% silver diamine fluoride (SDF) solution. Two-thirds (203/306) of the elders were followed for 3 years. Mean numbers of new root caries surfaces in the four groups were 2.5, 1.1, 0.9, and 0.7, respectively (ANOVA, p < 0.001). SDF solution, sodium fluoride varnish, and chlorhexidine varnish were more effective in preventing new root caries than giving OHI alone.

Effects of zinc fluoride on inhibiting dentin demineralization and collagen degradation <i>in vitro</i>: A comparison of various topical fluoride agents

“…SDF comprises of high concentrations of fluoride and Ag, thus one can anticipate greater efficacy in preventing root dentin caries 3) . However, SDF results in a strong browning of dentin surface and gingiva, thereby causing esthetic concerns.…”

“…Among treatments of NaF, acidulated phosphate fluoride (APF), and silver diamine fluoride (SDF), SDF was the most effective 3,4) . It is unique in terms of anti-bacterial [5][6][7] and anti-enzymatic effects 8) with silver ions (Ag + ) in addition to the demineralization inhibition.…”

Systematic Review on Noninvasive Treatment of Root Caries Lesions

“…Moreover, the access to approximal RCLs for restorative management is limited or requires extensive removal of sound dental hard tissues. Therefore, several approaches to prevent initiation (Burt et al 1986;Mojon et al 1998;Tan et al 2010) or inactivate RCLs (Papas et al 2007;Ekstrand et al 2013) have been proposed.…”

Evaluation of a new hardness tester (Cariotester): Comparison with transverse microradiography for assessing the inhibitory effect of fluoride application on bovine root dentin demineralization

“…It has recently been reported that silver diamine fluoride (SDF) is more effective in preventing root caries than are NaF varnish and chlorhexidine 27) . Sugawara et al 28) carried out an in vitro study using the Cariotester to evaluate the effect of SDF in inhibiting dentin demineralization.…”