Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report

Abstract

BackgroundRampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation.Case presentationA 14-year-old Chinese boy suffering from β–thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, and depapillation of tongue indicating an underlying condition of anemia. The poor oral condition due to topical and systemic immunosuppressants was seriously aggravated, and rampant caries developed rapidly, affecting all newly erupted, permanent teeth. The teeth were hypersensitive and halitosis was apparent. Strategies for oral health education and diet modification were given to the patient. Xylitol chewing gum was used to stimulate saliva flow to promote remineralization of teeth. Silver diamine fluoride was topically applied to arrest rampant caries and to relieve pain from hypersensitivity. Carious teeth with pulpal involvement were endodontically treated. Stainless steel crowns were provided on molars to restore chewing function, and polycarbonate crowns were placed on premolars, upper canines and incisors.ConclusionThis case report demonstrates success in treating a young teenager with severe rampant dental decay by contemporary caries control and preventive strategy.

Evaluation of silver diamine fluoride application in children and factors associated with arrested caries survival

“…The more often a child felt pain in his/her teeth, the lower the percentage of arrested caries found on the child. This research is consistent with a previous study that showed that SDF application was effective in overcoming toothaches caused by dentin hypersensitivity due to caries [8]. Caries are closely related to a child's ability to speak, mastication, social development, and quality of life [9].…”

Silver Diamine Fluoride Has Efficacy in Controlling Caries Progression in Primary Teeth: A Systematic Review and Meta-Analysis

“…From the 11 eligible papers, 5 were at low risk of bias [Yee et al, 2009b;Liu et al, 2012;Zhi et al, 2012;dos Santos et al, 2014;Duangthip et al, 2016] since they fulfilled the required features for randomization and allocation. Four studies were at high risk of bias [Vasconcelos, 2011;dos Santos et al, 2012a;Monse et al, 2012;Chu et al, 2014], and 2 studies were at "unclear" risk of bias [Llodra et al, 2005;Seberol and Ökte, 2013]. Color version available online…”

“…The outcomes were: (1) number of inactive carious surface [Chu et al, 2002a;Llodra et al, 2005;Yee et al, 2009b;Vasconcelos, 2011;Zhi et al, 2012;dos Santos et al, 2014;Duangthip et al, 2016]; (2) number of active carious surface [Llodra et al, 2005;Yee et al, 2009b;Vasconcelos, 2011;Liu et al, 2012;Monse et al, 2012;Seberol and Ökte, 2013;Chu et al, 2014;dos Santos et al, 2014]; (3) dmft index [Chu et al, 2002a;Llodra et al, 2005;Vasconcelos, 2011;dos Santos et al, 2012a;Seberol and Ökte, 2013]; (4) number of teeth with inactive carious lesions [dos Santos et al, 2012a]; (5) number of teeth with new carious lesions [Liu et al, 2012]; (6) number of inactive carious lesions in the first permanent molars [Llodra et al, 2005].…”

Silver diamine fluoride: An operative dentistry perspective

“…Full-mouth rehabilitation of teeth subjected to extreme caries insult has been reported, with SDF providing the opportunity to save many otherwise hopeless teeth [34]. Follow up on SDF treated lesions that have been restored should be approached in the same way as any restoration is monitored; the absence of clinical and radiographic evidence of caries activity or progression will relate to success.…”