Managing Early Childhood Caries with Atraumatic Restorative Treatment and Topical Silver and Fluoride Agents

Abstract

Early childhood caries (ECC) is a significant global health problem affecting millions of preschool children worldwide. In general, preschool children from families with 20% of the lowest family incomes suffered about 80% of the ECC. Most, if not all, surveys indicated that the great majority of ECC was left untreated. Untreated caries progresses into the dental pulp, causing pain and infection. It can spread systemically, affecting a child’s growth, development and general health. Fundamental caries management is based on the conventional restorative approach. Because preschool children are too young to cope with lengthy dental treatment, they often receive dental treatment under general anaesthesia from a specialist dentist. However, treatment under general anaesthesia poses a life-threatening risk to young children. Moreover, there are few dentists in rural areas, where ECC is prevalent. Hence, conventional dental care is unaffordable, inaccessible or unavailable in many communities. However, studies showed that the atraumatic restorative treatment had a very good success rate in treating dentine caries in young children. Silver diamine fluoride is considered safe and effective in arresting dentine caries in primary teeth. The aim of this paper is to review and discuss updated evidence of these alternative approaches in order to manage cavitated ECC.

Dental caries status of Lisu preschool children in Yunnan Province, China: a cross-sectional study

“…Thus, a community-based water fluoridation programme or a simple self-care programme via tooth brushing with affordable fluoridated toothpaste, along with parental oral health education can be options. For established severe dental caries, effective, low-cost and technically insensitive approaches, such as atraumatic restorative treatment and sodium diamine fluoride application, should be considered [37].…”

Model for Taking Care of Patients with Early Childhood Caries during the SARS-Cov-2 Pandemic

“…Said interventions are on average inexpensive, easy to apply, and do not necessarily presuppose high technology environments in order to be supplied. Because of their characteristics, they have been widely adopted, especially in the treatment of ECC, in more disadvantaged socio-economic and cultural environments and with uncooperative patients, such as children with fear of the dentist or subjects with special needs [35][36][37][38]. In all the categories just mentioned, where caries is more prevalent than in the basic population [6], minimally invasive techniques is a valid healthcare response.…”

The effect of the combined use of silver diamine fluoride and potassium iodide in disrupting the plaque biofilm microbiome and alleviating tooth discoloration: A systematic review

“…One such approach has been attributed to Nishino et al [5], who described the caries-arresting properties of silver diamine fluoride (SDF) in 1969. Since then, numerous randomized controlled trials (RCT) and systematic reviews have established that SDF is effective in arresting dental caries, particularly in the primary dentition [6][7][8][9][10][11][12][13][14][15][16][17][18][19] as well as in root caries lesions of the permanent dentition [20][21][22][23][24][25].…”