Two local dental treatments can stop most childhood cavities from getting worse over several years, according to a new study from NYU College of Dentistry published in JAMA Network Open.
Researchers treated cavities in more than 10,000 elementary school students in New York City and found that two noninvasive methods—noninvasive restorative treatment (ART) and silver diamine fluoride (SDF)—were highly effective in slowing or stopping tooth decay. The findings suggest that the treatment of childhood cavities is moving toward simple, nonsurgical options.
Tooth decay isn’t just a mouth problem. American children miss about 34 million hours of school each year because of emergency dental issues.
By bringing cavity care directly into schools, such programs can help improve children’s oral health and reduce the need for emergency treatments, such as painful extractions or treatments for infections.
In school dental programs, health care providers often use sealants, a thin protective coating applied to a child’s back teeth, to prevent cavities. But few programs target existing cavities.
ART removes cavities with a hand-held instrument and applies the same protective material as sealants to stop the progression of cavities. SDF has also emerged as a promising cavity prevention and treatment tool
Originally approved by the FDA to treat tooth sensitivity, the liquid, when brushed onto teeth, kills caries-causing bacteria and remineralizes teeth to prevent further decay.
ART vs. SDF in Schools
To compare the efficacy of SDF and ART, researchers at NYU College of Dentistry conducted a large clinical trial in elementary schools in New York City as part of their “Caried Away” caries prevention program.
During twice-yearly school visits, health care workers examined the children’s teeth and applied either ART or SDF, depending on the treatment the school was randomly assigned to, followed by a fluoride varnish treatment for any existing cavities.
In a previous analysis of the Caried Away study, NYU researchers reported that a single treatment with ART or SDF prevented approximately 50% of cavities from getting worse over a two-year period.
Long-term effectiveness of nonsurgical treatments
Their latest analysis, published in the journal JAMA Network Open, looked at more than 1,600 children ages 5 to 13 who had cavities in one or more teeth.
The children’s teeth, which included more than 10,000 cavities, were treated with either SDF or ART during biannual school visits.
The students were followed for up to four years to see if their cavities got worse or stayed the same.
“This study is the most powerful analysis of these different cavity prevention techniques because we looked at cavities on every tooth surface and measured them for four years,” said Ryan Richard Ruff, PhD, MPH, associate professor of epidemiology and health promotion at NYU College of Dentistry and principal investigator of Caried Away.
The researchers found that SDF and ART had similar effects when applied to cavities: SDF prevented 62% of cavitated surfaces from getting worse over four years, while ART prevented 55% of cavities from getting worse.
“Providing ART or SDF in schools can help avoid more invasive dental treatments and improve access to preventive care,” said Tamarinda J. Barry Godín, PhD, DDS, MPH, research scientist and director of the Caried Away program at NYU College of Dentistry.