Simple, low-cost treatment staves off tooth decay in kids

Scientists have revealed a simple, low-cost solution to the most prevalent chronic disease among children: tooth decay.

More than half of U.S. children aged between 6 and 9 have had a cavity in at least one of their baby teeth, according to the U.S. Centers for Disease Control and Prevention (CDC). And more than half of all U.S. teenagers aged 12 to 19 have had a cavity in at least one of their permanent teeth.

Tooth decay can be very painful and lead to problems with eating, speaking, playing and learning. Children in low-income families are twice as likely to be affected by cavities, compared with those in higher-income households, so finding low-cost, accessible solutions is an essential goal for public health.

Across the U.S., school sealant programs have dental professionals visiting schools to apply a thin, protective coating on the surface of the teeth to help harden and safeguard them against tooth decay. The CDC says these dental sealants can prevent 80 percent of cavities.

However, these sealants can be expensive and time-consuming to apply. Therefore, researchers have been searching for lower-cost alternatives. One such alternative is silver diamine fluoride, a solution originally approved by the Food and Drug Administration for treating tooth sensitivity.

“A growing body of research shows that silver diamine fluoride—which is quicker to apply and less expensive than sealants—can prevent and arrest cavities, reducing the need for drilling and filling,” said Richard Niederman, a professor of epidemiology and health promotion at the New York University College of Dentistry, in a statement.

The treatment is easy to apply and simply involves brushing the liquid onto the surface of the teeth, which kills decay-causing bacteria and remineralizes the teeth to prevent further decay.

In a new study, published in the journal JAMA Pediatrics, Niederman and his NYU colleagues compared the use of silver diamine fluoride with standard sealants in a cohort of roughly 4,100 children in New York City elementary schools.

Each school was randomly assigned either traditional sealants of silver diamine fluoride, followed by a fluoride varnish.

In 2023, the team said a single treatment of either treatment prevented 80 percent of cavities and kept 50 percent of existing cavities from worsening two years later. For context, at the start of the project 25 percent of the children studied had untreated cavities.

Now, in March 2024, the team has been able to confirm that the silver diamine fluoride treatment is just as effective at preventing cavities as a sealant in children after four years.

Ryan Richard Ruff, an associate professor of epidemiology and health promotion at the NYU College of Dentistry and the study’s first author, said in a statement: “Our longitudinal study reaffirms that both sealants and silver diamine fluoride are effective against cavities. Silver diamine fluoride is a promising alternative that can support school-based cavity prevention—not to replace the dental sealant model, but as another option that also prevents and arrests decay.”

Study co-author and associated program director Tamarinda Barry Godin added: “Most research shows that SDF can stop a cavity from progressing further. Our study demonstrated that SDF can prevent cavities from happening in the first place.”