Note: Single-source report; awaiting corroboration.
Tooth decay, or dental caries, affects about 40% of U.S. children and is the most common chronic disease in children and adults. Bacteria in the mouth produce acid that damages tooth enamel, leading to cavities, pain, infections, tooth loss, increased healthcare costs, and missed school days.
Silver diamine fluoride is a topical treatment for cavities that kills acid-producing bacteria and hardens affected tooth areas. Despite its low cost and simple application, the Food and Drug Administration previously lacked enough data for its approval in treating severe tooth decay in children.
An NIH-funded clinical trial led by Dr. Margherita Fontana enrolled 830 children aged one to six with severe early childhood caries and at least one cavity. Children received either silver diamine fluoride or a placebo at the start and at six months, with assessments at baseline, three, six, and eight months.
The results showed silver diamine fluoride stopped tooth decay at more than twice the rate of placebo. Over 50% of treated cavities showed no progression, compared to about 20% of untreated cavities. There was no difference between groups in rates of dental pain.
A noted side effect was permanent staining of decayed parts of treated primary teeth, which will eventually fall out. The treatment's ease of use suggests pediatricians, who see young children more often than dentists, could be trained to detect and treat dental decay effectively.