Trial Examines Liquid Treatment for Childhood Cavities
A clinical trial involving 830 children younger than 6 found that silver diamine fluoride (SDF), a liquid applied to cavities, stopped decay in more than half of affected baby teeth when administered at six-month intervals. The findings, published in JAMA Pediatrics, add U.S. evidence for a treatment already used in other countries.
Researchers led by the University of Michigan recruited children through dental clinics, pediatric practices, and Head Start programs in Michigan, New York, and Iowa. Dentists apply the 38% SDF solution directly to decayed areas using a small applicator. Unlike a filling, the procedure does not require drilling, an injection, or sedation, and it does not restore lost tooth structure.
SDF combines silver, which acts against bacteria associated with decay, and fluoride, which helps strengthen teeth. Arresting a cavity means preventing further deterioration, rather than repairing the existing damage. Treatment may need to be repeated. One visible drawback is that the decayed portion of a treated tooth turns permanently dark, which may affect families’ decisions, particularly for front teeth.
Untreated cavities can cause pain and infection and may eventually require surgery under general anesthesia. Because some young children struggle with conventional dental procedures, a quick application could offer another way to manage certain cavities. The researchers also identified potential uses for older adults and people who face barriers to dental care, although this trial studied young children.
In the United States, SDF was approved for treating tooth sensitivity in 2014; its use to arrest cavities has been off-label. The researchers say the trial could support an application for FDA approval for that purpose and encourage broader access. SDF is not appropriate for every cavity, and children who receive it may still need fillings or other dental treatment later. Ongoing dental care remains important for monitoring treated teeth over time.