Using Silver fluoride in adults with special needs

Abstract

Aim or Purpose: As little is known about the effectiveness of AgF in adults with special needs, this study compared two AgF products in Australia, for dental caries arrest, by clinical ratings of caries activity (CCA) and fluorescence measurement of the bacterial load(BL). Materials and Methods: This split-mouth clinical study, over two appointments 3-months apart, compared the impact of AgF/KI and AgF/SnF₂ on carious lesions. Adult patients attending MN-OHC Special Needs Dentistry clinic with similar carious lesions (CL) in contralateral teeth of the same arch were recruited. CCA was assessed as active/inactive and BL with laser-induced-fluorescence score(LIFs). Bivariate analysis undertaken to assess the baseline to review of CCA, mean of LIFs for BL, relationship between the two AgF and any confounding factors. For Statistical significance, p<0.05 was used. Ethics approved by MN/UQ(HREC/2021/QRBW/73736 and 2021/HE002354). Results: Fifty-six teeth (28 treatment pairs) across 12 participants were included. The CCA and LIFs were comparable at baseline between the selected contralateral teeth. There was statistical significance in caries improvement between baseline and review in terms of CCA (82.14% of teeth became inactive, 12.5% of teeth remained inactive, and 5.36% remained active, p<0.0001), and likewise a reduction for BL by LIFs(Baseline LIFs mean=71.9,STD=28.6,95%CI[64.4,79.4];Review LIFs mean=47.0,STD=24.3,95%CI[40.6, 53.4],p<0.0001). There was no significance in changes to CCA(p=0.7881) or LIFs(p=0.4286) between the two AgF. Conclusions: A single treatment with both AgF products was clinically effective at 3-months post-treatment in arresting CL in participants. Further research is required to assess the impact of these two AgF on BL of carious lesions over longer time periods, and to determine when a second treatment is required.