Mechanisms of silver diamine fluoride on arresting caries: a literature review

05 March 2019 Scientific journals

The International Dental Journal (IDJ) is FDI’s primary scientific publication. Published every two months, the IDJ features peer-reviewed articles relevant to oral health worldwide. In 2018, the most-downloaded article in the IDJ was Mechanisms of silver diamine fluoride on arresting caries: a literature review (3,204 downloads). The third-most downloaded article was Early childhood caries among 5- to 6-year-old children in Southeast Asia (1,365 downloads).

These articles were written together by eight authors; four of the authors contributed to both articles. FDI interviewed two of the four authors, Prof. Chun Hung Chu and Dr Sherry Shiqian Gao, to learn more about their research on early childhood caries in Southeast Asia and on silver diamine fluoride as a simple, low-cost solution to prevent tooth decay.

IDJ Authors

From left to right: Dr Duangporn Duangthip, Prof. Edward Chin Man Lo, Prof. Chun Hung Chu, Dr Sherry Shiqian Gao

Establishing a preliminary picture of early childhood caries rates in Southeast Asia

The authors conducted a literature search of all published papers on caries in 5- to 6-year-old children in 11 countries in Southeast Asia. Early childhood caries is a global problem; with their research, the authors present the current status of early childhood caries rates in Southeast Asia and facilitate future country-by-country comparisons.

When asked about the challenges that the authors encountered during their research, they referred to differences in how the published papers measured and evaluated oral health. Rather than using standardized guidelines on the assessment of oral health established by the World Health Organization (WHO), researchers often developed their own methodology. These differences in measuring oral health make it difficult to compare oral health data across regions and develop informed, evidence-based solutions to combat tooth decay.

Prof. Chu says that solving the high rates of early childhood caries in Southeast Asia remains a significant challenge:

"Definitely… conventional care is not able to solve the problem. It’s not only [a question of] money, we also don’t have…enough dentists to solve the problem in a conventional way. That’s why we think the use of alternative strategies, such as the use of [silver diamine fluoride] treatment, can be one of the ways to deal with the problem."

Dr Gao advocates for silver diamine fluoride treatment as a realistic and impactful solution to managing early childhood caries, especially in low-income countries:

"One of the major research interests of our group is to [use] silver diamine fluoride [to] manage early childhood caries. I think this strategy is particularly invaluable for underdeveloped countries, because, as Prof. Chu said before, conventional treatment is not available nor affordable for children in countries [with high rates of dental caries, like Cambodia and Vietnam]. If we can apply a simple and low-cost strategy, such as silver diamine fluoride treatment, it would be super helpful for the children living in those underdeveloped areas, and maybe some low-income populations in cities."

The authors plan to continue their research and contribute to the wider body of scientific literature on these topics.

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