Randomized Clinical Trial on Preventing Root Caries among Community-Dwelling Elders

Area of Science:

• Dentistry
• Geriatric Medicine
• Preventive Medicine

Background:

• Dental root caries is a prevalent issue among the elderly population.
• Existing evidence on the efficacy of silver diamine fluoride (SDF) for preventing root caries is limited.
• There is a need for effective preventive strategies for root caries in older adults, particularly in fluoridated communities.

Purpose of the Study:

• To compare the effectiveness of annual silver diamine fluoride (SDF) application versus placebo in preventing root caries among elders.
• To evaluate the additional benefit of potassium iodide (KI) when applied after SDF.
• To assess the impact of oral hygiene and baseline caries experience on root caries development.

Main Methods:

• A 30-month randomized clinical trial involving 323 elders with exposed root surfaces in a water-fluoridated area.
• Intervention groups included annual application of placebo (tonic water), SDF solution, or SDF followed by KI solution.
• Oral hygiene instructions and fluoride toothpaste were provided to all participants; root surface status was assessed every 6 months.

Main Results:

• Annual SDF or SDF/KI application significantly reduced new root caries compared to placebo (mean new lesions: 0.4 and 0.5 vs. 1.1, P < 0.001).
• No significant difference was observed between the SDF and SDF/KI groups (P > 0.05).
• Higher visible plaque index and baseline DMFT scores were associated with increased root caries development.

Conclusions:

• Annual topical application of silver diamine fluoride (SDF) or SDF/potassium iodide (KI) is effective in preventing dental root surface caries in community-dwelling elders.
• SDF provides a significant preventive benefit for root caries in this population.
• Maintaining good oral hygiene is crucial for preventing root caries, even with topical fluoride applications.