Longitudinal effectiveness of silver diamine fluoride on caries lesions in adults: A retrospective study using a...

Silver diamine fluoride (SDF) is used to treat caries lesions in primary teeth in children and has been found to be effective. Older adults may also benefit from the use of SDF in treating initial coronal or root caries lesions, yet such studies are lacking. The authors aimed to determine the factors related to the longevity of adult patients' teeth after SDF treatment.

Data were obtained from the AxiUm database of the College of Dentistry, University of Iowa. Patients 18 years and older who underwent SDF treatment from January 1, 2016, through December 31, 2021, were included. Patient variables included demographic characteristics, medical history, tobacco use, and total number of SDF treatments. The tooth variables included tooth number, number of SDF applications, and any subsequent treatment. The outcome was tooth survival, defined as no need for subsequent treatment and no need for root canal or extraction. The analyses included χ² tests, Cox survival models, and Kaplan-Meier curves.

The analysis included 1,772 patients and 2,985 SDF-treated teeth. Tobacco use was linked to more subsequent treatments, whereas multiple SDF applications reduced them. Teeth with preexisting crowns were more likely to require root canal therapy or extraction.

In adults, the application of SDF more than once increased the longevity of teeth. Tobacco use was associated with an increased chance of a tooth having subsequent treatment (eg, restoration, extraction, and root canal therapy) after SDF application.

Repeated SDF applications may enhance tooth survival in adults, although tobacco use and existing crowns could reduce SDF effectiveness.