Silver Diamine Fluoride Treatment of Active Root Caries Lesions in Older Adults: A Case Series

Study Overview
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Brief Summary
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The authors conducted a case series to determine the outcomes of treatment of root surface caries lesions when the teeth were treated topically with 38% silver diamine fluoride.

Detailed Description
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The study is a prospective, single center case series. The cases were consecutive. Participation was offered to every patient who qualified based on age and the presence of an active lesion in a root surfaces, in a furcation, or under an individual crown or crown abutment for a fixed prosthesis. The study was conducted at the dental clinic of the Roseman College of Dental Medicine in South Jordan, Utah. The University of California, San Francisco protocol for applying topical silver diamine fluoride was adapted for use with these patients. Lesions were flushed with water and then dried with compressed air, isolated with cotton rolls, and then 38% silver diamine fluoride (Advantage Arrest, Elevate Oral Care, West Palm Beach, FL) was applied repeatedly for two minutes with the manufacturer supplied dental applicator. The silver diamine fluoride was stored under the manufacturer's recommended conditions. If the patient complained about the taste, the lesion was coated with sodium fluoride varnish. All of the lesions were reevaluated for dental caries lesion activity about every six months and retreated regardless of their arrest status. Follow-up was for 30 months or until loss to follow-up.

Official Title
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Silver Diamine Fluoride Treatment of Active Root Caries Lesions in Older Adults: A Case Series

Conditions
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Root Caries

Intervention / Treatment
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* Device: Silver Diamine Fluoride 38%


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least 1 active root surface caries lesion by Nyvad criteria Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Case series, consecutive
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Silver Diamine Fluoride<br>Topical application of one drop of silver diamine fluoride 38% to active untreated roof surface caries, lesions at the furcation, or lesions at crown margins. Application was repeated once each six months. | Device: Silver Diamine Fluoride 38%<br>* Dental caries arrest medication<br>* Other names: Advantage Silver Arrest;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dental caries lesion activity 1 | Nyvad score based on visual/tactile examination | 6-12 months | 
| Dental caries lesion activity 2 | Nyvad score based on visual/tactile examination | <6 months | 
| Dental caries lesion activity 3 | Nyvad score based on visual/tactile examination | 12-18 months | 
| Dental caries lesion activity 4 | Nyvad score based on visual/tactile examination | 18-24 months | 
| Dental caries lesion activity 5 | Nyvad score based on visual/tactile examination | 24-30 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Caries lesion fluorescence 1 | Laser fluorescence measurement at the surface of the lesion | <6 months | 
| Caries lesion fluorescence 2 | Laser fluorescence measurement at the surface of the lesion | 6-12 months | 
| Caries lesion fluorescence 3 | Laser fluorescence measurement at the surface of the lesion | 12-18 months | 
| Caries lesion fluorescence 4 | Laser fluorescence measurement at the surface of the lesion | 18-24 months | 
| Caries lesion fluorescence 5 | Laser fluorescence measurement at the surface of the lesion | 24-30 months |