The Effect of Silver Diamine Fluoride (SDF) on Bacteria Involved in Root or Cervical Carious Lesions

Study Overview
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Brief Summary
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The study will compare bacteria levels in cavities before and after silver diamine fluoride (SDF) treatment.

Detailed Description
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To assess the effect of silver diamine fluoride (SDF) treatment on microorganisms present in root caries or cervical lesions by collecting microbial deposits before and 1 month after SDF application. Bacterial samples will be collected from 20 adult subjects at the initial visit before application of SDF and one month after. At the 1 month recall, examination for caries arrest will be performed. All 40 bacterial samples will be sent to the Forsyth Institute to verify bacterial composition using HOMINGS technology.

Official Title
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The Effect of Silver Diamine Fluoride (SDF) on Bacteria Involved in Root or Cervical Carious Lesions Using HOMINGS Technology. A Clinical Study

Conditions
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Caries

Intervention / Treatment
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* Device: Silver Diamine Fluoride (SDF)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Generally healthy adult participants 18 years of age and older. At least one tooth with active (soft) cavitated lesions of ICDAS score 5 or 6 near the gingival margin (coronal cervical caries at the CEJ or exposed root surfaces with soft active carious lesions exposing dentin). Exclusion Criteria: Adult participants who suffer from serious life-threatening medical diseases that interfere with basic daily self care activities. Patients taking antibiotics within the last two weeks. Patients using chlorhexidine or fluoride mouth washes within the last two weeks. Pregnant or breastfeeding women. Teeth with arrested (hard) cervical or root caries lesions. Teeth that have been diagnosed with an abscess or an irreversible pulpitis, or are mobile.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Silver Diamine Fluoride (SDF)<br>Application of Silver Diamine Fluoride (SDF) to root or cervical carious lesions (cavities). Collection of plaque pre- and one month post-SDF application. | Device: Silver Diamine Fluoride (SDF)<br>* No caries removal will take place. Bacterial samples will be collected using Gracey curettes at the initial visit before application of SDF and one month after. The tooth will be dried and SDF will be placed on the carious dentin until saturated. Excess will be blotted dry with a cotton pellet<br>* Other names: Silver Dental Arrest;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Bacterial Composition Before and One Month After SDF Application to Root or Cervical Caries Lesions | Using human oral microbiome identification using next-generation sequencing (HOMINGS), change in the total bacterial composition of all subjects was measured by the difference of the number of bacteria count from baseline to one month after SDF application. | baseline, One month after SDF | 
| Caries Arrest of Teeth Measured by Change in Dentin Texture (Soft, Hard) | Caries were examined for hardness or softness before and after SDF application. The change in the texture was examined after one month of SDF application the change from soft to hard is noted below. | One month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Assessment of Appearance of Treated Tooth (Concern With the Appearance of Study Tooth, Desire for the Study Tooth to be Filled) | Each subject was asked if they were concerned with the appearance of the tooth that SDF was applied too. They were also asked if they wanted the study tooth to be filled with a tooth color filling. | One month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Caries, Cavity, Silver Diamine Fluoride (SDF), HOMINGS