IADR Abstract Archives
Medical Management of Caries in Primary Dentition Using Silver Nitrate
Objectives: Medical management of caries utilizing silver compounds has recently gained national attention. This study compares medical management of caries in primary teeth utilizing silver nitrate and fluoride varnish to conventional restorative treatment.
Methods: The study population consisted of Amish children ages 2-11 years living in the vicinity of Kalona, Iowa. This population was selected due to known high caries rate, low fluoride exposure, lack of dental insurance, and episodic dental care. Children with at least one primary tooth with caries extending into dentin were invited to enroll in a two-arm, parallel group, patient-randomized controlled pilot trial. Enrollees were assigned to either: 1) conventional restorative caries management (CON); or 2) medical management of caries using silver nitrate and fluoride varnish (SN). Sample allocation ratio was 2SN:1CON.
Baseline measures and outcome data were assessed through direct reporting, clinical examination including blinded radiograph assessment, and child/parent questionnaires. Outcome measures included incidence of caries, pain or infection, patient quality of life, cost-effectiveness, and acceptability of treatment strategies.
Results: Results reported are from an ongoing two-year clinical trial still in enrolment. To date, 84 children have been screened for eligibility; 66 were eligible and enrolled. Nineteen were assigned to CON and 47 to SN. Thirty nine children (59.1%) were males. Mean age was 7.43±2.16 years. Total number of teeth with caries into dentin eligible for the study was 274. Sixty three (23%) for CON and 211 (77%) for SN. Fifty one children (19 CON, 32 SN) completed treatment and six month recall. No complaints were reported by parents or patients, including black discoloration associated with silver nitrate.
Conclusions: Preliminary findings suggest high levels of acceptability for silver nitrate treatment. To date, effectiveness of silver nitrate on dental caries has not been reported. Future results will provide information regarding clinical and cost effectiveness of medically managing caries in children.
Methods: The study population consisted of Amish children ages 2-11 years living in the vicinity of Kalona, Iowa. This population was selected due to known high caries rate, low fluoride exposure, lack of dental insurance, and episodic dental care. Children with at least one primary tooth with caries extending into dentin were invited to enroll in a two-arm, parallel group, patient-randomized controlled pilot trial. Enrollees were assigned to either: 1) conventional restorative caries management (CON); or 2) medical management of caries using silver nitrate and fluoride varnish (SN). Sample allocation ratio was 2SN:1CON.
Baseline measures and outcome data were assessed through direct reporting, clinical examination including blinded radiograph assessment, and child/parent questionnaires. Outcome measures included incidence of caries, pain or infection, patient quality of life, cost-effectiveness, and acceptability of treatment strategies.
Results: Results reported are from an ongoing two-year clinical trial still in enrolment. To date, 84 children have been screened for eligibility; 66 were eligible and enrolled. Nineteen were assigned to CON and 47 to SN. Thirty nine children (59.1%) were males. Mean age was 7.43±2.16 years. Total number of teeth with caries into dentin eligible for the study was 274. Sixty three (23%) for CON and 211 (77%) for SN. Fifty one children (19 CON, 32 SN) completed treatment and six month recall. No complaints were reported by parents or patients, including black discoloration associated with silver nitrate.
Conclusions: Preliminary findings suggest high levels of acceptability for silver nitrate treatment. To date, effectiveness of silver nitrate on dental caries has not been reported. Future results will provide information regarding clinical and cost effectiveness of medically managing caries in children.