Non-surgical Treatment of Dentin Caries in Preschool Children

Objective: Untreated dentin caries in primary teeth is commonly found in preschool children worldwide. Use of simple non-surgical approaches to manage the situation has been advocated recently. To review and evaluate the effectiveness of non-surgical methods in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children. Methods: A systematic search of the main electronic databases (Pubmed, Cochrane Collaboration, EMBASE) was conducted to identify peer reviewed papers published in English in the years 1947-2014. Search keywords and MeSH headings were “dental caries”, “primary dentition” and various non-surgical treatments (fluoride, sealant, resin infiltration, xylitol, chlorhexidine, CPP-ACP, ozone, etc.). The inclusion criteria were clinical studies conducted in children under 6 years old, and reported findings on caries arrest or caries progression in primary teeth. Data were extracted by two reviewers independently and the quality of included studies was assessed. Results: The search identified 320 deduplicated papers for screening. Among these, 287 papers did not satisfy the study inclusion criteria. Consequently, 33 full papers were retrieved and reviewed. Finally, 4 papers were included. Three studies reported that topical applications of silver diammine fluoride (SDF) solution could arrest dentin caries in preschool children. One study supported that having a daily toothbrushing exercise in kindergarten using toothpaste with 1000 ppm fluoride could stabilize the caries situation in young children. Conclusion: There is some evidence to support the effectiveness of SDF applications or daily toothbrushing with fluoride toothpaste in arresting the progression of active dentin caries in preschool children. More well-designed randomized controlled trials are required to confirm these findings.