A flouride that costs less than $15 per tooth drops cavity risk 80 percent, study finds

An easy, relatively painless dental procedure can help your child avoid cavities.

Silver diamine fluoride, combined with dental sealant, can drop a child’s risk of developing a cavity by 80 percent over the next two years, New York University researchers found. They also found that it could prevent existing cavities from worsening in about 50 percent of cases.

Dental sealants work by forming a barrier between enamel and bacteria in the mouth, preventing exposure to toxic chemicals that erode enamel. The silver and fluoride in the product also kills bacteria, further protecting teeth.

About half of American children have dental cavities, which are linked to poor grades at school, bad self-esteem and digestive issues in children.

Doctors also warn that after the Covid pandemic, the number of children with dental decay is set to soar due to reduced access to dentists and disrupted routines.

The above picture shows a tooth before and after a dental sealant is applied. It is placed into cavities to prevent tooth decay

Dental cavities are the most common disease in children, with over half suffering at least one before their eighth birthday, estimates suggest.

If left untreated, they can lead to pain and infections which affect a child’s eating, speaking, playing and learning. There is also a risk of tooth loss.

The Centers for Disease Control and Prevention (CDC) says children with dental cavities are more likely to miss school and get worse grades than those who don’t.

They are also more at risk of poor social skills, because lower self-esteem caused by cavities may lead to them being less likely to associate with children, an Italian study from 2021 found.

A University of North Carolina study from 2011 found children with bad oral health were three times as likely to miss school than their peers – and performed worse academically.

They could also have trouble chewing or swallowing, which leaves them at higher risk of suffering from indigestion and vomiting, experts say.

To reduce these risks, health officials recommend children brush their teeth for two minutes twice a day to remove bacteria. 

But the CDC and American Dental Association (ADA) have also recommended dental sealants — thin coatings painted on the back teeth to prevent cavities — to prevent tooth decay in youngsters. 

In 2017, the CDC started funding a program to roll these out to schools. But they are at pains to point out this is in addition to teeth brushing. 

Dental sealants work by covering teeth with a protective layer that blocks out germs and food.

Dentists say that this means toxic chemicals released by bacteria that break down sugars in the mouth don’t reach the enamel, where they would normally cause it to decay.

Sealants are not a replacement for children brushing their teeth for two minutes twice a day, dentists say.

But they do provide added protection for those hard-to-reach areas in the mouth using a toothbrush — the grooves in molars — helping to minimize the risk of cavities.

In the study, published today in JAMA Network Open, researchers compared silver diamine fluoride (SDF) and glass ionomer sealant. 

SDF is a less expensive sealant — costing about $100 to $350 per mouth — and can be applied in less time and by a registered nurse rather than a dentist.

The silver in SDF may also kill bacteria in the mouth that could harm enamel. 

Scientists say it could ‘substantially improve’ the rate of dental cavities among children.

For the study, the scientists recruited 2,998 children from 47 schools across New York City. 

All were in kindergarten through to third grade, meaning they were between five and nine years old.

Children were split into two groups to receive either SDF or the glass sealant.

They had their dental health assessed and then the sealant was applied to the grooves or pits in the middle of the molars and premolars.

Treatment was carried out between 2019 and 2020, before the program was halted because of the Covid pandemic.

When scientists returned two years later, they re-examined children’s teeth to establish how effective the sealants were.

They found that out of the SDF participants, 81 percent (418 youngsters) had no new cavities. 

Dental cavities are the most common disease among children. But researchers at New York University say 80 percent of youngsters did not develop new cavities two years after they got sealants applied to their teeth (stock image)

Dental cavities are the most common disease among children. But researchers at New York University say 80 percent of youngsters did not develop new cavities two years after they got sealants applied to their teeth (stock image)

Among those who already had cavities when they got the treatment, 56 percent (193) showed no further development.

For comparison, in the glass ionomer group, 82 percent formed no new cavities (567).

Among those who already had cavities, 46 percent (220) had no further development.

The scientists noted that both treatments were as effective as each other.

‘Without prevention, dental cavities grow continuously if not treated,’ said Dr Richard Niederman, an epidemiologist at NYU and lead author of the study.

‘Cavity prevention treatment, provided just before schools closed during the pandemic, was remarkably effective over the following two-year period.

‘I know of no other dental preventive intervention that had this great a beneficial impact across the pandemic.’

Dr Ryan Ruff, an oral health epidemiologist who was also involved in the study, added: ‘Our results support the use of SDF for cavity prevention in school-based oral health programs and offer an opportunity for expanding access to critical oral health care.’

What are dental sealants? 

Dental sealants are a fluid painted onto teeth that creates a barrier between enamel and harmful bacteria.

It is normally painted onto the molars and premolars in the mouth, into the grooves between them that can be hard to reach using a toothbrush.

Dentists say the barrier stops toxic substances released by bacteria that break down sugar in the mouth reaching enamel, and eroding it.

The treatments can last for about three months to a year, but in some cases they may last much longer.

Dentists say they are not a replacement for brushing your teeth for about two minutes twice a day.

But they will also help to reduce someone;s risk of developing cavities.

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