Faculty Bibliography
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The effect of silver diamine fluoride in preventing in vitro primary coronal caries under pH-cycling conditions
OBJECTIVES/OBJECTIVE:) ions, in preventing enamel demineralization under pH-cycling conditions in the presence or absence of twice-daily fluoride application. DESIGN/METHODS:; silver control, 253,900 ppm Ag); potassium fluoride (KF; fluoride control, 44,800 ppm F); deionized water. Treatments were applied once. Specimens in each treatment group were divided into two subgroups (n = 18). During the subsequent 7-day pH-cycling phase, specimens were treated twice daily with either 275 ppm fluoride as sodium fluoride or deionized water, immediately before and after a 3-h cariogenic challenge with exposure to artificial saliva at all other times. Changes in color, Vickers surface microhardness (SMH), transverse microradiography (TMR) was calculated. Data were analyzed using two-way ANOVA. RESULTS:and deionized water (p < 0.0001). There was no statistically significant difference between SDF, SDF + KI and KF with twice daily fluoride treatments (p > 0.8). However, KF was more effective in preventing demineralization than SDF and SDF + KI in the absence of fluoride treatments (p = 0.0002). KI did not affect the ability of SDF to prevent demineralization (p > 0.4). CONCLUSION/CONCLUSIONS:SDF and SDF + KI appears to be an effective option in preventing primary coronal caries.
PMID: 33161341
ISSN: 1879-1506
CID: 4676302
Journal of the American Dental Association. JADA. 2020:151(10):755-763.DOI: 10.1016/j.adaj.2020.06.022
Teaching and utilization of silver diamine fluoride and Hall-style crowns in US pediatric dentistry residency programs
BACKGROUND:Nonsurgical caries management, particularly silver diamine fluoride (SDF) and Hall-style crowns, present alternative options for populations that have barriers to traditional treatment. The authors aimed to assess changes in the teaching and utilization of these modalities in pediatric dental residency programs. METHODS:The authors e-mailed a 29-question electronic survey regarding the utilization and teaching of nonsurgical caries management agents to US pediatric dentistry residency program directors. Data were compared with results from a similar survey conducted in 2015 to analyze trends, report protocols, barriers for utilization, and possible reasons for changes. RESULTS:Respondents from 82 programs completed the surveys (89% response rate). Although only 26% of respondents reported using SDF in 2015, 100% reported its utilization in 2020 (P < .001). The Hall-style crown technique is taught didactically in 90% of programs, and 69.5% of respondents use it at least sporadically in their clinics. Long wait times for the operating room (4 weeks-14 months) and sedation (1 week-12 months) motivate increased utilization of SDF, interim therapeutic restorations, and Hall-style crowns. Guidelines supporting off-label utilization of SDF have also resulted in its increased utilization. CONCLUSIONS:US pediatric residency programs have universally adopted SDF for caries arrest in the primary dentition, and this trend seems to extend to other nonsurgical caries management agents. These changes are likely driven by diverse barriers to delivery of traditional restorative care. PRACTICAL IMPLICATIONS/CONCLUSIONS:The rapid increases in teaching and utilization of minimal intervention techniques provide clinicians with more options for caries management in patients with barriers to traditional treatment.
PMCID:7510543
PMID: 32979954
ISSN: 1943-4723
CID: 4616282
Use of Non-Vital Pulp Therapies in Primary Teeth
PMID: 33087217
ISSN: 1942-5473
CID: 4660962
A Systematic Review and Meta-Analysis of Nonvital Pulp Therapy for Primary Teeth
PMID: 32847665
ISSN: 1942-5473
CID: 4587452
Effectiveness of In Vitro Primary Coronal Caries Prevention with Silver Diamine Fluoride - chemical vs biofilm models
OBJECTIVES/OBJECTIVE:) and fluoride (F-) ions, in preventing enamel demineralization using biofilm and chemical models. METHODES/UNASSIGNED:, 0.2% Carbopol 907, pH adjusted to 5.0 for five days. Vickers surface microhardness was used to determine the extent of enamel demineralization. Data were analyzed using one-way ANOVA. RESULTS:and DIW. CONCLUSION/CONCLUSIONS:KI application after SDF treatment appears to impair SDF's ability to prevent biofilm-mediated but not chemically induced demineralization. CLINICAL SIGNIFICANCE/CONCLUSIONS:SDF may be a viable option in preventing primary coronal caries.
PMID: 32593705
ISSN: 1879-176x
CID: 4524732
Quality Appraisal of Child Oral Health-Related Quality of Life Measures: A Scoping Review
BACKGROUND/UNASSIGNED:Children's oral health-related quality of life (COHQoL) measures are well known and widely used. However, rigorous systematic reviews of these measures and analyses of their quality are in absence. OBJECTIVES/UNASSIGNED:To systematically review and quantitatively assess the quality of COHQoL measures through a scoping review. DATA SOURCES/UNASSIGNED:Systematic literature search of PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE (Excerpta Medica database), HaPI (Health and Psychosocial Instruments), and DOSS (Dentistry and Oral Sciences Source). STUDY ELIGIBILITY/UNASSIGNED:The measure's focus was COHQoL; the child age ranged from 5 to 14 years; the publication was either a research article or a systematic review and related to caries; and it was written in English or had an English abstract. Two authors independently selected the studies. Disagreements were reconciled by group discussions with a third author. APPRAISAL/UNASSIGNED:The International Society for Quality of Life Research minimum standards for patient-reported outcome measures were used for quality appraisal. SYNTHESIS/UNASSIGNED:Descriptive analysis. RESULTS/UNASSIGNED:We identified 18 measures. Their quality scores ranged from 9.5 to 15.0 on a scale of 16. The quality appeared to bear no relationship to the citation and use of these measures. However, elements of these measures might be more useful than others, depending on the age-specific use and primary quality concerns. LIMITATIONS/UNASSIGNED:Some of the information on the minimum standards of the 18 measures cannot be found in the existing literature. Measures published without English abstract were not searched. CONCLUSIONS/UNASSIGNED:The quality of these measures is suboptimal. Researchers and practitioners in this field should exercise caution when choosing and using these measures. Efforts at improving the quality of the COHQoL measures, such as refining existing ones or developing new measures, are warranted. KNOWLEDGE TRANSFER STATEMENT/UNASSIGNED:Researchers, clinician scientists, and clinicians can use the results of this study when deciding which oral health-related quality of life measure they wish to use in children.
PMID: 31238010
ISSN: 2380-0852
CID: 3962742
Journal of the American Dental Association. JADA. 2019:150(2):140-146.DOI: 10.1016/j.adaj.2018.10.016
Silver and fluoride content and short-term stability of 38% silver diamine fluoride
BACKGROUND:As silver diamine fluoride (SDF) gains popularity for caries arrest, the authors aimed to investigate the content of fluoride and silver in 38% SDF produced for the US market and its short-term stability. METHODS:Five samples of 38% SDF were evaluated when the bottle was first opened, and at 7 and 28 days. Fluoride concentrations were determined with a fluoride ion-selective electrode, and silver concentrations were determined with a simultaneous inductively coupled plasma mass spectrometer. pH was measured with a pH probe. Weight and volume of individual drops were measured. RESULTS:At day 0, 40% of individual measured values were above the expected fluoride concentration, and at day 28, 93% were above the expected fluoride concentration (P = .005). At day 0, 19% of individual measured values were below the lowest expected silver concentration, and at day 28, 93% were below (P < .001). Acidity (pH 10) was consistent over the 3 periods. Mean (standard deviation) weight of a drop was 40 (4.0) milligrams, and mean (standard deviation) volume was 32.55 (1.89) microliters, 30% more than the reported value of 25 μL. CONCLUSION/CONCLUSIONS:Over 28 days, the product pH is stable, whereas the fluoride content tends to increase and the silver content tends to decrease. Drops were larger than expected when dispensed from the bottle. PRACTICAL IMPLICATIONS/CONCLUSIONS:Drops are larger than expected, so each delivers higher than expected quantities of silver and fluoride. Clinicians should exercise caution when using this product on young children, replace the cap immediately, and use as soon as dispensed.
PMID: 30691572
ISSN: 1943-4723
CID: 3631322
Silver diamine fluoride (SDF): Its role in caries management
Silver diamine fluoride (SDF) combines the antibacterial properties of silver and the remineralizing actions of fluoride in an alkaline solution that creates an unfavourable environment for collagen degradation. Clinical trials have proven the efficacy of SDF as a caries-arresting agent in primary teeth and root caries in the elderly. It is minimally invasive, inexpensive, safe and easy to apply, but a sign of arrest is the dark discoloration of the lesions where it is applied. SDF provides clinicians with a valuable additional tool in their armamentarium for caries management that aims to stop the disease process at the tooth surface, when traditional restorative therapy is not the best option, and when aesthetic results are not a concern.
SCOPUS:85077915296
ISSN: 0305-5000
CID: 4332522
Evidence-Based Dentistry Update on Silver Diamine Fluoride
This article reviews current evidence on the effectiveness of silver diamine fluoride (SDF) as a caries arresting and preventive agent. It provides clinical recommendations around SDF's appropriate use as part of a comprehensive caries management program. Systematic reviews confirm that SDF is effective for caries arrest on cavitated lesions in primary teeth and root caries in the elderly. It may also prevent new lesions. Application is easy, noninvasive, affordable, and safe. Although it stains the lesions dark as it arrests them, it provides clinicians with an additional tool for caries management when esthetics are not a primary concern.
PMID: 30447792
ISSN: 1558-0512
CID: 3479192
Parental Expressed Concerns about Silver Diamine Fluoride (SDF) Treatment
Background: The staining associated with its caries arrest may be a deterrent for the use of Silver Diamine Fluoride (SDF). This study aims to elucidate the concerns that inform parents' perceptions and acceptance of SDF as a treatment option for their child. Study Design: We analyzed qualitative data obtained through an investigation in which parents attending a pediatric dental appointment participated in a survey, which included an open-ended question to evaluate their opinions about SDF staining. Thematic analysis of the comments, offered by the subsample of participants who replied to this question (n=43), yielded insights about perception of SDF therapy. Results: Most parents who provided comments were mothers (83.7%), college graduates (72.1%), primarily white (48.8%) or Hispanic (27.9%). Six themes emerged from the thematic analysis of the parents' responses: Esthetic Concerns, Psychosocial Concerns, SDF Treatment Process, Risks and Side Effects, Situational Benefits, and Dental Treatment Process. While many of the parents' comments are related to appearance, other topics that merit consideration when discussing SDF treatment were mentioned. Conclusions: Although parents are concerned about the esthetic impact of SDF, they understand the risks of alternative treatments and welcome information that will allow them to make an informed decision. Location of the cavities and visibility of the staining appear to heavily influence the decision to accept or reject this therapy.
PMID: 30964719
ISSN: 1053-4628
CID: 3914092
