It stands to reason that most of us think that cavity prevention and tooth care is targeted towards children or even young adults.  But the truth of the matter is that the problem of tooth decay is more serious in U.S. adults than in children, yet it has received far less interest.  It is a fact that while the adult population has grown and life span has increased, tooth loss has decreased overall.  This opens the door to the fact that adult cavity occurrence is increasing. But there are valid reasons for the rise in tooth decay in adults.

While it is true that we are living longer, this also means that our dental health is not something that can be ignored or made light of.  Diminished personal hygiene, the inability to get to a dental professional, fear of the dental procedures, a condition called “dry mouth,”  mouth hyper-sensitivity, complications of Alzheimer’s or other similar diseases and even the use of multiple prescriptions all contribute to this ongoing problem.  .

A 2013 report by the Centers for Disease Control and Prevention (CDC) estimates 1.4 million people in the U.S. live in nursing homes and 1.2 million live in hospice settings.  “These individuals tend to have medical, behavioral, physical and financial limitations that beg a reasonable option.”  Another important factor when looking at the overall picture of adult dental care.

Until now, there has been no choice for treating tooth decay or cavities in the U.S. besides standard, routine dental practices.  But now there is another option that specifically trained dentists can offer to their patients, including both children and adults.

The “anatomy” of a cavity is that it is a complex “disease” in which bacteria causes the calcified tissue (tooth) to lose precious minerals and begin to degrade or break down. Bacteria and enzymes then become part of the decay process and the cavity then progresses.  What is now available to stop this process is a clear, paintable liquid solution with the chemical name of Silver Diamine Fluoride (SDF).  It was cleared by the FDA in 2015 for use by exclusively trained dentists in treating tooth sensitivity, however, it is also being used for specific dental cavity procedures.

The silver element acts as substance that kills bacteria and prevents the possible formation of bacterial film on the tooth, while the fluoride acts to avoid further disintegration of the tooth enamel. The Journal of Multidisciplinary Care has affirmed that fluoride alone is not sufficient enough to positively affect dental cavity control without the addition of an element that would limit bacteria.  SDF satisfies both of these needs

However, as the American Dental Association notes, “SDF is not a complete solution to caries risk.  Single application has been reported to be insufficient for sustained benefit” and can lose its effectiveness over time.  This is true especially for seniors.  The only side effects noted, beyond an allergy to silver, are an unpleasant metallic taste, potential temporary irritation of gum tissue and possible reversible staining of the tooth in the area of where the SDF is applied. A very small price to pay for such a cost-effective and safe alternative treatment of cavities even if it has to be applied semi-annually!

What I find amazing, is that in countries like Argentina, Japan, Australia, as well as other nations, dentists have been putting the silver diamine fluoride solution on areas of tooth decay for more than 80 years.  So although it has taken longer that it maybe should have, U.S. residents finally have an affordable option for dental care for themselves and their families, especially those who are caregivers or have loved ones with physical, financial or health needs that makes regular dental care very difficult or even impossible.

References

“UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent.”    National Center for Biotechnological Information. National Institutes of Health. Journal of the California Dental Association. Author manuscript.  2016 Jan; 44(1): 16–28. Web. 10 July 2016.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4778976/

Featherstone, John and Jeremy Horst.  “Fresh Approach to Caries Arrest in Adults.” The Journal of Multidisciplinary care: Decisions in Dentistry. 15 October 2015.  Web. 11 July 2016.  http://decisionsindentistry.com/article/fresh-approach-to-caries-arrest-in-adult

“Long-Term Care Services in the United States: 2013 Overview.” Centers for Disease Control. December, 2013.  Web.  11 July 2016. http://www.cdc.gov/nchs/data/nsltcp/long_term_care_services_2013.pdf.

“Silver Diamine Fluoride in Caries Management.” ­­­American Dental Association: Science and Research. 12 July 2016. Web. 19 July 2016. http://www.ada.org/en/science-research/science-in-the-news/silver-diamine-fluoride-in-caries-management

Categories: Health