In a study of nearly 3,000 schoolchildren, silver diamine fluoride (SDF) – a liquid that is brushed onto teeth to prevent cavities or keep them from worsening – was as effective against cavities as dental sealants, the standard of care. A single dose of either topical treatment given in primary schools prevented roughly 80% of cavities and kept 50% of cavities from worsening.

The findings, published in JAMA Network Open, offer an efficient and cost-effective approach to improving children’s oral health through school-based care. Dental caries (cavities) is the most common chronic disease in children, and those from low-income families are twice as likely to have cavities as those from higher-income families. Without proper and timely intervention, cavities can lead to severe infections, reduce children’s quality of life, and are associated with lower student academic performance and school attendance.

CariedAway is a randomised trial comparing the effectiveness of two cavity-prevention techniques: a ‘simple’ treatment using SDF and fluoride varnish; and, a ‘complex’ treatment using traditional glass ionomer sealants and fluoride varnish. Both are non-invasive and applied to the surface of teeth to prevent and arrest cavities in children, but for the same time and cost, providers can treat more children with the simpler SDF therapy.

The study included 2,998 children in kindergarten through to third grade at 47 New York City schools. The schools were randomised to receive either the simple or complex treatment. Two years later, researchers returned to each school for follow-up.

They found that both the simple and complex treatments were successful: just one cavity prevention treatment prevented more than 80% of cavities (81% for SDF and 82% for sealants) and stopped half of cavities from progressing (56% for SDF and 46% for sealants).