A Cluster-Randomized Clinical Trial of Silver Diamine Fluoride vs Atraumatic Restoration in Older Adults.
S Nelson, J M Albert, D Selvaraj et al.
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In 30 seconds
This multicenter cluster-randomized noninferiority trial compared biannual 38% silver diamine fluoride (SDF) with atraumatic restorative treatment (ART) plus fluoride varnish in adults aged 62 years or older living in subsidized housing. At 52 weeks, caries arrest was 88% with SDF and 92% with ART (difference, -0.04; 95% CI, -0.08 to 0.01), meeting the study’s noninferiority criterion. The mean number of new carious lesions was also similar between groups. The findings support SDF as a minimally invasive option for caries control in this population.
Key findings
- At 52 weeks, caries arrest was 88% with SDF versus 92% with ART (difference, -0.04; 95% CI, -0.08 to 0.01).
- Mean new carious lesions at 52 weeks were 0.67 ± 1.72 with SDF and 0.66 ± 1.71 with ART (difference, 0.01; 95% CI, -0.31 to 0.32).
- Both outcomes met the trial’s criterion for noninferiority of SDF compared with ART.
Why it matters
Older adults may face barriers to affordable dental care, while untreated caries can affect health. These results indicate that a topical, minimally invasive approach achieved caries outcomes comparable to ART over 52 weeks in older adults in subsidized housing. This evidence may inform consideration of accessible caries-control options in settings serving similar populations.
What to keep in mind
Follow-up was limited to 52 weeks, so the trial does not establish longer-term comparative outcomes.