Épidémiologie : libre accès

Abstrait

A Randomised Controlled Trial and Microbiological Investigation of Caries-Related Microorganisms and Dental Cavities in Preschoolers

Jenny Rothen

The efficiency and safety of 38% silver diamine fluoride in stopping caries lesions were examined in the Stopping Cavities Trial. The investigation used two parallel groups in a double-blind, randomised, placebo-controlled superiority trial. The locations were preschools in Oregon. A total of 66 preschoolers with less than one lesion were enrolled. Applying topically to the lesion either silver diamine fluoride (38%) or a placebo (blue-tinted water). Caries arrest (lesion inactivity, according to Nyvad criteria) occurred 14–21 days after intervention as the main endpoint. All children's dental plaque was collected, and RNA sequencing was used to determine the microbial composition of two lesions and one unaffected surface before treatment and at follow-up for three kids from each group. In the silver diamine fluoride group, the average proportion of arrested caries lesions was greater (0.72; 95% CI; 0.55, 0.84) than in the (0.05; 95% CI: 0.00, 0.16; placebo group). The probability of arrested caries was considerably higher in the treatment group, according to confirmatory analysis using generalised estimating equation log-linear regression, based on the number of arrested lesions and accounting for the number of treated surfaces and length of follow-up. No damage was seen. No consistent changes in the relative number of caries-associated bacteria or the establishment of antibiotic or metal resistance gene expression were seen after RNA sequencing analysis. In preschoolers, topical 38% silver diamine fluoride is efficient and safe for preventing cavities. Clinical Importance: The procedure can be used in primary care settings and could lessen the burden of untreated dental decay in the general population.