Healthcare: Dental Carries

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Dental carries is one of the most common oral diseases in the world, and it often goes untreated due to the expense of treatment. According to the World Health Organization (WHO) 60 to 90 percent of school aged children throughout the world suffer from untreated dental carries. Ethnic minorities, the poor, the elderly, and those who are mentally and/or physically disabled are other disparities who also suffer from untreated dental caries (Alcorn & Rogo; 2012). Looking for a way to solve the epidemic of dental caries by providing affordable treatment, silver diamine fluoride (SDF), also known as the “silver fluoride bullet,” was created. Claiming to be both affordable and effective, SDF could be the answer to low cost carries treatment the world has been searching for. The purpose of this paper is to research the efficacy of silver diamine fluoride in comparison to sodium fluoride varnish. Our PICO question is: In a patient with dentinal caries, will the use of silver diamine fluoride compared to sodium fluoride varnish, be more effective at arresting caries?

Fluoride has been established for many years as an effective material in the fight against caries. Silver has been used in health care as an anti-bacterial agent in many medical applications such as silver sutures and silver catheters. Silver diamine fluoride was created to conjoin the effectiveness of both. According to a critical review by Rosenblatt et al (2009), “…silver interacts with sulfhydryl groups of proteins and with DNA, altering hydrogen bonding and inhibiting respiratory processes, DNA unwinding, cell-wall synthesis, and cell division (Pg #?).” It is through those means that pathogens are destroyed and biofilm formations are hindered. The study by Lou et al (201...

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... teeth was 79% and 65% in the permanent first molars. The arrest rate for caries on both permanent and primary teeth was 77%. In comparison, a study done on children in Greenland, the arrest rate for dentinal caries applied with just NaF varnish was only 33%(Ekstrand, et al; 2010)

In answering the PICO question, silver diamine fluoride is more effective at arresting dentinal caries than sodium fluoride varnish. In reviewing these research studies, SDF is an affordable, effaceable alternative to restorative treatment that can be particularly helpful in areas without much dental personal, equipment, or facilities. Further study is needed to determine the recommended interval, exact application, and longer term outcomes. In conclusion, research suggests SDF would be a great carries treatment solution for people around the world, especially those in disparity groups.

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