Effectiveness of Fluoride Varnish Combined with Silver Nitrate and Tricalcium Phosphate

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People of all ages suffer from dental caries, but it can lead to disastrous effects for children because it can interrupt their school performance and quality of life. To remedy this, a group of Chinese researchers at the University of Hong Kong decided to investigate the effectiveness of two fluoride application protocols in arresting caries in the primary teeth of young children. Their research findings were compiled in a study titled “Randomized Clinical Trial on Sodium Fluoride with Tricalcium Phosphate,” and was published in the Journal of Dental Research.

The History and Benefits of Fluoride

Fluorine is one of the most abundant elements on the Earth’s surface. The mineral can easily be found in our rocks, soil, and water. The ionic mineral is also the root word of “fluorescence” due to its innate ability to softly glow under ultraviolet light while in its natural state.

Fluoride, which is the ionic form of fluorine, has microbial properties that work to prevent and control tooth decay by remineralizing enamel. Although the mineral naturally exists in groundwater and natural springs, it is chemically unstable in its natural form and usually doesn’t have a high enough concentration of fluoride to actively fight dental decay. To remedy this situation, scientists have learned to develop synthesized versions of calcium-fluoride in laboratories before it is added to our public water supply. Man-made sodium-fluoride is also a common additive in toothpaste, mouthwash, varnish, and other dental products that are designed to help protect tooth enamel.

About the University of Hong Kong Dental Study

A clinical study conducted by researchers from the University of Hong Kong decided to conduct a 24 month randomized controlled trial with a double-blind, parallel design to compare the effectiveness of two popular oral solutions for dental caries on 3-year-old children. The results revealed that functionalized tricalcium phosphate, when combined with a solution containing 25% silver nitrate (AgNO3) and varnish comprised of 5% sodium fluoride (NaF), is more effective in arresting caries in primary teeth than when only the latter two are used.

A total of 408 children with active dental caries participated in the clinical study. The scientists randomly assigned them into two equal-size groups. The first one, Group A, received a semiannual application of a 25% silver nitrate (AgNO3) solution followed by a commercially available varnish with 5% sodium fluoride (NaF) on the carious tooth surfaces over the 24-month span. Meanwhile, the children in Group B received the same silver nitrate solution, but it was paired with a  5% sodium fluoride (NaF) that contained functionalized tricalcium phosphate (fTCP).

First, the scientists evaluated the mean number of arrested carious tooth surfaces per child. They found that the arrest rates at the tooth surface level were significantly lower at 42% for Group A compared to 57% for Group B. Next, they decided to use a hierarchical generalized linear model to see which combination proved to have a higher predicted probability in arresting dental caries. By the end of the study, they had gathered enough evidence to conclude that the Group B solutions with functionalized tricalcium phosphate had a much higher predicted probability of arresting caries than the other group. This was especially true when the caries was located on the anterior teeth, covered in plaque, and was on the lingual surface.

In Conclusion

Chronic oral diseases like dental caries are very pervasive, so scientists and dental professionals should continue to look for new effective treatment solutions. Once the public becomes more aware of how dental caries is preventable or can be remedied with products such as varnishes and other oral solutions, the quicker young children will be able to enjoy their future with healthy teeth.

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