Silver diamine fluoride and education to prevent and arrest root caries among community-dwelling elders

Caries Res. 2013;47(4):284-90. doi: 10.1159/000346620. Epub 2013 Feb 5.


Background/aims: Root caries among elderly communities is of growing public health concern globally. This controlled clinical trial investigated the effectiveness of silver diamine fluoride and oral health education in preventing and arresting root caries.

Methods: Two hundred sixty-six elderly subjects who had at least 5 teeth with exposed root surfaces and did not have serious life-threatening medical diseases were allocated to 3 groups according to a computer-generated random list: group 1 (the control group) received oral hygiene instructions (OHI) annually; group 2 received OHI and silver diamine fluoride (SDF) application annually, and group 3 was given OHI and SDF application annually, plus an oral health education (OHE) programme every 6 months.

Results: Two hundred twenty-seven elderly subjects were followed for 24 months. The mean numbers of new root caries surfaces in groups 1, 2 and 3 were 1.33, 1.00 and 0.70, respectively (ANOVA, p < 0.05). Group 3 had fewer root surfaces with new caries than group 1 (Scheffé multiple-comparison test, p < 0.05). The mean numbers of arrested root caries surfaces in groups 1, 2 and 3 were 0.04, 0.28 and 0.33, respectively (ANOVA, p < 0.01). Group 3 and group 2 had a greater number of active root caries surfaces which became arrested than group 1 (Scheffé multiple-comparison test, p < 0.05).

Conclusion: Annual application of SDF together with biannual OHE was effective in preventing new root caries and arresting root caries among community-dwelling elderly subjects.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Cariostatic Agents / therapeutic use*
  • DMF Index
  • Dental Care for Aged*
  • Double-Blind Method
  • Female
  • Fluorides, Topical
  • Health Education, Dental*
  • Hong Kong
  • Humans
  • Independent Living
  • Male
  • Middle Aged
  • Mouthwashes
  • Prospective Studies
  • Quaternary Ammonium Compounds / therapeutic use*
  • Root Caries / prevention & control*
  • Sample Size
  • Silver Compounds
  • Statistics, Nonparametric
  • Surveys and Questionnaires


  • Cariostatic Agents
  • Fluorides, Topical
  • Mouthwashes
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • silver diamine fluoride