Fluoride Application for Root Caries Management: Focusing on the Use of Silver Diamine Fluoride & Fluoride Burnishes

Abstract

 The risk of root caries is known to increase with aging due to age-related alveolar bone regression, periodontal disease, improper brushing, and reduced saliva secretion. In addition, along with an increase in the number of residual natural teeth in elderly people, the incidence of periodontal disease is also expected to increase in the future. Root caries can be divided into active and inactive types based on visual and tactile evaluation, and active caries can enter an inactive state by non-invasive treatments such as fluoride application. Silver diamine fluoride (SDF) is a cavity prevention and progression inhibitor containing a high concentration (55,000 ppm) of fluoride. SDF applied to the tooth surface once or twice a year is a cost-effective treatment option for caries. The combination of potassium iodide (KI) and SDF has been evaluated as a method for reducing the resultant blackening of carious teeth, which is a disadvantage of SDF. In addition, fluoride burnish is a coating material that causes 5% (22,600 ppm) NaF to remain for 4 to 6 hours at the application site, preventing caries. Since there is sufficient evidence supporting cavity prevention and inhibition of progression, this treatment is actively used in Western countries for a wide range of subjects, from children to the elderly. Products applied in Japan have been approved as dentin hypersensitivity anesthetics, although they are expected to be widely used in the future to prevent and inhibit the progression of caries. SDF and fluoride burnish are easy to use and suitable for elderly people who need nursing care and for home visits. In addition to self-care, it is necessary to respond to the expected increase in root caries by enriching professional dental care.