Liquid Stops Cavities in Kids Without Drilling or Pain

Every year, thousands of young children end up in emergency rooms because of untreated cavities, facing pain so severe their families have nowhere else to turn. Now researchers have proven that a quick, affordable liquid can stop many of these cavities without a single needle, drill, or dose of sedation.

The treatment is called silver diamine fluoride, or SDF. Dentists brush it onto a cavity with a small applicator in just seconds per tooth. The liquid stops decay on contact, requiring no removal of tooth material and no scary equipment.

A major clinical trial led by the University of Michigan tracked 830 children younger than age 6 across Michigan, New York, and Iowa. When researchers applied SDF every six months, it stopped tooth decay in more than half of the affected baby teeth. The findings were published in JAMA Pediatrics.

"This is a very effective and safe treatment, even in children as young as 1," said Margherita Fontana, professor of dentistry at the University of Michigan and the study's lead investigator. The research began in 2018 and continued through the COVID-19 pandemic, generating the evidence needed for potential FDA approval.

Tooth decay affects more than 40% of American children, making it the most common chronic childhood disease. Untreated cavities can cause intense pain, infections, difficulty eating and sleeping, and missed school days. Some children eventually need surgery under general anesthesia because the decay becomes so severe.

SDF has been used successfully in other countries for decades. US dentists have used it off-label since 2014, when it was approved as a device for tooth sensitivity. This new trial provides the rigorous clinical data needed for the FDA to approve it specifically as a cavity treatment.

The treatment does have one visible drawback. The silver permanently darkens the decayed part of the tooth. For many families, though, that trade-off beats the alternative of invasive procedures or ongoing pain.

The Ripple Effect

The impact could reach far beyond dental offices. Young children often see pediatricians years before their first dental visit. If doctors in medical settings can apply SDF, many more cavities could be treated early, before they become painful emergencies.

The treatment could be especially valuable for very young children, older adults, people with disabilities, and patients with severe dental anxiety. It also offers hope for families with limited access to conventional dental care or those who struggle to afford standard procedures.

For some children, reapplying SDF every few months can control the cavity until the baby tooth naturally falls out. In adults, it could work as long-term treatment or provide temporary protection until a permanent solution becomes possible.

The National Institute of Dental and Craniofacial Research provided more than $12 million to support the study. Co-investigator Amr Moursi of New York University said FDA approval "could lead to increased utilization by providers, enhanced payments by insurers, and more consistent product quality."

Fontana sees potential for widespread change: "For almost anyone, this can arrest the decay and stop the infection and the pain it causes."