Clinical application of fluorescence lasers to evaluate the efficacy of arresting caries with silver diamine fluoride

Abstract

Objective: This clinical trial used fluorescence lasers to assess the effectiveness of Silver Diamine Fluoride (SDF) in preventing active dentin caries in baby teeth. Subject and method: Preschool children aged 3 to 5 years old with at least one active dentin caries lesion were selected from a SOS Children's Village in Vietnam. A total of 32 children with 126 caries lesions were treated with 38% SDF, applied only once. DIAGNOdent pen 2190 - Kavo device and sharp sickle-shaped probes were used to evaluate lesions independently at certain timepoints including: Before the intervention and 5 minutes, one day, and one week after the intervention. For the evaluation of treatment results, the caries lesions were diagnosed as prevented if their surfaces were hard and difficult to probe or the measured laser index ≤ 20, while the lesions were assessed as active if they were soft and easy to probe or the measured laser index > 20. Result: In general, before SDF was applied, all decayed tooth surfaces had soft dentin and laser indexes > 30. The average value of laser index measured on caries lesions was significantly reduced from 88.2 (SD = 9.3) at baseline to 19.6 (SD = 13.7) at one week after intervention (p<0.001, χ² test). Based on fluorescence laser method, the caries arrest rates were 80.2%, 73.2% and 70.6% respectively for the post-intervention periods, while the assessment by probes for caries arrest rates were 82.5%, 80.2% and 77.8%, respectively (p<0.05, χ² test). The difference between the two methods was due to some caries lesions that were smooth and hard on probing but still have laser index > 20. Conclusion: The fluorescence laser device can be applied clinically to assess the effectiveness of preventing caries with SDF, the evaluation results are more accurate than the lesion probe method.