Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region of China.
Division of Pediatric Dentistry, The Ohio State University, Columbus, OH, United States.
J Dent. 2024 Oct;149:105308. doi: 10.1016/j.jdent.2024.105308. Epub 2024 Aug 12.
The objective of this study is to investigate the beneficial effect of not rinsing for 30 min in arresting early childhood caries after SDF therapy.
This randomised clinical trial recruited 3- to 4-year-old kindergarten children with active (soft) dentine caries. A questionnaire was sent to the parents to collect children's demographic data and oral health-related behaviours. A dentist conducted an oral examination and measured the caries experience using dmft index and oral hygiene using visible plaque index. After 38 % SDF therapy, the children were randomly allocated into two groups. Children in group A were instructed to rinse with water immediately, whereas children in group B were asked to refrain from rinsing, drinking, or eating for 30 min. After six months, the same examiner determined the lesion activity (active/arrest) of the SDF-treated carious tooth surface. Generalized Estimating Equations was used to compare the proportion of caries arrest (caries-arrest rate) between the two groups.
This study recruited 298 children with 1,158 decayed tooth surfaces receiving SDF therapy at baseline and evaluated 275 (92 %) children with 1,069 (92 %) SDF-treated tooth-surface at the six-month examination. The demographic background, oral hygiene and caries status of two groups were comparable at baseline (p > 0.05). The caries-arrest rate for group A and group B were 65 % (337/519) and 61 % (338/550), respectively (p = 0.28).
This randomised clinical trial found not rinsing for 30 min after SDF therapy is not better than immediate rinsing in arresting early childhood caries.
Topical SDF application leaves an unpleasant taste in the mouth, which may affect the acceptance or even rejection of SDF therapy among young children. This study provides clinicians with information to make their decision on postoperative instruction after SDF therapy.
本研究旨在探讨 SDF 治疗后不冲洗 30 分钟对抑制幼儿早期龋的有益作用。
这项随机临床试验招募了 3 至 4 岁有活跃（软性）牙本质龋的幼儿园儿童。向家长发放问卷，收集儿童的人口统计学数据和口腔健康相关行为。牙医进行口腔检查，使用 dmft 指数测量龋病经验，使用可见菌斑指数测量口腔卫生。在 38% SDF 治疗后，将儿童随机分为两组。A 组儿童被指示立即用水冲洗，而 B 组儿童则被要求在 30 分钟内不漱口、不饮水或进食。6 个月后，同一检查者确定 SDF 治疗过的龋损牙面的病变活性（活跃/静止）。使用广义估计方程比较两组的龋齿静止率（龋齿静止率）。
本研究共招募了 298 名接受基线 SDF 治疗的 1158 颗龋齿牙面的儿童，并对 275 名（92%）接受 SDF 治疗的 1069 颗（92%）牙面的儿童进行了 6 个月的评估。两组儿童的人口统计学背景、口腔卫生和龋病状况在基线时相当（p>0.05）。A 组和 B 组的龋齿静止率分别为 65%（337/519）和 61%（338/550）（p=0.28）。
这项随机临床试验发现，SDF 治疗后不冲洗 30 分钟并不优于立即冲洗，以抑制幼儿早期龋。
局部 SDF 应用在口腔中留下一种不愉快的味道，这可能会影响儿童对 SDF 治疗的接受程度，甚至拒绝 SDF 治疗。本研究为临床医生提供了 SDF 治疗后术后指导决策的信息。
