Outcomes of Silver Diamine Fluoride (SDF) Treatment Among Older Adults: A Retrospective Analysis.

Abstract

Introduction: Silver diamine fluoride (SDF) is a safe and convenient method for managing root caries in older adults, but the amount of time that this intervention extends the life of an affected tooth is not clear. This paper aims to evaluate the outcomes of SDF use in older adults in a dental school setting using a retrospective cohort analysis of electronic health records over a period of 2 years.

Methods: A total of 169 patient records were selected for survival analysis after screening using the selection criteria. Demographic and treatment variables were collected. Multivariable Accelerated failure time (AFT) models were used to evaluate relationships between the survival of teeth that received SDF treatment and available variables.

Results: The 24-month survival for the whole sample of patients was found to be 45%. Patients who had SDF reapplied after an initial SDF treatment had a greater increase in the length of time until tooth failure than did those who only received an initial SDF treatment over a 2-year period. For patients receiving SDF treatment, those with more baseline restorative treatments experienced tooth failure more quickly than did those with fewer such treatments. We found a low to moderate association between survival times and the number of sites where SDF was applied, and between survival times and prescription of high-fluoride toothpaste.

Conclusion: In older adults receiving SDF application, multiple reapplications at the site prolonged survival time while poorer outcomes were seen in patients who had higher baseline restorative treatment needs.