To Prevent Childhood Tooth Decay, Focus on the Cause

by | Jun 14, 2023 | Children's Oral Health

Most recent fluoride news has focused on the recently released NTP report, which affirmed that

there is…a large body of evidence on IQ effects in children. There is also some evidence that fluoride exposure is associated with other neurodevelopmental and cognitive effects in children.

Still, many insist that fluoride’s benefits outweigh any harms – even as some research suggests those benefits are modest at best.

For instance, a randomized clinical trial in the Journal of Dental Research looked at the impact of topical fluoride treatment on the development of cavities. More than 1200 toddlers were randomly divided into two groups. Those in the test group were given toothbrushes, fluoridated toothpaste, standard dental advice, and fluoride treatments every six months for three years. The control group was given only the dental advice.

By the end of the study, 37% of the control group participants had developed decay. So had 34% of those in the fluoride group. Those in the control group averaged 9.6 decayed tooth surfaces. Those in the control group averaged 7.2,

This well-conducted trial failed to demonstrate that the intervention kept children caries free, but there was evidence that once children get caries, it slowed down its progression.

Flash forward to now and a new study in BMC Oral Health, which investigated the effectiveness of topical fluoride treatments on preschoolers with cavities between their teeth.

Over 150 public school students had dental exams and x-rays, and were assigned to one of three groups: one that had 5% sodium fluoride applied to their teeth, one that had 38% silver diamine fluoride applied, and one that received a placebo. Each had a follow-up exam every six months over the course of the next year and a half.

By the end of the study, the kids in the placebo group had a caries (decay) rate of 24%. That was actually three points lower than the caries rate in the silver diamine fluoride group. The sodium fluoride group had a caries rate of 17%.

But once the researchers controlled for cluster effects and confounding factors, their analysis showed zero difference in caries development rates – results that jibed, they noted, with other recent research.

Based on the 18-month results, the caries development rates increased over time regardless of the intervention group. After adjusting for clustering and confounding, no statistically significant differences in preventing approximal caries development in primary teeth were observed between the semi-annual application of 5%NaF varnish, 38%SDF, and placebo in high caries-risk preschool children in the school-based setting. [emphasis added]

So what should we do to prevent decay? Start by targeting the cause rather than chasing symptoms and fixing damage as it occurs.

Diet is where it starts, limiting sugar – “the only cause of caries,” as another paper in the Journal of Dental Research put it – and ensuring adequate nutritional intake, especially those nutrients known to support natural, ongoing tooth remineralization.

Both the Weston A. Price Foundation and the Price-Pottenger Nutrition Foundation have a lot of excellent material on proper nutrition for children to get you started. You’ll also find plenty of resources here on our blog.

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