The effectiveness of medical nurses in treating children with silver diamine fluoride in a school-based caries prevention program

Ryan Richard Ruff, Tamarinda Barry Godín, Richard Niederman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The sustainability of school-based oral health programs depends on the utilization of effective, efficient treatments and the availability of a trained clinical workforce. The objective of this study was to determine whether registered nurses are comparable to dental hygienists in the application and effectiveness of silver diamine fluoride (SDF) and fluoride varnish (FV) for the prevention of dental caries. Methods: CariedAway was a school-based study of SDF and FV versus dental sealants and atraumatic restorations. Within the SDF + FV arm, participants were treated by either a licensed dental hygienist or a registered nurse, both under the supervision of a paediatric dentist. Although initial treatment assignment in CariedAway was randomized, assignment to provider was not. The proportion of children who remained caries free after 2 years was assessed for non-inferiority using two-group proportion tests, adjusting for the clustering effect of schools. Results: A total of 417 children with no untreated caries at baseline were analysed including 298 treated by hygienists and 119 by nurses. The proportion of children who remained caries free after 2 years was 0.81 and 0.80 for those treated by hygienists and nurses, respectively, for a difference of 0.01 (95% CI = −0.07, 0.098) and within the pre-determined non-inferiority margin. Conclusions: Nurses may be effective in treating children with silver diamine fluoride and other fluoride varnishes in school-based oral health programs.

Original languageEnglish (US)
Pages (from-to)398-405
Number of pages8
JournalCommunity Dentistry and Oral Epidemiology
Volume52
Issue number4
DOIs
StateAccepted/In press - 2023

Keywords

  • child
  • dental caries
  • nurses
  • silver diamine fluoride

ASJC Scopus subject areas

  • General Dentistry
  • Public Health, Environmental and Occupational Health

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