Unexpected sequel to silver fluoride followed by stannous fluoride treatment of root stumps supporting an overlay denture in an aged‐care patient

Abstract

An institutionalized high care dementia patient, who is unable to maintain his own oral health, presented with five lower anterior carious root stumps supporting a lower overlay denture. Due to limited cooperation, his root stumps were treated with only silver fluoride followed by stannous fluoride applied topically on a 4-monthly cycle. Almost one and a half years after his initial application, there were unexpected calculus formations on the root stumps accompanied by marked gingival inflammation and gingival hyperplasia. At this point prognosis was considered very poor. Because the patient's cooperation was so poor, no attempt was made to remove the calculus deposits. Following continued topical applications directly to the area, there was evidence of a marked and unexpected improvement in gingival health. Some 4 years and 4 months after the initial application, the root stumps demonstrated a hard glossy surface surrounded by healthy gingival tissue. There had been no change in the patient's oral care, minor changes to medications and there had been no operative or periodontal interventions.

Effect of Fluoride on Cytotoxicity Involved in Mitochondrial Dysfunction: A Review of Mechanism

“…Fluorine is a small molecular element with active polarity and often exists in nature. Some studies have shown that long-term exposure to fluoride and exceeding the threshold of the body will not only cause damage to various tissues of the body ( 102 ), but also invade the central nervous system and produce dementia ( 103 ). Some studies have also shown that fluoride can lead to fetal mental retardation, mainly because fluoride can break through the placental barrier, enter the fetal brain, and accumulate in the fetal brain ( 104 ).…”

Laser fluorescence assessment of dental caries arrest with two silver fluoride agents in patients with special needs– a preliminary report

“…To date, there has been limited research into the use of either of these recently developed AgF/KI or AgF/SnF 2 treatments for dental caries arrest, including in adults with special needs. Positive results have been reported from studies conducted in Sydney, Australia for CSDS used in elderly patients with cognitive disability whose cooperation was limited [ 8 , 13 ]. In these reports, caries arrest outcomes were assessed using clinical visual-tactile scores of lesion status [ 8 , 13 , 14 ].…”

“…Positive results have been reported from studies conducted in Sydney, Australia for CSDS used in elderly patients with cognitive disability whose cooperation was limited [ 8 , 13 ]. In these reports, caries arrest outcomes were assessed using clinical visual-tactile scores of lesion status [ 8 , 13 , 14 ].…”