Innovative Zinc-Based Treatment Could Replace Silver Diamine Fluoride in Cavity Care

Tooth decay remains the most prevalent health issue worldwide, affecting billions despite being both preventable and treatable. Traditionally, cavities are managed with drilling and filling, but recent advances propose less invasive methods. One such promising approach involves applying a clear liquid called silver diamine fluoride (SDF) directly onto teeth surfaces. FDA-approved for reducing tooth sensitivity, SDF also exhibits antimicrobial properties that prevent cavity formation and halt small lesions from worsening. Its affordability and ease of application make it suitable for use in diverse settings, including schools, rural clinics, and for patients with limited access to dental care. However, a significant drawback is the staining effect—silver in SDF reacts with decay, causing the treated area to turn black, which is often undesirable for visible front teeth. This staining is permanent, limiting its acceptance among patients concerned with aesthetics. Researchers, including NYU Professor Marc Walters, have investigated alternatives to overcome this obstacle. His team turned to zinc, an essential nutrient known for its antimicrobial properties and safety profile, commonly found in foods and dental products like toothpaste. Walters explored a zinc phosphate compound capable of penetrating deep into dentinal tubules, the microscopic channels in teeth that measure approximately 40,000 per square millimeter. To simplify application, Walters developed zinc tetramine difluoride—a molecule that begins as a liquid and reacts within dentinal tubules to form zinc oxide, effectively blocking the tubules and releasing zinc over time. This process results in a colorless deposit that prevents bacteria growth and reduces sensitivity without staining the teeth. Early studies show rapid action, with nerve blocking occurring within minutes, and long-term persistence of zinc oxide for months, promising ongoing protection. The zinc-based treatment not only aims to provide immediate relief from sensitivity but also offers sustained antimicrobial activity. Collaborative efforts involve licensing agreements with companies like Southern Dental Industries and partnerships with NYU researchers to refine formulations, assess efficacy, and evaluate safety towards clinical trials. Their goal is to create a simple, effective, non-staining cavity treatment that could revolutionize dental care by enabling minimally invasive, aesthetic, and accessible solutions for managing tooth decay. Positive prospects include its potential availability over-the-counter, reducing the need for traditional drilling, especially benefiting children and elderly patients. With extensive prior use of zinc in dental applications confirming safety, the transition from research to market could be expedited, ultimately reducing tooth decay and associated pain globally.