The use of Silver Fluoride for oral health and wellbeing in aged care residents: Protocol for a Cluster Randomised Controlled Trial (Preprint)

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BACKGROUND There are specific challenges in identifying and delivering effective treatments which can protect and improve oral health in residential aged care facilities (RACFs). This is especially the case in those living in regional and rural areas. Given the consequences of poor oral health for older people living in RACFs, there is an urgent need for high-quality evidence on oral health interventions that are appropriate to context and need, accessible, and cost-effective for aged care residents. Applying aqueous forms of silver fluoride (AgF) can be effective and suitable for improving this population’s oral health and wellbeing. OBJECTIVE This paper outlines a research protocol which aims to test the effectiveness of an AgF intervention package in reducing tooth sensitivity, tooth pain, arresting caries, and improving oral health and wellbeing in older adults living in regional and rural RACFs. METHODS This study protocol describes a cluster randomised controlled trial with two parallel arms. The control arm will receive delayed intervention after 3-months. This approach allows for all participants to receive an oral examination and access to AgF treatment by the end of the study. Study sites include RACFs in public and private sectors across rural and regional Queensland and New South Wales, Australia. Oral assessments will be undertaken for RACF residents who provided consent, with at least one natural tooth. Teeth will be assessed for eligibility to receive AgF treatment. Outcomes at the 3-month follow-up will be collected through survey and clinical examination and include tooth sensitivity and pain, dental caries and oral health-related quality of life. RESULTS This clinical study is part of an overarching project funded by the MRFF Dementia Ageing and Aged Care Grant #2024439. Data collection commenced in May 2025 for the cluster randomized controlled trial and is anticipated to continue until March 2026. CONCLUSIONS This research protocol will provide a rigorous test of the efficacy of a minimally invasive intervention package of AgF to improve the oral health and wellbeing of older adults in RACFs. CLINICALTRIAL This clinical trial has been registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12625000072415: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12625000072415

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