Currently accepted at: JMIR Research Protocols
Date Submitted: Nov 27, 2025
Open Peer Review Period: Dec 8, 2025 - Feb 2, 2026
Date Accepted: Mar 23, 2026
(closed for review but you can still tweet)
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/87903
The final accepted version (not copyedited yet) is in this tab.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The use of Silver Fluoride for oral health and wellbeing in aged care residents: Protocol for a Cluster Randomised Controlled Trial
ABSTRACT
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. Clinical Trial: 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
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.