Peter Milgrom – Prevention and Early Detection of Caries-2025 CSPD Saturday Session 2 Prevention and Early Detection of Caries Speaker Peter Milgrom

Video Transcription

Video Summary

Dr. Peter Milgram, a distinguished oral health scholar with over 50 years of experience, delivered a comprehensive session on advancements in dental caries prevention and treatment, focusing primarily on fluoride varnish, povidone iodine, and silver diamine fluoride (SDF). He emphasized that fluoride varnish alone is insufficient for caries prevention, especially given regulatory limitations and inconsistent product efficacy in the U.S. He advocated combining fluoride treatments with regular fluoridated toothbrushing and adjunct antimicrobials to maximize benefits.<br /><br />Dr. Milgram highlighted the success of Washington State’s Access to Baby and Child Dentistry (ABCD) program, which incentivized dentists to provide early childhood oral care, and discussed his role in introducing fluoride varnish and SDF to U.S. dentistry. He presented data supporting the additive effect of fluoride varnish and povidone iodine—a safe, FDA-approved antimicrobial—showing that combined application reduces caries more effectively than fluoride alone.<br /><br />Regarding SDF, he noted its quick application time and effectiveness in arresting and preventing caries, especially in fearful or special-needs patients, recommending its use before sealants. Dr. Milgram cautioned against unregulated nanoparticle SDF products lacking safety and efficacy data, urging clinicians to demand evidence and prioritize trusted products, such as his FDA-approved Advantage Arrest.<br /><br />He also addressed fluoride hesitancy among parents, advising practitioners to employ motivational interviewing and offer alternatives like povidone iodine. Finally, he endorsed glass ionomer sealants over resin options in challenging clinical conditions, highlighting accessible training videos for their application. Overall, Dr. Milgram urged dental professionals to expand their clinical toolkit with evidence-based, combined preventive strategies to improve patient outcomes.

Keywords

Dr. Peter Milgram

dental caries prevention

fluoride varnish

povidone iodine

silver diamine fluoride

SDF

Access to Baby and Child Dentistry

fluoride hesitancy

glass ionomer sealants

motivational interviewing