Efficacy of 30% silver diamine fluoride compared to atraumatic restorative treatment on dentine caries arrestment in primary molars of preschool children: A 12-months parallel randomized controlled clinical trial

Abstract

Objectives: This clinical trial investigated the efficacy of silver diamine fluoride (SDF) in arresting dentine caries in primary molars of preschoolers. Time required for treatment, adverse effects, parental aesthetic perception, anxiety and oral health related to quality of life (OHRQoL) was evaluated.

Materials and methods: Children, 2-5 years old, with active dentine caries lesions on the occlusal surface of primary molars were randomly allocated to test group (SDF) or control group (atraumatic restorative treatment/ART). The dmf-t/DMF-T and ICDAS indexes determined the presence of caries and activity. The main outcome after 3, 6 and 12-month follow-up was assessed by a blind examiner. The time required to perform the treatments was recorded and a facial image scale was applied to assess anxiety before and after treatment. Adverse events and aesthetic perception were assessed through questions addressed to caregivers; and the OHRQoL through the B-ECOHIS questionnaire.

Results: In 68 patients that were randomized, the mean number of treated teeth per child was 2.42(1.04) and 2.09(1.18) in the SDF and ART groups (p = 0.074), respectively. The mean difference of arrested lesions between the groups after 12 months was -0,07(0.05; - 0.17-0.30). The time required to treat with SDF was lower than the ART (p < 0.001). There was no difference in the percentage of adverse events + aesthetic perception (p = 0.709), and the change in anxiety (p = 0.155). There was a less impact in OHRQoL after ART treatment, but only when the parents' distress subscale was considered (p = 0.012).

Conclusion: SDF requires much less chair-time and have similar results as ART in arresting caries lesion, anxiety, adverse effects, aesthetic perception and quality of life.

Keywords: Cariostatic agents; Dental atraumatic restorative treatment; Dental caries; Glass lonomer cements; Quality of life; Tooth deciduous.