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Randomized Controlled Trial
. 2023 Oct;73(5):667-673.
doi: 10.1016/j.identj.2022.12.005. Epub 2023 Jan 20.

Caries Prevention Using Silver Diamine Fluoride: A 12-Month Clinical Trial

Faith Miaomiao Zheng  1 , Iliana Gehui Yan  1 , Duangporn Duangthip  1 , Edward Chin Man Lo  1 , Sherry Shiqian Gao  2 , Chun Hung Chu  3
Affiliations
Randomized Controlled Trial

Caries Prevention Using Silver Diamine Fluoride: A 12-Month Clinical Trial

Faith Miaomiao Zheng et al. Int Dent J. 2023 Oct.

Abstract

Objective: This clinical trial aimed to compare the caries-preventive effect of annual application of 38% silver diamine fluoride solution (SDF) with 5% sodium fluoride varnish (FV) to the anterior primary teeth of children. The hypothesis was that SDF was superior to FV at 1 year. Secondary objectives were to determine the child's cooperation and the parent's satisfaction and assess adverse effects.

Method: We recruited 688 3- to 4-year-old children and randomly allocated them to receive SDF or FV (positive control) on their 6 upper anterior teeth. Tooth-surface status was recorded using the decayed, missing, and filled surfaces index. A trained observer rated the child's cooperation as "totally cooperative" or "not totally cooperative." We used a questionnaire to determine the parent's satisfaction as "satisfied," "neutral," or "dissatisfied." Adverse effects (yes/no) were evaluated 1 day and about 1 year after treatment.

Results: Of the children, 434 (SDF, n = 209; FV, n = 225) completed the trial. The mean new decayed tooth surfaces developed for SDF and FV groups were 0.4 ± 1.5 and 0.4 ± 1.3, respectively (P = .65). Child's cooperation for SDF and FV therapy was 71% (244/344) and 70% (241/344), respectively (P = .89). Parent's satisfaction for SDF and FV therapy was 71% (148/209) and 69% (155/225), respectively (P = .29). Adverse effects were found neither at 1 day nor at about 1 year after treatment for either treatment arm.

Conclusions: SDF is not superior to FV for caries prevention in primary upper anterior teeth at 1-year follow-up. Child's cooperation and parent's satisfaction were similarly high with SDF and FV therapy at 1-year follow-up. Neither short-term nor long-term adverse effects were observed. This study is registered at ClinicalTrials.gov (NCT04399369).

Keywords: Caries; Children; Early childhood; Oral health; Prevention; Silver diamine fluoride.

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Conflict of interest statement

Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Consort flow diagram.
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