Caries arresting effect using silver-diamine-fluoride with different concentration and periodicity

Abstract

OBJECTIVES: To compare the efficacy of silver diamine fluoride (SDF) solutions at pre-prepared concentrations of 38% and 12% when applied annually or biannually over 18 months in arresting dentine caries in primary teeth. METHODS: Children aged 3-4 years who had at least one tooth with dentine caries were randomly allocated to receive four treatment protocols: Group 1 – annual application of 12% SDF; Group 2 – biannual application of 12% SDF; Group 3 – annual application of 38% SDF; and Group 4 – biannual application of 38% SDF. Clinical examinations at 6-month intervals were conducted to assess whether active carious lesions became arrested. Information on the children’s background and oral hygiene habits was collected through a parental questionnaire at baseline and follow-up examinations. RESULTS: A total of 888 children with 4,220 dentine carious tooth surfaces received treatment at baseline. After 18 months, 831 children (94%) were examined. The caries arrest rates were 46%, 53%, 61% and 69% for Groups 1, 2, 3 and 4, respectively (p<0.001). After clustering effect adjustment, the results of the final logistic regression model indicated that concentration, frequency of application, lesion site, tooth position, visible plaque index score, visible plaque on lesion and size of lesion were the remaining significant predictors for caries arrest. No significant interaction between concentration and frequency of application was found. The effect size of concentration was much greater than frequency. CONCLUSIONS: Based on the 18-month results, SDF is more effective in arresting dentin caries in the primary teeth of preschool children at 38% than 12% and when applied biannually rather than annually. THIS ABSTRACT IS BASED ON RESEARCH THAT WAS FUNDED ENTIRELY OR PARTIALLY BY AN OUTSIDE SOURCE: Health and Health Service Research Fund (#09101101) and General Research Fund (#765213M