International Journal of Clinical Pediatric Dentistry

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VOLUME 15 , ISSUE S2 ( Special Issue-2 (Cariology), 2022 ) > List of Articles


A Comparative Study to Evaluate the Effectiveness of Silver Diamine Fluoride at Different Time Durations of Application in Treating Carious Primary Teeth: A Randomized Trial

Parul Singhal, Deepak Chauhan

Keywords : Deciduous molars caries, Duration of application, ICDAS, Primary tooth, Seconds, Silver diamine fluoride

Citation Information :

DOI: 10.5005/jp-journals-10005-2326

License: CC BY-NC 4.0

Published Online: 16-03-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background and objectives: Ideally every child must have access to preventive and restorative care of greater quality. However, in rural areas, resources and dental care services are limited. Silver diamine fluoride (SDF) has been identified as an efficient topical cariostatic and preventive medicament for managing ECC in children who cannot be treated conventionally. Since SDF is an emerging alternative for caries prevention and arrest, AAPD recommends more practice-based research to evaluate its efficacy. The aim of this study was to evaluate the effectiveness of silver diamine fluoride at different time durations of application in treatment of carious primary teeth in children with least access to dental care. Methodology: This was a prospective, randomized, field trial that included patients with primary tooth. Primary tooth presenting carious lesion in ICDAS 3–6 category were randomly assigned to one of the three groups. Results: At 3-week mean rank of lesions arrested in Group 1 and Group 2 were 73.3 and 72.29, whereas it was 86.9 in case of Group 3. At 6 months it was 79.15, 77.29, and 75.96 in Group 1, 2, and 3 , respectivel (p > 0.05). Conclusion: SDF is effective in controlling caries progression in both cavitated and non-cavitated lesion with minimal time duration of application (30 seconds). This approach may be of great utility as an alternative to other expensive preventive and therapeutic methods in communities with limited resources. Nonetheless obtaining caregiver consent is mandatory.

  1. Mei ML, Lo ECM, Chu CH. Arresting dentine caries with silver diamine fluoride: what's behind it? J Dent Res 2018;97(7):751–758. DOI: 10.1177/0022034518774783
  2. Contreras V, Toro MJ, Elías-Boneta AR, et al. Effectiveness of silver diamine fluoride in caries prevention and arrest: a systematic literature review. Gen Dent 2017;65(3):22–29.
  3. Horst JA, Ellenikiotis H, Milgrom PL. UCSF protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. J Calif Dent Assoc 2016;44(1):16–28.
  4. Mei ML, Li QL, Chu CH, et al. Antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries. Ann Clin Microbiol Antimicrob 2013;12:4. DOI: 10.1186/1476-0711-12-4
  5. Zhao IS, Gao SS, Hiraishi N et al. Mechanisms of silver diamine fluoride on arresting caries: a literature review. Int Dent J 2018;68(2):67–76. DOI: 10.1111/idj.12320
  6. Crystal YO, Marghalani AA, Ureles SD, Use of silver diamine fluoride for dental caries management in children and adolescents, including those with special health care needset al. Pediatr Dent 2017;39(5):135–145.
  7. Wakshlak RB, Pedahzur R, Vanier D. Antibacterial activity of silver-killed bacteria: the “zombies” effect. Sci Rep 2015;5:9555. DOI: 10.1038/srep09555
  8. Dikmen B. Icdas II criteria (international caries detection and assessment system.) J Istanb Univ Fac Dent 2015;49(3):63–72. DOI: 10.17096/jiufd.38691
  9. Frencken J. Atraumatic restorative treatment and minimal intervention dentistry. Br Dent J 2017;223(3):183–189. DOI: 10.1038/sj.bdj.2017.664
  10. Clemens J, Gold J, Chaffin J. Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth. J Public Health Dent 2018;78(1):63–68. DOI: 10.1111/jphd.12241
  11. Bijella MFTB, Bijella VT, Silva MSMB, et al. Avaliação clínica da aplicação de diamino-fluoreto de prata a 12% (Bioride) na dentição decídua e seu efeito na incidência de cárie em primeiros molares permanentes. Rev Paul Odontol 1991; 13: 28–35.
  12. Llodra JC, Rodriguez A, Ferrer B, et al. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res 2005;84(8):721–724. DOI: 10.1177/154405910508400807
  13. Braga MM, Mendes FM, De Benedetto MS, et al. Effect of silver diamine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. J Dent Child (Chic) 2009;76(1):28–33.
  14. Yee R, Holmgren C, Mulder J, et al. Efficacy of silver diamine fluoride for arresting caries treatment. J Dent Res 2009;88(7):644–647. DOI: 10.1177/0022034509338671
  15. Dos Santos VE, de Vasconcelos FM, Ribeiro AG, et al. Paradigm shift in the effective treatment of caries in schoolchildren at risk. Int Dent J 2012;62(1):47–51. DOI: 10.1111/j.1875-595X.2011.00088.x
  16. Monse B, Heinrich-Weltzien R, Mulder J, et al. Caries preventive efficacy of silver diamine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines. BMC Oral Health 2012;12:52. DOI: 10.1186/1472-6831-12-52
  17. Duangthip D, Chu CH, Lo ECM. A randomized clinical trial on arresting dentine caries in preschool children by topical fluorides–18 month results. J Dent 2016;44:57–63. DOI: 10.1016/j.jdent.2015.05.006
  18. Watson PS, Pontefract HA, Devine DA et al. Penetration of fluoride into natural plaque biofilms. J Dent Res 2005;84(5): 451–455. DOI: 10.1177/154405910508400510
  19. Slayton RL, Urquhart O, Araujo MWB, et al. Evidence–based clinical practice guideline on no restorative treatments for carious lesions. J Am Dent Assoc 2018;149(10):837–849. DOI: 10.1016/j.adaj.2018.07.002
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