International Journal of Clinical Pediatric Dentistry

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VOLUME 16 , ISSUE 1 ( January-February, 2023 ) > List of Articles

ORIGINAL RESEARCH

Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial

Aishwarya Jain, Anshula Deshpande, Yash S Shah, Vidhi Jaiswal, Brijesh Tailor

Keywords : Fluoride therapy, Fluoride varnish, Preschoolers, Randomized clinical trial, Silver diamine fluoride, Topical

Citation Information : Jain A, Deshpande A, Shah YS, Jaiswal V, Tailor B. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023; 16 (1):1-8.

DOI: 10.5005/jp-journals-10005-2488

License: CC BY-NC 4.0

Published Online: 22-03-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Introduction: Dental caries is a site-specific, multifactorial chronic disease affected globally. The prevalence of dental caries is strongly associated with social and economic disadvantage, and also the susceptibility of children to dental caries. Dental caries prevention can be achieved with topical fluoride agents. Topical fluoride promotes the remineralization of early carious lesions and reduces the demineralization of healthy enamel. Aim: The aim of this randomized clinical trial was to compare the effectiveness of silver diamine fluoride (SDF) and sodium fluoride varnish (FV) in preventing new carious lesions in preschoolers. Materials and methods: This randomized clinical trial was conducted on 285 children aged 3–6 years. Children were randomly allocated into three groups namely, group I—deionized distilled water (DIW), group II—sodium FV, and group III—SDF. The biannual application was performed at an interval of 6 months. New carious lesions were recorded using defs and International Caries Detection and Assessment System (ICDAS II) under LED magnifying loupes. Descriptive and inferential statistics were applied and tabulated using Statistical Package for the Social Sciences (SPSS) 23.0 software. Result: There was a significant difference seen in the mean values of group III (SDF) when compared with group II (FV) and also between group III (SDF) and group I (DIW) when defs index was used. The mean score of ICDAS II after 12 months in group I (DIW) was −1.171, group II (FV) was −0.690, and group III (SDF) was −0.374. Conclusion: silver diamine fluoride (SDF) was found to be most effective in preventing dental caries and also it appears to be the most cost-saving fluoride therapy.


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  1. Oral health [Internet]. Who.int. [cited 2021 Feb 2]. Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health
  2. Brown LJ, Wall TP, Lazar V. Trends in total caries experience: permanent and primary teeth. J Am Dent Assoc 2000;131(2):223–231. DOI: 10.14219/jada.archive.2000.0151
  3. Mortimer KV. The relationship of deciduous enamel structure to dental disease. Caries Res 1970;4(3):206–223. DOI: 10.1159/000259643
  4. ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med 1991;2(3):283–296. DOI: 10.1177/10454411910020030101
  5. Petersson LG, Twetman S, Dahlgren H, et al. Professional fluoride varnish treatment for caries control: a systematic review of clinical trials. Acta Odontol Scand 2004;62(3):170–176. DOI: 10.1080/00016350410006392
  6. Marinho VC, Worthington HV, Walsh T, et al. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2013;(7):CD002279. DOI: 10.1002/14651858.CD002279.pub2
  7. van Rijkom HM, Truin GJ, van't Hof MA. A meta-analysis of clinical studies on the caries-inhibiting effect of fluoride gel treatment. Caries Res 1998;32(2):83–92. DOI: 10.1159/000016436
  8. Milgrom P, Horst JA, Ludwig S, et al. Topical silver diamine fluoride for dental caries arrest in preschool children: a randomized controlled trial and microbiological analysis of caries associated microbes and resistance gene expression. J Dent 2018;68:72–78. DOI: 10.1016/j.jdent.2017.08.015
  9. Gotjamanos T, Afonso F. Unacceptably high levels of fluoride in commercial preparations of silver fluoride. Aust Dent J 1997;42(1):52–53. DOI: 10.1111/j.1834-7819.1997.tb00097.x
  10. 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
  11. Crystal YO, Marghalani AA, Ureles SD, et al. Use of silver diamine fluoride for dental caries management in children and adolescents, including those with special health care needs. Pediatr Dent 2017;39(5):135–145.
  12. Lussi A, Imwinkelried S, Pitts N, et al. Performance and reproducibility of a laser fluorescence system for detection of occlusal caries in vitro. Caries Res 1999;33(4):261–266. DOI: 10.1159/000016527
  13. Honkala E, Runnel R, Honkala S, et al. Measuring dental caries in the mixed dentition by ICDAS. Int J Dent 2011;2011:150424. DOI: 10.1155/2011/150424
  14. Neuhaus KW, Longbottom C, Ellwood R, et al. Novel lesion detection aids. Monogr Oral Sci 2009;21:52–62. DOI: 10.1159/000224212
  15. 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
  16. Blinkhorn AS, Byun R, Johnson G, et al. The dental health of primary school children living in fluoridated, pre-fluoridated and nonfluoridated communities in New South Wales, Australia. BMC Oral Health 2015;15:9. DOI: 10.1186/1472-6831-15-9
  17. Abanto J, Tsakos G, Paiva SM, et al. Impact of dental caries and trauma on quality of life among 5- to 6-year-old children: perceptions of parents and children. Community Dent Oral Epidemiol 2014;42(5):385–394. DOI: 10.1111/cdoe.12099
  18. Grund K, Goddon I, Schüler IM, et al. Clinical consequences of untreated dental caries in German 5- and 8-year-olds. BMC Oral Health 2015;15(1):140. DOI: 10.1186/s12903-015-0121-8
  19. Adiatman M, Yuvana AL, Nasia AA, et al. Dental and periodontal status of 5 and 12 year old children in Jakarta and it's satellite cities. J Dent Indones 2016;23(1):5–9. DOI: 10.14693/jdi.v23i1.982
  20. Lin YC, Wang WC, Chen JH, et al. Significant caries and the interactive effects of maternal-related oral hygiene factors in urban preschool children. J Public Health Dent 2017;77(3):188–196. DOI: 10.1111/jphd.12183
  21. Chen KJ, Gao SS, Duangthip D, et al. Dental caries status and its associated factors among 5-year-old Hong Kong children: a cross-sectional study. BMC Oral Health 2017;17(1):121. DOI: 10.1186/s12903-017-0413-2
  22. Miglani S. Burden of dental caries in india: current scenario and future strategies. Int J Clin Pediatr Dent 2020;13(2):155–159. DOI: 10.5005/jpjournals-10005-1733
  23. Bhatia HP, Srivastava B, Khatri S, et al. Prevalence of dental caries among 3-15 year old school children in Ghaziabad City and its adjoining areas-a correlated survey. J Oral Health Community Dent 2012;6(3):135–140.
  24. Sudha P, Bhasin S, Anegundi RT. Prevalence of dental caries among 5-13-year old children of Mangalore city. J Indian Soc Pedod Prev Dent 2005;23(2):74–79. DOI: 10.4103/0970-4388.16446
  25. Patil S, Shivakumar Km, Siddhi H, et al. Prevalence of untreated dental caries among the preschool children of Western Maharashtra. J Dent Oral Hygiene 2015;7(11):175–178. DOI: 10.5897/JDOH2015.0174
  26. Ngatemi TP. Counseling with tooth brushing demonstration method as an effort to improve tooth brushing skills and the status of dental and oral hygiene in early childhood at school. Medico Legal Update 2021;21(1):684–687. DOI: 10.37506/mlu.v21i1.2391
  27. Dong YM, Pearce EI, Yue L, et al. Plaque pH and associated parameters in relation to caries. Caries Res 1999;33(6):428–436. DOI: 10.1159/000016547
  28. Ashkenazi M, Bidoosi M, Levin L. Effect of preventive oral hygiene measures on the development of new carious lesions. Oral Health Prev Dent 2014;12(1):61–69. DOI: 10.3290/j.ohpd.a31219
  29. Holmes RD. Tooth brushing frequency and risk of new carious lesions. Evid Based Dent 2016;17(4):98–99. DOI: 10.1038/sj.ebd.6401196
  30. Alves LS, de Oliveira RS, Nora ÂD, et al. Dental students’ performance in detecting in vitro occlusal carious lesions using ICDAS with e-learning and digital learning strategies. J Dent Educ 2018;82(10):1077–1083. DOI: 10.21815/JDE.018.100
  31. Borutta A, Reuscher G, Hufnagl S, et al. Caries prevention with fluoride varnishes among preschool children. Gesundheitswesen 2006;68(11):731–734. DOI: 10.1055/s-2006-927247
  32. Arruda AO, Senthamarai Kannan R, Inglehart MR, et al. Effect of 5% fluoride varnish application on caries among school children in rural Brazil: a randomized controlled trial. Community Dent Oral Epidemiol 2012;40(3):267–276. DOI: 10.1111/j.1600-0528.2011.00656.x
  33. Oliveira BH, Salazar M, Carvalho DM, et al. Biannual fluoride varnish applications and caries incidence in preschoolers: a 24-month follow-up randomized placebo-controlled clinical trial. Caries Res 2014;48(3):228–236. DOI: 10.11 59/000356863
  34. Muñoz-Millán P, Zaror C, Espinoza-Espinoza G, et al. Effectiveness of fluoride varnish in preventing early childhood caries in rural areas without access to fluoridated drinking water: a randomized control trial. Community Dent Oral Epidemiol 2018;46(1):63–69. DOI: 10.1111/cdoe.12330
  35. Jiang EM, Lo EC, Chu CH, et al. Prevention of early childhood caries (ECC) through parental toothbrushing training and fluoride varnish application: a 24-month randomized controlled trial. J Dent 2014;42(12):1543–1550. DOI: 10.1016/j.jdent.2014.10.002
  36. Chibinski AC, Wambier LM, Feltrin J, et al. Silver diamine fluoride has efficacy in controlling caries progression in primary teeth: a systematic review and meta-analysis. Caries Res 2017;51(5):527–541. DOI: 10.1159/000478668
  37. Gao SS, Zhao IS, Hiraishi N, et al. clinical trials of silver diamine fluoride in arresting caries among children: a systematic review. JDR Clin Trans Res 2016;1(3):201–210. DOI: 10.1177/2380084416661474
  38. Fung MHT, Duangthip D, Wong MCM, et al. Randomized clinical trial of 12% and 38% silver diamine fluoride treatment. J Dent Res 2018;97(2):171–178. DOI: 10.1177/0022034517728496
  39. Chu CH, Mei L, Seneviratne CJ, et al. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent 2012;22(1):2–10. DOI: 10.1111/j.1365-263X.2011.01149.x
  40. Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002;81(11):767–770. DOI: 10.1177/0810767
  41. Chu CH, Gao SS, Li SK, et al. The effectiveness of the biannual application of silver nitrate solution followed by sodium fluoride varnish in arresting early childhood caries in preschool children: study protocol for a randomised controlled trial. Trials 2015;16:426. DOI: 10.1186/s13063-015-0960-2
  42. Trieu A, Mohamed A, Lynch E. Silver diamine fluoride versus sodium fluoride for arresting dentine caries in children: a systematic review and meta-analysis. Sci Rep 2019;9(1):2115. DOI: 10.1038/s41598-019-38569-9
  43. Yu OY, Zhao IS, Mei ML, et al. Caries-arresting effects of silver diamine fluoride and sodium fluoride on dentine caries lesions. J Dent 2018;78:65–71. DOI: 10.1016/j.jdent.2018.08.007
  44. Zhang J, Sardana D, Li KY, et al. Topical fluoride to prevent root caries: systematic review with network meta-analysis. J Dent Res 2020;99(5):506–513. DOI: 10.1177/0022034520906384
  45. Duangthip D, Jiang M, Chu CH, et al. Non-surgical treatment of dentin caries in preschool children–systematic review. BMC Oral Health 2015;15:44. DOI: 10.1186/s12903-015-0033-7
  46. Mohammadi N, Farahmand Far MH. Effect of fluoridated varnish and silver diamine fluoride on enamel demineralization resistance in primary dentition. J Indian Soc Pedod Prev Dent 2018;36(3):257–261. DOI: 10.4103/JISPPD.JISPPD_4_18
  47. Hansen R, Shirtcliff RM, Ludwig S, et al. Changes in silver diamine fluoride use and dental care costs: a longitudinal study. Pediatr Dent 2019;41(1):35–44.
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