Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial
Abstract Background Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC l...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Oral Health |
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| Online Access: | https://doi.org/10.1186/s12903-023-03597-5 |
| _version_ | 1827707987399016448 |
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| author | Enas B. Abdellatif Mona K. El Kashlan Maha El Tantawi |
| author_facet | Enas B. Abdellatif Mona K. El Kashlan Maha El Tantawi |
| author_sort | Enas B. Abdellatif |
| collection | DOAJ |
| description | Abstract Background Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS. Methods Children aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents’ satisfaction with their children’s appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated. Results The study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children’s appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23). Conclusion SDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC. Trial registration This trial was registered in the clinicaltrials.gov registry (#NCT05642494). |
| first_indexed | 2024-03-10T16:57:19Z |
| format | Article |
| id | doaj.art-e1441b429b2b4363aaef364a78ec73fa |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-03-10T16:57:19Z |
| publishDate | 2023-11-01 |
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| spelling | doaj.art-e1441b429b2b4363aaef364a78ec73fa2023-11-20T11:07:13ZengBMCBMC Oral Health1472-68312023-11-012311910.1186/s12903-023-03597-5Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trialEnas B. Abdellatif0Mona K. El Kashlan1Maha El Tantawi2Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria UniversityDepartment of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria UniversityDepartment of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria UniversityAbstract Background Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS. Methods Children aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents’ satisfaction with their children’s appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated. Results The study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children’s appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23). Conclusion SDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC. Trial registration This trial was registered in the clinicaltrials.gov registry (#NCT05642494).https://doi.org/10.1186/s12903-023-03597-5Early childhood cariesSilver diamine fluorideSodium fluoride varnishChildrenEnamel cariesDentin caries |
| spellingShingle | Enas B. Abdellatif Mona K. El Kashlan Maha El Tantawi Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial BMC Oral Health Early childhood caries Silver diamine fluoride Sodium fluoride varnish Children Enamel caries Dentin caries |
| title | Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial |
| title_full | Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial |
| title_fullStr | Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial |
| title_full_unstemmed | Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial |
| title_short | Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial |
| title_sort | silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries a 6 months follow up of a randomized field trial |
| topic | Early childhood caries Silver diamine fluoride Sodium fluoride varnish Children Enamel caries Dentin caries |
| url | https://doi.org/10.1186/s12903-023-03597-5 |
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