Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries: a randomised clinical trial

Sci Rep. 2024 Apr 7;14(1):8123. doi: 10.1038/s41598-024-58850-w.

Abstract

Knowledge gaps exist regarding optimal silver diammine fluoride (SDF) regimens and the efficacy of new products for arresting dental caries in young children. We evaluated the effectiveness of 38%-SDF (SDI-RivaStar), Tiefenfluorid (TF) comparing with Placebo (P), all in conjunction with behavioural modification (BM), in preventing major complications (endodontic/extractions/pain)-a patient-centred outcome-due to early childhood caries over 12 months in children under 71-months. A six-arm, patient/parent-blinded, superiority, placebo-controlled randomised control trial at the university clinic in Riga, Latvia, from 1/9/20-31/8/22 (Protocol registration ISRCTN17005348). The trial tested six protocols, using three compounds (P/SDF/TF) under two regimes: annual and biannual (P1/P2/TF1/TF2/SDF1/SDF2) for major complications. Secondary outcomes included minor complications and parental satisfaction. All groups received BM. 373/427 randomised children (87.3%) completed the study. SDF2 had a significantly lower rate and risk of major (21.5%, OR = 0.28, 95%CI [0.11, 0.72], p < 0.05) and minor complications (OR = 0.16 (95%CI [0.05, 0.50], p = 0.002). Overall satisfaction was 96% (p > 0.05). SDF biannual application with BM effectively prevented major complications of early childhood caries and was well accepted by children and their parents. Trial registration number: ISRCTN17005348, principal investigator: Ilze Maldupa, registration date: 30/06/2021.Clinical trial registration number: ISRCTN registry: ISRCTN17005348, https://doi.org/10.1186/ISRCTN17005348 , registration date: 30/06/2021.

Keywords: Early childhood caries; Non-invasive caries management; Patient-centred outcomes research; Randomised controlled trial; Silver diammine fluoride.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cariostatic Agents* / therapeutic use
  • Child, Preschool
  • Dental Caries Susceptibility
  • Dental Caries* / drug therapy
  • Dental Caries* / prevention & control
  • Fluoride Treatment
  • Fluorides, Topical / therapeutic use
  • Humans
  • Infant
  • Parents
  • Patient Satisfaction
  • Personal Satisfaction
  • Quaternary Ammonium Compounds / therapeutic use
  • Silver Compounds / therapeutic use
  • Treatment Outcome

Substances

  • Cariostatic Agents
  • Fluorides, Topical
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • silver diamine fluoride

Associated data

  • ISRCTN/ISRCTN17005348