Survival of Silver Diamine Fluoride Varnish Treated Teeth among Children with Single/Multiple Applications: A Split-mouth Randomized Clinical Trial

Introduction: Utilizing 38% silver diamine fluoride (SDF) has been demonstrated in clinical trials to prevent and halt early childhood caries (ECC). Based on a research evaluation, it has been found that 38% SDF can effectively prevent new tooth decay and stop existing tooth decay in children's primary teeth.

Objective: This study aimed to assess the survival of teeth treated with repeated applications of 38% SDF in children with ECC and to compare the outcomes between single and multiple applications.

Materials and methods: A split-mouth, double-blind, active-control, parallel-arm randomized controlled trial was conducted following Consolidated Standards of Reporting Trials (CONSORT) guidelines. Children aged 4-5 years with bilateral ECC were recruited from a primary government school in Maharashtra, India. Treatment involved applying 38% SDF to carious lesions, with lesions randomized into two groups: single application and double application. Follow-ups were conducted at 6 and 12 months to assess lesion progression, depth, and survival.

Results: Eighty-four primary carious teeth from 42 female participants were included. Lesions were predominantly occlusal or proximal, with varying sizes and depths. After 12 months, 12 lesions failed in group I (single application) and 3 in group II (double application). The intergroup comparison of mean levels at 12 months showed a statistically significant difference (p = 0.01). Intragroup comparisons showed an increase in lesion depth and level from baseline to 6 months, with a subsequent rise from 6 to 12 months in group I. The mean survival rate of teeth after SDF application at the end of 12 months was around 94% for group II, while for group I it further decreased from 70 to 58%.

Conclusion: Repeated applications of 38% SDF showed improved survival rates of teeth in children with ECC compared to single applications. Double application of SDF demonstrated superior efficacy in maintaining tooth survival over 12 months.

How to cite this article: Kharat PB, Rajpurohit L, Mathur A, et al. Survival of Silver Diamine Fluoride Varnish Treated Teeth among Children with Single/Multiple Applications: A Split-mouth Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(11):1211-1218.