Purpose: To investigate the oral health-related quality of life (OHRQoL) of young children in a randomized clinical trial (RCT) of silver diammine fluoride (SDF) and five percent sodium fluoride varnish (NaFV) to manage early childhood caries (ECC). Methods: Children younger than 72 months of age with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth received two applications of 38 percent SDF and five percent NaFV as part of an RCT testing three different frequency regimes (one, four, and six months apart). The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was completed at three study visits. Statistical analyses included descrip- tive and parametric methods. A P -value of ≤0.05 was significant. Results: Eighty-two children (58.5 percent male) were recruited with a mean age of 44.3±14.2 months. Significant improvement in total ECOHIS scores for all children was observed following treatment (baseline mean scores=4.52±4.77 versus third visit mean scores=3.19±3.78, P =0.01) and family impact scores for all children (base- line mean scores=3.00±2.98 versus third visit mean scores=1.68±2.01, P ≤0.001). However, no significant change in the mean child impact score was observed among all the children ( P =0.97). The parental distress and family function domains showed the most improvement with SDF treatment. No significant ECOHIS score differences were found among the three frequency groups across visits. Conclusions: Children showed better OHRQoL after applying 38 percent SDF and five percent NaFV. No significant differences were found between treatment groups. SDF is a viable non-restorative option for managing ECC as it has a positive effect on OHRQoL.