Silver Diamine Fluoride Research Articles

Silver Diamine Fluoride (SDF) Efficacy in Arresting Cavitated Caries Lesions in Primary Molars: A Systematic Review and Metanalysis.

A systematic review and meta-analysis were carried out to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in cavitated primary molars. A search for randomized and non-randomized trials with follow-up > 6 months was performed using PubMed, Scopus and Embase. The Cochrane risk of bias tools were used for the quality assessment. The success rate and odds ratios were chosen to calculate the effect size for the meta-analysis. A total of 792 papers were identified and 9 were selected. A high variability regarding SDF application protocol was found; otherwise, caries arrest was always recorded using visual/tactile methods. Two studies were judged at low risk of bias, six at moderate risk and one at high risk. Data from five studies were aggregated for meta-analysis. Heterogeneity was found moderate (I2 = 35.69%, p = 0.18). SDF application was found to be overall effective (fixed effect model) in arresting caries progression (ES = 0.35, p < 0.01). In a total of 622 arrested lesions, out of 1205 considered, the caries arrest rate was 51.62% ± 27.40% (Confidence = 1.55) using SDF ≥ 38% applied annually or biannually. In conclusion, when applied to active cavitated caries lesions in primary molars, SDF appears to be effective in arresting dental caries progression, especially if applied biannually.

Co-production of an information video on silver diammine fluoride – with children, for children

Introduction Silver diammine fluoride (SDF) is a relatively recent introduction to clinical practice in the UK as a caries management option for children’s primary teeth. However, implementation and uptake are likely to be improved by the availability of child focused information, which is key to ensuring that children understand information about their treatment choices. This study engaged children to co-produce an information video about SDF and explored other children’s opinions about the video. Methods A video was co-produced with children that explained caries management options with a focus on SDF. Children created the content and had substantial input into the editing process. Qualitative semi-structured interviews were carried out with 16 children, aged 4–8 years, based on a topic guide to explore their views on the video. Framework analysis was then performed. Results The video was viewed positively overall although participants did offer diverse views on some specific aspects. The data could be summarised through the following themes: video style and format, caries specific information and views on SDF. Conclusions Our study showed that children recognise the value and utility of an information video co-produced by their peers for provision of information about SDF as a caries management option.

Minimal Intervention Dentistry (MID) mainstream or unconventional option? Study exploring the impact of COVID-19 on paediatric dentists’ views and practices of MID for managing carious primary teeth in children across the United Kingdom and European Union

PurposeTo explore the techniques used to manage carious primary teeth during the COVID-19 pandemic by paediatric dentists and dentists with a special interest in paediatric dentistry (DwSI) who are members of the British Society of Paediatric Dentistry (BSPD) and the European Academy of Paediatric Dentistry (EAPD), and their views on the use of minimal intervention dentistry (MID) in children prior to, during and post the COVID era.MethodsA total of 212 paediatric dentists and DwSI completed an online questionnaire. Six MID techniques were explored: fissure sealants, resin infiltration, Hall Technique (HT), 38% silver diamine fluoride (SDF), atraumatic restorative treatment (ART), stepwise removal and selective caries removal.ResultsThe majority were specialists (26%) followed by clinical academics (23.1%) working mainly in university teaching hospitals (46.2%). Routine dental treatment for children with carious primary teeth was provided by the majority (92.5%) during the pandemic. HT (96%) and 38% SDF (65.7%) were the most commonly used techniques among the BSPD members whereas conventional restoration of non-selective caries removal and pulp therapy remained the most widely used technique among the EAPD members (66.2%). Most of the MID techniques were used as a treatment option (48.1%) rather than a choice (43.4%), with most of these choices having been affected by the patient’s behaviour (82.5%). More than one thirds (39.2%) of the participants were reluctant to adopt MID after the pandemic. Several barriers such as lack of teaching and confidence as well as perceived lack of evidence were identified.ConclusionA range of MID techniques is practiced broadly by a sample of paediatric dentists and DwSI across the United Kingdom (U.K) and European Union (E.U). The majority of clinicians are willing to continue using these techniques going forward after COVID restrictions are lifted. The pandemic served as an opportunity for many dentists to become familiar with various MID practices, such as SDF, which has been already established some time ago.

Best clinical practice guidance for treating deep carious lesions in primary teeth: an EAPD policy document

PurposeThe European Academy of Paediatric Dentistry (EAPD) has developed this best clinical practice guidance to help clinicians manage deep carious lesions in primary teeth.MethodsThree expert groups conducted systematic reviews of the relevant literature. The topics were: (1) conventional techniques (2) Minimal Intervention Dentistry (MID) and (3) materials. Workshops were held during the corresponding EAPD interim seminar in Oslo in April 2021. Several clinical based recommendations and statements were agreed upon, and gaps in our knowledge were identified.ResultsThere is strong evidence that indirect pulp capping and pulpotomy techniques, and 38% Silver Diamine Fluoride are shown to be effective for the management of caries in the primary dentition. Due to the strict criteria, it is not possible to give clear recommendations on which materials are most appropriate for restoring primary teeth with deep carious lesions. Atraumatic Restorative Technique (ART) is not suitable for multi-surface caries, and Pre-formed Metal Crowns (PMCs) using the Hall technique reduce patient discomfort. GIC and RMGIC seem to be more favourable given the lower annual failure rate compared to HVGIC and MRGIC. Glass carbomer cannot be recommended due to inferior marginal adaptation and fractures. Compomers, hybrid composite resins and bulk-fill composite resins demonstrated similar values for annual failure rates.ConclusionThe management of deep carious lesions in primary teeth can be challenging and must consider the patient’s compliance, operator skills, materials and costs. There is a clear need to increase the use of MID techniques in managing carious primary teeth as a mainstream rather than a compromise option.

Evaluation of Micro-shear Bond Strength of Glass Ionomer Cement to Silver Diamine Fluoride Treated Artificial Dentinal Caries

Evaluation of Micro-shear Bond Strength of Glass Ionomer Cement to Silver Diamine Fluoride Treated Artificial Dentinal Caries

Effect of Silver Diamine Fluoride and Potassium Iodide on Micro-tensile and Shear bond strength of Glass Ionomer Restoration to carious Dentin of Primary Molar (In vitro study)

Effect of Silver Diamine Fluoride and Potassium Iodide on Micro-tensile and Shear bond strength of Glass Ionomer Restoration to carious Dentin of Primary Molar (In vitro study)

Knowledge and use of Silver Diamine Fluoride (SDF) by dentists in Lahore: A cross-sectional study

Background: Silver Diamine Fluoride (SDF) has emerged as a promising alternative to the traditional caries management concept of ‘drill and fill’. It offers a conservative, inexpensive, painless and simple way to stop caries progression. Aim: To assess the knowledge and use of Silver Diamine Fluoride among dental practitioners in Lahore. Methodology: A cross-sectional study was conducted after getting institutional ethical approval. A pre-validated questionnaire was used to collect data from 186 dental practitioners. Data was analyzed using SPSS V 25. Results: Among the participants, 101(54.3) were females and 83(44.6%) were males. 30.6% and 47.8% of the participants strongly agreed and agreed to the use of SDF to arrest cavitated lesions. Regarding the barriers in SDF usage, permanent black discoloration was chosen by 70.4%, concern over patient satisfaction by 55.7% and the fact that SDF not restoring tooth anatomy if it is not followed by a restoration by 40.3% of the participants. 72.6% of the participants reported that they have never used SDF, 20.2% sometimes and 7.2% often use SDF. 55.9% of the participants expected an increase infuture usage of SDF. Conclusion: Dentists have a fair knowledge about the use of SDF and its application in clinical practice. However, there is disparity in its use among the dental practitioners due to the black discoloration and concern over parental acceptance. Keywords: Minimally invasive; Silver Diamine Fluoride; Caries arrest

Cost-effectiveness analysis of silver diamine fluoride to divert dental general anaesthesia compared to standard care.

The aim is to perform a model-based cost-effectiveness analysis of a silver diamine fluoride (SDF) protocol intervention to divert dental general anaesthesia (DGA) among Victorian children aged 2-10 years. Data inputs were based on an Australian single-cohort 2017/18 study. Intervention costs for standard care were derived from two subgroups of children: (1) children who received standard care without DGA, and (2) children who received standard care with DGA. Two scenarios were modelled due to limited post-follow-up data: (1) children receiving SDF had standard care without DGA (base-case scenario), and (2) children receiving SDF did not receive standard care without DGA (alternative scenario). A simple decision-tree model with probabilistic sensitivity analysis (PSA) estimated the incremental costs per diverted DGA. The probability of children requiring specialist referral and offered SDF, but the primary carer opted for DGA is 0.124 (SD 0.034), and the probability of children requiring DGA in standard care is 0.346 (SD 0.036). For both the base-case and alternative scenario, the incremental cost-effectiveness ratio outcome is dominant and their cost-effectiveness being either 74.8% or 100% respectively. The SDF protocol intervention is cost-effective dental caries management option for young children where referral for DGA is considered. © 2022 Australian Dental Association.

Principals' Perspectives on Joining a Kindergarten Outreach Dental Service: A Qualitative Study.

In this qualitative study, the researchers explored principals’ perspectives on a free outreach dental service with silver diamine fluoride (SDF) therapy for children in kindergarten. Two researchers recruited kindergarten principals using purposive sampling. They conducted individual semi-structured interviews to collect the principals’ perspectives regarding their adoption of and experience with the service. They manually transcribed the interview verbatim into text and followed a thematic approach for data analysis. The researchers interviewed eight principals. The principals identified the prevalent caries status and importance of oral health promotion for kindergarten children. They acknowledged that the service enhanced dental knowledge, fostered oral hygiene practice and improved children’s oral health. To adopt this service, they needed to ensure adequate capacity to perform the service. They had no concern with staining by SDF because the parents were informed and consented to the SDF therapy. They appreciated the free service provided by a professional team managed by a reputable university. In conclusion, the principals were generally satisfied with the outreach dental service. They realised the necessity of oral health promotion. They found that parents accepted the SDF therapy although the SDF stained their children’s carious teeth. They needed support from their teachers and the children’s parents to run the service.

Fluoride and silver ion concentrations and pH in silver diamine fluoride solutions from Argentina.

The aim of this study was to measure the fluoride (F) and silver (Ag) ion concentration and the pH, over time, of 2 solutions of 38% silver diamine fluoride (SDF) produced in Argentina. The brand Fluorsilver® was established as Group 1 (G1) (Densell), and the brand FAgamin® (Tedequim) as Group 2 (G2), each with two different lots. The following were determined at time 0 (t0) and 30 days after opening (t30): a) fluoride concentration (w/v) by visible spectrophotometry b) Ag content (w/v) by atomic absorption spectrophotometry c) pH. Results: The data in the freshly opened bottles were for G1 lot1/lot2: a) 0.96/1, b) 8.3/7.8, c).11.5/11.3; G2 lot1/lot2: a) 11.5/9.9, b) 39/39, c) 7/6,9; and after 30 days, G1 lot1/lot2: a) 0.85/0.81, b) 7.2/8.2, c) 11.3/11.6; G2 lot1/lot2: a) 9.35/8.43, b) 38/38, c) 7.6/7.6. Conclusion In relation to the expected values (5.0-5.9% fluoride and 24.4-28.8% silver), the average concentration of fluoride and silver ions was lower for G1, but higher for G2. The pH was alkaline for G1 and neutral for G2. Over the 30 days, the content of fluoride and silver tended to decrease.

SMART: Silver diamine fluoride reduces microtensile bond strength of glass ionomer cement to sound and artificial caries-affected dentin.

Silver-modified atraumatic restorative technique (SMART) is an emerging restorative technique; however, the effect of silver diamine fluoride (SDF) application on the bond strength of glass ionomer cement (GIC) is unknown. This study aimed to determine if SDF application to sound and artificial caries-affected dentin (ACAD) immediately prior to GIC restoration affected microtensile bond strength (µTBS). Caries was induced on extracted molars using a pH-cycling protocol that was validated against natural caries (similar µTBS). Dentin surfaces were treated with 38% SDF, control groups with de-ionized water and immediately restored. Beam-shaped specimens were sectioned and subjected to tensile forces for µTBS determination. Two hundred and eighty-seven specimens from 40 teeth were tested. SDF application significantly (p<0.001) reduced µTBS in sound dentin (19.00±8.20 MPa vs. 14.60±6.68 MPa), while no difference was found in ACAD. No difference was found in failure mode among groups. For SMART, SDF application on sound dentin before immediate GIC restoration may decrease bond strength.

Effects of a 445 nm diode laser and silver diamine fluoride in preventing enamel demineralisation and inhibiting cariogenic bacteria

ObjectiveTo study the effects of a 445 nm diode laser (L) and silver diamine fluoride (F) on preventing enamel demineralisation and inhibiting cariogenic bacteria. MethodsThirty-three enamel slices were sectioned each into four blocks for four groups to receive L with F (LF), F, L and Water (W, control). Ten blocks from each group were used to evaluate demineralisation. Surface morphology, lesion depth and nanohardness of the blocks after pH-cycling were studied by scanning electron microscopy (SEM), nanohardness test, and micro-computed tomography, respectively. Twenty-three blocks per group were used for biofilm assessment. Morphology, viability, and growth kinetics of the Streptococcus mutans biofilm were assessed by SEM, confocal laser scanning microscopy, and the counting of colony-forming units (CFUs), respectively. ResultsSEM images of LF-treated enamel showed an intact surface compared with other groups. Nanohardness (GPa) for LF, F, L and W were 1.43±0.17, 1.01±0.11, 1.04±0.13 and 0.73±0.14, respectively (p < 0.001; LF>F, L>W). Their lesion depths (µm) were 46±8, 52±6, 88±13 and 111±9, respectively (p < 0.001; LF, F<L<W). SEM showed few bacteria for LF and F compared with other groups. Their dead-live ratio were 1.67±0.13, 1.60±0.15, 0.39±0.05 and 0.32±0.05, respectively (p < 0.001; LF, F>L>W). Log CFUs for LF, F, L and W were 4.2±0.3, 4.5±0.2, 7.9±0.3 and 9.4±0.2, respectively (p < 0.05; LF<F<L<W). Two-way ANOVA analysis revealed an interaction effect on nanohardness and Log CFUs between the laser irradiation and SDF treatment (p < 0.001). ConclusionThis study showed a superior caries preventive effect of a combined treatment of the diode laser and SDF. Because diode laser and SDF are affordable and readily available, clinicians can provide this treatment to their patients for caries prevention. Clinical significance statementDiode lasers are handy, afforable and readily avaliable to clinicians. This study provides information of use of 445 nm diode laser for caries prevetion. The laser irradiation hopefully can be added before conventional topical SDF application.

Silver Diamine Fluoride Applications in Dentistry: Review Article

The worth of using Silver Diamine Fluoride (SDF) during COVID-19 pandemic has highly increased due to its low invasiveness and non-aerosolizing technique. The blend of silver and fluoride in an alkaline solution has a great action in arresting active enamel and dentin carious lesions, also acting as a desensitizer to lessen dentine hypersensitivity in adults, this review article was conducted to highlight the SDF mechanism of action, clinical applications, and its main indications and contraindications.

Color changes and shear bond strength to simulated caries lesions treated with a novel solution of 20% silver nanoclusters in polymethacrylic acid

The aims of the study were: (1) To compare the staining effect on demineralized dentin simulating caries between silver nanoclusters (AgNCls) synthesized using polymethacrylic acid (PMAA) and silver diammine fluoride (SDF), and (2) to measure the shear bond strength (SBS) of a glass ionomer cement (GIC) to simulated caries lesions with and without the application of AgNCls/PMAA or SDF. Dentine blocks 4 mm thick from twenty-four non-carious third molars were sectioned and coated with nail varnish (Revlon, New York, USA). Simulated caries lesions on occlusal dentin surfaces were created (66 h in 0.05 M acetate buffer 2.2 mM calcium/phosphate pH 5.0). Specimens were divided into groups and treated with (n = 8): (A) 20% AgNCls/PMAA; (B) SDF 38% (Fagamin, Tedequim, Córdoba, Argentina); or (C) without treatment. AgNCls/PMAA or SDF were applied on the exposed surfaces with a microbrush for 10 s. Samples were incubated for 24 h at 37 °C at 100% relative humidity. Surface color was measured according to the CIE-L*a*b* system before and after demineralization (R0 and R1), 24 h and one week after treatment (R2 and R3), using a spectrophotometer (CM-600D Konica Minolta Sesing Inc., Japan). Groups A and B received an extra application of AgNCls/PMAA or SDF before a conventional GIC (Fuji IX-Gold Label, GC Corp, Tokyo, Japan) was bonded using a mold, 4 mm diameter × 3 mm high. For SBS, a Universal Testing Machine (Digimess RS-8000-5, China)—crosshead speed of 1 mm/min—was used. Statistical analysis was performed using ANOVA, Student-t and Scheffe-test at a significance of p < 0.05. Group A presented a stable color p = 0.24 between R1-R2 and R1-R3 in contrast to significant color changes in Group B (p = 0.02). SBS was higher (p < 0.01) in Group A (10.4 ± 2.7 MPa) compared to Groups B (3.3 ± 1.3 MPa) and C (4.0 ± 0.4 MPa), where no differences between the latter groups were observed (p = 0.77). Results of this preliminary study demonstrated that 20% AgNCls/PMAA did not stain simulated carious dentin and improved SBS of the GIC. The relevance of this study relies on the development of a therapeutic system to potentially arrest caries lesions without staining.

Compare the physicochemical and biological properties of engineered polymer-functionalized silver nanoparticles against Porphyromonas gingivalis

BackgroundSome polymer-functionalized AgNPs (P-AgNPs) have been developed to optimize the biological properties of AgNPs. However, there are no studies in the literature comparing the differences in physicochemical and biological properties of AgNPs caused by various polymer-functionalizations and providing evidence for the selection of polymers to optimize AgNPs.MethodsTwo AgNPs with similar nano-size and opposite surface charges were synthesized and functionalized by seven polymers. Their physicochemical properties were evaluated by UV-Visible absorption, dynamic light scattering, transmission electron microscopy and inductively coupled plasma optical emission spectroscopy. Their biological properties against Porphyromonas gingivalis and human gingival fibroblast were investigated by MIC determination, time-dependent antibacterial assay, antibiofilm activity and cell viability assay. Silver diamine fluoride, AgNO3 and metronidazole were used as positive controls.ResultsComparative analysis found that there were no significant differences between P-AgNPs and AgNPs in nano-size and in surface charge. Raman spectroscopy analysis provided evidence about the attachment of polymers on AgNPs. For antibacterial property, among the negatively charged AgNPs, only polyvinylpyrrolidone (PVP)-functionalized AgNPs-1 showed a significant lower MIC value than AgNPs-1 (0.79 vs. 4.72 μg/ml). Among the positively charged AgNPs, the MIC values of all P-AgNPs (0.34–4.37 μg/ml) were lower than that of AgNPs-2 (13.89 μg/ml), especially PVP- and Pluronic127-AgNPs-2 (1.75 and 0.34 μg/ml). For antibiofilm property, PVP-AgNPs-1 (7.86 μg/ml, P = 0.002) and all P-AgNPs-2 (3.42–31.14 μg/ml, P < 0.001) showed great antibiofilm effect against P. gingivalis biofilm at 5* to 10*MIC level. For cytotoxicity, all negatively charged AgNPs and PVP-AgNPs-2 showed no cytotoxicity at MIC level, but significant cytotoxicity was detected at 2.5* to 10*MIC levels.ConclusionAmong the polymers studied, polymer functionalization does not significantly alter the physical properties of AgNPs, but modifies their surface chemical property. These modifications, especially the functionalization of PVP, contribute to optimize the antibacterial and antibiofilm properties of AgNPs, while not causing cytotoxicity at the MIC level.

Silver diamine fluoride therapy for dental care.

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is used to control early childhood caries, arrest root caries, prevent fissure caries and secondary caries, desensitise hypersensitive teeth, remineralise hypomineralised teeth, prevent dental erosion, detect carious tissue during excavation and manage infected root canals. SDF is commonly available as a 38% solution containing 255,000 ppm silver and 44,800 ppm fluoride ions. Silver is an antimicrobial and inhibits cariogenic biofilm. Fluoride promotes remineralisation and inhibits the demineralisation of teeth. SDF also inactivates proteolytic peptidases and inhibits dentine collagen degradation. It arrests caries without affecting dental pulp or causing dental fluorosis. Indirect pulp capping with SDF causes no or mild inflammatory pulpal response. However, direct application of SDF to dental pulp causes pulp necrosis. Furthermore, SDF stains carious lesions black. Patients must be well informed before SDF treatment. SDF therapy is simple, painless, non-invasive, inexpensive, and requires a simple armamentarium and minimal support. Both clinicians and patients generally accept it well. In 2021, the World Health Organization included SDF as an essential medicine that is effective and safe for patients. Moreover, it can be used for caries control during the COVID-19 pandemic because it is non-aerosol-generating and has a low risk of cross-infection.

Evaluation of the Masking Effect of Different Glass Ionomer Restorations following Silver Diamine fluoride and Potassium Iodide Application: An In Vitro Study

Abstract Objectives This is an in vitro study that aimed to evaluate the ability of different glass ionomer restorations to mask the discoloration produced following silver diamine fluoride (SDF) only and after potassium iodide (KI) application. Materials and Methods Thirty-six extracted human adult posterior teeth were collected. Box-shaped cavities (4 × 2 × 2 mm3) were prepared along the cementoenamel junction. Specimens were randomly divided into two major groups according to the materials applied under the restorations group (A) 38% silver diamine fluoride (SDF) followed by immediate application of potassium iodide (KI), group (B) 38% silver diamine fluoride (SDF) only. Each group was further subdivided according to the restorative material applied as follows (n = 6): subgroup (I) zirconia reinforced glass ionomer, subgroup (II) resin-modified glass ionomer restoration, and subgroup (III) high viscous glass ionomer restoration. Color assessment of all specimens was performed using a reflective spectrophotometer. Specimens' color was assessed color of normal dentin then assessed immediately after application of SDF (group A) and after application SDF + KI (group B) with the respective restorative material used. Statistical Analysis Data showed parametric distribution and variance homogeneity and were analyzed using one-way analysis of variance followed by Tukey's post hoc test. Results Intergroup comparisons showed that for SDF and SDF + KI samples, there was a significant difference between the different restorative materials (p &lt; 0.001). For glass ionomer, SDF samples had significantly higher color change value than SDF + KI (p &lt; 0.001), while for RMGI and zirconia reinforced glass ionomer, SDF + KI samples had significantly higher value (p &lt; 0.001) although zirconia reinforced glass ionomer showed the least color change following SDF (6.00 ± 2.74). Conclusion Within the limitations of this study, we could conclude that using zirconia reinforced glass ionomer could have a good masking effect on discoloration produced by SDF. While the resin-modified glass ionomer restoration showed more discoloration and darkening effect even after using of KI. Also, using KI in combination with SDF had a good masking effect on discoloration that produced by SDF.

CHANGES IN PARENTAL SATISFACTION AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PRESCHOOL CHILDREN AFTER RECEIVING ATRAUMATIC RESTORATIVE TREATMENT WITH OR WITHOUT PRIOR SILVER DIAMINE FLUORIDE APPLICATION.

To investigate the short-term and long-term changes in parental satisfaction and oral health-related quality of life (OHRQoL) of preschool children after receiving atraumatic restorative treatment (ART) with or without prior silver diamine fluoride (SDF) application. In a randomized controlled trial, preschool children with cavitated dentine caries lesions in their primary teeth were randomly assigned into two groups to receive either application of SDF solution or placebo (tonic water) on the caries lesions 10 weeks before receiving ART restorations. The information on parental satisfaction and OHRQoL of the children were collected through self-completed questionnaires at baseline, the 6-month and the 24-month follow-up. A five-point scale, from 1 (very dissatisfied) to 5 (very satisfied), was used by parents to indicate their satisfaction with their child's dental conditions. A higher parental satisfaction score indicates that parents were more satisfied with their child's dental condition. In addition, the Chinese version of Early Childhood Oral Health Impact Scale (ECOHIS) was adopted to assess the children's OHRQoL, and a higher ECOHIS score indicates greater negative impacts of oral health on the child's OHRQoL. A total of 194 children participated in this study, with 101 and 93 children receiving SDF and placebo application before ART restorations, respectively. After placement of ART restorations, at 6-month and 24-month follow-up, parental satisfaction scores with their child's dental health status were significantly higher compared with those at baseline (P <.001) indicating the parents were more satisfied at follow-ups. Regarding OHRQoL, no statistically significant changes were found in the child impact section (CIS), family impact section (FIS) and total ECOHIS scores in both study groups at the 6-month follow-up. In contrast, at the 24-month follow-up, the CIS (P = .025) and total ECOHIS scores (P = .015) of the children in the control group were significantly higher than those at baseline (greater negative impacts), but not the FIS score. In this study, after one-off placement of ART restorations irrespective of prior SDF application, short-term and long-term parental satisfaction with their child's dental health status was improved, but not the children's OHRQoL.

Knowledge, Attitude, and Practice Regarding Nonrestorative Cavity Control among Pediatric Dentists: A Questionnaire-Based Cross-Sectional Study

Introduction: According to the worldwide burden of illnesses, unresolved dental decay is one of the most frequent oral diseases. One the significant barriers noticed during dental treatment of the children is fear and anxiety due to conventional treatment procedures. Hence, various dental caries removal and arrest techniques that are noninvasive and child friendly have to be incorporated by the pediatric dentists in their day-to-day practice. Aim: To evaluate knowledge, attitude, and practice regarding nonrestorative cavity control (NRCC) among pediatric dentists in India through the online survey. Materials and Methodology: An online questionnaire-based cross-sectional survey was carried out between January 2021 and May 2021 among the pediatric dentists in India. A structured questionnaire was used to assess the knowledge, attitude, and practice regarding NRCC technique. Self-administered questionnaire with 16 close-ended questions were formulated with multiple choice or Yes-No options. A total of 12 pediatric dentists working only as faculty, 47 only as practitioners, 39 as both faculty and practitioners, and 116 as postgraduate students participated in the study. Results: In the present study, 85% of pediatric dentists were aware about the concept of NRCC but not regarding the steps and the technique used in the concept. Most commonly chosen cariostatic agent was silver diamine fluoride (95.3%) followed by sodium fluoride varnish (86.9%) to use at concentrations 38% and 5%, respectively. 55.6% of the respondents stated that NRCC had various advantages which gave the technique an edge over other conventional techniques, whereas food impaction following slicing of the teeth (52.8%) was the most common disadvantage of this technique. Conclusion: The detailed knowledge related to NRCC is poor and misunderstood by most of the participants; hence, it warrants for the need to increase the awareness regarding this child friendly technique and motivate the pediatric dentists in using the same.

IN VITRO EVIDENCE INDICATES SILVER DIAMINE FLUORIDE PRETREATMENT OF DENTINE MAY REDUCE BOND STRENGTH OF DENTAL ADHESIVES, BUT NOT OF GLASS IONOMER CEMENTS.

Bonding of Glass-Ionomer Cement and Adhesives to Silver Diamine Fluoride-treated Dentin: An Updated Systematic Review and Meta-Analysis. Fröhlich TT, Botton G, Rocha RO. J Adhes Dent. 2022;24(1):29-38. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. Systematic review with meta-analysis of data.