Use Of Silver Diamine Fluoride Research Articles

Silver Diamine Fluoride Use in Children with Special Health-care Needs: Breaking the Barriers

Abstract Dental caries is the most common unmet dental need of children with special health-care needs (SHCNs), and their treatment is challenging in routine dental settings. Based on surplus evidence, silver diamine fluoride (SDF) is a simple, safe, cost-effective, and efficient topical solution for treating dental caries. It is a clear, colorless, odorless fluoride-containing solution, does not require an extensive armamentarium for its application, and can be used in any setting. However, even with worldwide acceptance, there occurs limited research regarding SDF use in children with special needs. This review aims to update the possibilities and acceptability of SDF usage in patients with special needs with dental caries as a promising option for managing dental caries and improving their quality of life.

Knowledge, Attitudes, and Practices About the Use of Silver Diamine Fluoride Among Dentists in Riyadh, Saudi Arabia: A Cross-Sectional Study.

Introduction Dental caries is a worldwide disease affecting children and older populations.There aremultiple interventionsto treatdentalcariesthat could be sometimeshard todeliver,due to the general statusof patientssuch as insufficient cooperationormedicallycompromising conditions. Therefore, another alternative to control dental caries is being used andhasbeenrecentlyintroduced and approved by the Saudi FDA which is silver diamine fluoride (SDF). Objectives This study aimed toinvestigate the level of knowledge, attitudes, and practices about the use of SDF among dentists in Riyadh, Saudi Arabia. Materials and methods Thiscross-sectionalstudywas conductedusingpretested,anonlinedigitally designedquestionnairesentto500 Saudi Commission for Health Specialties (SCFHS) registereddentists working in the following specialties: general practitioners, interns,restorative,family, pediatric, and public health dentistswho are working in public and private hospitals and clinics. One-way ANOVAwas usedto determine the comparison of participants'knowledge and Practice with three variables (participants' specialty, place of work, and years of experience), while Chi-square was used for the comparison of respondent's attitudes about the use of SDF and the above same variables. Result A totalof265responseswerereceived(response rate is53%). Themajority of therespondents were general practitioners and interns 144 (54.3%).Over50% of dentists believedthat theywereveryinformedaboutSDF. The mean score of knowledgeand practices of SDF of participants was found below average 49.13 (19.81) and 43 (26.12), respectively. Correlation ofthemeanscoreknowledgeand practicing SDFwith the type of specialty showed that pediatric dentists had statically significant (P<0.05)higher mean of knowledge 66.94 (SD=17.64)and practicing of SDF 61.93 (22.12) as compared to other specialties,whileno statistically significant differences were found among the groups in the overall knowledge andpractices based on years of experience andworkplace.Attitudeswere correlated with the three above variables (specialty, years of experience, and place of work)and showed thatpediatric dentists had the highest satisfaction with the results of SDF (85.3%)andweremorewilling to recommend using it to others(91.2%) as compared totheother groups(P<0.05).Nostatistically significant differenceswerefound with respect to the latervariables. Conclusion The findings of this studyshowed that irrespective of the positive attitude of participants towards SDF,pediatric dentistswere found to have higher knowledge and use SDF more than other dentists in different specialties. Furthermore, they showed higher satisfaction with its use. Years of experienceand workplace had no effect on the level of knowledge or practice among participants.

Parental acceptability of silver diamine fluoride: The UK and US experiences.

International data suggest that parents may have reservations about the use of silver diamine fluoride (SDF). The aims of this study were to: (1) examine the acceptance of parents/carers towards the use of SDF for the management of caries in children's primary teeth in secondary care dental settings in the UK and the United States and (2) determine which factors may affect the acceptance of the use of SDF. This was a cross-sectional questionnaire of SDF acceptability, completed by parents of young children. It was validated and adapted to local populations. Data were analysed with descriptive and inferential statistics. Of the 113 Sheffield parents, 73% reported that they would accept SDF treatment of children's posterior teeth, with 58% reporting this for anterior teeth. Parents having less concern about posterior aesthetics had a statistically significant effect on reported acceptance of SDF (p = .013). In the Colorado sample (n = 104), 72% reported that they would accept SDF on posterior teeth, and 58% reported that they would accept SDF on anterior teeth. Concerns about aesthetics had an effect on decreasing SDF acceptance overall (p = .0065) in anterior (p = .023) and posterior teeth (p = .108). The majority of parents in the two study populations accepted the treatment using SDF. However, concern about aesthetics had an influence on acceptability.

The use of silver diamine fluoride as a non-invasive treatment option for geriatric and palliative care patients

The use of silver diamine fluoride as a non-invasive treatment option for geriatric and palliative care patients

Disinfection by methylthionine chloride and chitosan in combination with Photo radiation therapy on caries affected dentin nano hardness, adhesive integrity, and bond failure.

The aim of the study was to assess the disinfection efficacy, bond integrity, and nano hardness of caries-affected dentin (CAD) surface bonded to resin cement when disinfected with chlorhexidine (CHX), Methylene blue activated by Photodynamic therapy (MB-PDT), chitosan, silver diamine fluoride (SDF), chitosan activated by PDT, and SDF-diode laser against S. mutans. A total of 60 human mandibular molars were extracted non-traumatically and gathered using ICDAS criteria. The dentin surface was prepared, leaving CAD to receive a disinfection procedure. After inoculation with S. mutans, the CAD samples were divided into six groups and disinfected with various disinfectants (n = 10) CHX, MB-PDT, chitosan, chitosan-PDT, SDF, and SDF+ diode laser. Survival rates of S. mutans were analyzed following the restoration of samples with resin cement via the etch and rinse method to assess SBS. Also, nano hardness was analyzed. Statistical analysis was performed by using the ANOVA and the Tukey multiple test (p<0.05). The Kruskal-Wallis test was used to evaluate the change in survival rate. Related to the survival rates, the SDF+ diode laser displayed the highest reduction in S. mutans levels and chitosan presented the lowest level of disinfection. The intergroup comparison revealed that CHX and chitosan-PDT displayed comparable outcomes of S. mutans survival rate to that of SDF+ diode laser (p>0.05). Likewise, MB-PDT and SDF displayed a comparable survival rate of S. mutans to Chitosan disinfection (p>0.05). Considering SBS and nano hardness, the highest SBS and NH were exhibited by the SDF+ diode laser, and the lowest SBS and NH values were exhibited by MB-PDT. The intragroup comparison revealed that CAD specimens disinfected with Chitosan-PDT showed comparable SBS and NH values to the SDF+ diode laser (p>0.05). CHX, chitosan, and SDF exhibited bond values and NH comparable to MB-PDT (p<0.05). Synergistic use of Silver diamine fluoride with diode laser and chitosan activated by PDT can be used as an alternative to CHX for controlling S. mutans growth, promoting enhanced bond efficacy and nano hardness for bonding resin cement to the caries-affected dentin.

The use of silver diamine fluoride in dentistry: A literature review

The use of silver diamine fluoride in dentistry: A literature review

Clinical Findings Arising from the Use of Silver Diamine Fluoride to Prevent or Treat Caries Lesions and Dentinal Hypersensitivity: A Data Mining Analysis

Clinical Findings Arising from the Use of Silver Diamine Fluoride to Prevent or Treat Caries Lesions and Dentinal Hypersensitivity: A Data Mining Analysis

Silver Diamine Fluoride

BACKGROUND Silver diamine fluoride can be used as an intervention or treatment for active and progressing untreated carious lesion not involving the pulp among children in slums, remote areas, rural areas and other underserved and un-served communities. Silver diamine fluoride stains teeth after use and it is available in different concentrations like 10 % , 12%, 30% and 38%. METHOD An electronic literature search in African journals online and Science direct was done in September , 2023 using the Population, Concept and Context framework. Search terms and keywords were combined by Boolean operators. Two independent investigators screened titles and abstracts of publications on silver diamine fluoride use among children. Original (primary) research articles with accessible full text were included for review, while review articles, systematic reviews, viewpoints, books, letters, thesis, editorials, book chapters, dissertations, perspectives were among articles excluded during screening. Original research articles involving teeth (in-vitro studies) were also excluded during screening. RESULTS Abstract and full texts were screened using inclusion criteria by two independent investigators. One article with accessible full text was included as it was assessed to meet the inclusion criteria and aim of the review. The study design was a randomised controlled clinical trial and it was carried out in Egypt. CONCLUSION Silver diamine fluoride (SDF) is a simple, non-aerosol-generating, painless, non-technique sensitive treatment procedure for active carious lesion not involving the pulp. More studies from diverse ethnic population in Africa countries will fill the gaps in knowledge and add to the existing literature.

Acceptance of silver diamine fluoride use in community dwelling older adults, nursing home residents, and caregivers

ObjectivesTo compare the level of acceptance of silver diamine fluoride (SDF) treatment between different functional groups of older adults aged 65-years-old and above. MethodsThree groups were recruited representing functionally-independent (“Community dwelling”), frail (“Nursing home”), and functionally-dependent older adults (“Caregiver”: proxy respondent involved in caring for an older adult of all functional levels). Participants viewed a video on SDF and an interviewer-led questionnaire collected demographics, dental experience and perception on SDF use. ResultsThe study recruited 201 participants (100 “Community dwelling”, 51 “Nursing home”, 50 “Caregiver”). Overall, 73 % of participants were accepting of SDF treatment. Those in the “Community dwelling” group were most accepting (85 %), followed by the “Nursing home” group (61 %) and “Caregiver” group (60 %) (p<0.001). Participants were more accepting of SDF use on posterior (73 %) compared to anterior teeth (46 %). They were more accepting when SDF was presented as a treatment to avoid infection and pain (87 %), and general anesthesia (78 %). In a regression analysis, “Nursing home” and “Caregiver” participants were three times less likely to accept SDF (OR 0.27 [95 % CI: 0.13 to 0.60], and OR 0.27 [95 % CI: 0.12 to 0.58] respectively) compared to “Community dwelling” participants. After adjusting for other factors, only the “Caregiver” group remained significant (Adjusted OR 0.32 [95 % CI: 0.13 to 0.78]). ConclusionsOlder adults were accepting of SDF and this treatment modality has the potential to be a routine treatment option in dental caries management in this population. However, this was less certain among frail and functionally dependent older adults. CLINICAL SIGNIFICANCEAn SDF program to manage caries is likely to be well-received by functionally-independent older adults. However, the acceptance among frail and functionally-dependent older adults were lower even though SDF is mostly likely to benefit these populations. There is a need to investigate this relatively lower levels of acceptance.

Audit: The use of silver diamine fluoride in a community dental service.

Audit: The use of silver diamine fluoride in a community dental service.

Impact of the COVID-19 pandemic on oral health care use in the United States through December 2021

BackgroundThe purpose of this study was to assess the effects of the COVID-19 pandemic on oral health care provided from July 2020 through December 2021 using national claims data. MethodsDeidentified quarterly claims from 2017 through 2021 were analyzed (2017-2019 provided prepandemic data). Data were sorted into multiple treatment categories. Analyses compared prepandemic with postpandemic procedure volumes and were stratified according to age groups (0-5 years, 6-18 years, 19-64 years, ≥ 65 years). ResultsFor children aged 0 through 5 years, use of sealants and topical fluorides other than varnish were considerably lower in 2021, as were direct operative and palliative procedures from 2020 through 2021. Only use of silver diamine fluoride, prefabricated crowns, and oral surgery increased significantly (P < .05) in some quarters. For children aged 6 through 18 years, diagnostic, direct operative, periodontic, oral surgery, and palliative procedures were significantly lower in most of 2020 through 2021, and only prefabricated crowns and indirect operative procedures increased significantly in more than 3 quarters. For adults aged 19 through 64 years, diagnostic and preventive procedures were significantly lower in 3 quarters, and direct operative, gingival surgery, endodontic, and palliative procedures were significantly lower in most of 2020 through 2021. Only occlusal guards and scaling and root planing increased significantly in more than 3 quarters. For adults 65 years and older, direct operative, gingival and osseous surgery, and palliative procedures were significantly lower in more than 3 quarters; all other procedures increased significantly in more than 3 quarters. ConclusionsThe pandemic was associated with changes in the provision of oral health care that persisted for more than 1 year. Practical ImplicationsReductions in preventive procedure volumes across age groups younger than 65 years may have implications for longer-term effects of the pandemic.

A multi-site service evaluation of silver diamine fluoride use for children

Introduction The use of silver diamine fluoride (SDF) is relatively new to the UK. It is unknown how it is being used and for what indications in UK paediatric dental services.Aim To: 1) establish how SDF is being used across different paediatric dental settings in the UK; and 2) consider parental and patient views on the treatment experience and side effect of discolouration.Method A multi-site service evaluation was carried out across six paediatric dentistry units covering hospital and community services. Data were collected prospectively from 17/02/2020 to 02/03/2022. Simple descriptive statistics were used to analyse the data.Results Data were collected for 54 patients. The included patients had an age range of 2-13 years, with a mean of 4.9 years. The reason SDF was chosen was reported as: to avoid general anaesthetic (n = 25); to avoid extractions (n = 8); stabilisation (n = 25); acclimatisation (n = 24); and insufficient cooperation for other treatment (n = 17). In total, 42 cases had SDF applied to the primary dentition. This was in the anterior dentition for 18 patients and the posterior dentition for 15, with nine patients having SDF applied both anteriorly and posteriorly. The majority of children and parents were accepting of the technique and immediate aesthetic outcome.Conclusion In the services involved in this multi-site service evaluation, SDF is used for young patients in the primary dentition for the purpose of caries arrest. The technique was viewed positively by the majority of parents and children.

Caries arrest using silver diamine fluoride: Knowledge, attitude, and perception of parents in Saudi Arabia.

The objective was to assess the current knowledge, attitudes, and perceptions of parents toward the use of Silver Diamine Fluoride in children's primary teeth and identify related factors. In this cross-sectional study, data were collected from Parents of pediatric patients who had appointments at the King Saud University Pediatric Dentistry Clinic and several private clinics in Riyadh, Saudi Arabia from Jan to April 2021. A simple random sampling method was used. An electronic questionnaire was designed to collect data regarding participants' demographics and their knowledge, attitude, and perception toward the use of SDF for their children. A higher proportion of parents/relatives (87.3%) was strongly satisfied with the speed of treatment and its benefits. In terms of disadvantages, 23.8% and 30.4% of the parents/relatives were satisfied and dissatisfied, respectively (P < 0.05). Regarding attitudes, the majority of participants 22.8% responded as neutral to using SDF to treat their children's anterior primary teeth (P < 0.05), whereas 32.2% agreed to the use of SDF in their children's posterior primary teeth (P < 0.05). A higher proportion of parents/relatives who were in the age group of >50 years (27.8%) had responded as "satisfied" compared with the responses of other age groups (P < 0.05). The present study demonstrates that SDF is acceptable among Saudi parents/relatives to arrest dental caries. However, pigmentation of anterior teeth is a major concern.

Use of Silver Diamine Fluoride and Glass Ionomer Cement (SMART-Silver Modified Atraumatic Restorative Treatment) In Pediatric Dentistry

Using silver diamine fluoride and glass ionomer cement (SMART-Silver Modified Atraumatic Restorative Treatment) in pediatric dentistry can provide a cost-effective, fast, and non-invasive approach to restoring cavities. Silver diamine fluoride is a liquid fluoride that prevents cavity-causing germs from spreading. This can be paired with glass ionomer cement to fill cavities and restore tooth structure. This therapy technique also takes less time than typical restorative treatments so that children may be treated sooner and with fewer disturbances to their daily life. Silver diamine fluoride and glass ionomer cement have become popular in pediatric dentistry for treating cavities due to their numerous benefits. This literature review comprehensively assesses the utilisation of Silver Diamine Fluoride (SDF) and Glass Ionomer Cement (GIC) in pediatric dentistry in the context of SMART-Silver Modified Atraumatic Restorative Treatment. It summarises the findings of existing literature regarding the dental procedures, treatment approaches, and materials used for the treatment, as well as the clinical outcomes, advantages, limitations, and potential applications. SMART-Silver Modified Atraumatic Restorative Treatment is an effective and minimally invasive technique that is particularly useful during the current COVID-19 pandemic, as it does not require any aerosol output while allowing dental caries to be managed without local anaesthesia in a timely, efficient, and cost-effective manner [1]. It also eliminates the need for extracting and replacing decayed teeth, thus restoring dental health and overall quality of life. In addition, the Silver-modified Atraumatic Restorative Technique is an ideal approach for managing preschool caries, as it can halt and control the progression of caries without adversely affecting any surrounding healthy tooth structures. This review establishes the utility of SMART-Silver Modified Atraumatic Restorative Treatment and underlines its effectiveness in pediatric dentistry, particularly today. Treatment and underlines its effectiveness in pediatric dentistry, particularly today. Keywords: Anaesthesia, Dentistry, Cavities, COVID-19 pandemic, Dental caries, Glass ionomer cement, Invasive, Pediatric, silver diamine fluoride, SMART-silver modified atraumatic restorative treatment

Parental Acceptance of Silver Diamine Fluoride Treatment for Carious Lesions

Objectives The purpose of this study was to determine parental acceptability of the use of Silver Diamine Fluoride (SDF) as an alternative treatment for carious legions. In addition, we examined potential factors influencing higher levels of SDF acceptance. Methods Project was approved by the institutional review board. Parents of patients receiving care at Nova Southeastern University’s dental clinics were asked to review an educational document related to the use and side effects of SDF; surveys were then distributed to assess willingness to use this treatment for their child. SDF acceptance was measured by mean scores on the SDF Feasibility Questionnaire; higher scores indicated higher levels of SDF acceptance. Descriptive statistics were calculated to describe the sample (N=160) in terms of demographic and patient characteristics, and previous behavioral and dental visit characteristics. Bivariate logistic regression models were used to predict higher SDF acceptability by patient demographics, and behavioral and dental visit characteristics. Results Over half of the sample was male (62%), and ages 1-10 (65%); 38% were diagnosed with Autism Spectrum Disorder (ASD). In terms of dental history, 51% reported having a cavity, and 27% had been treated with nitrous oxide, 19% had oral sedation and 14% had general anesthesia. Those reporting the previous use of oral sedation had two times higher odds of SDF acceptance score (OR 2.2; [95% CI 0.99, 4.85], p=.05). Demographics, diagnosis of ASD, previous cavities and behavior during treatment had no impact on SDF acceptance. Conclusion Findings suggest that SDF was more acceptable among those with a history of oral sedation, perhaps because SDF is a less time-consuming and risky procedure. In addition, given that oral conscious sedation does not guarantee cooperation and can take multiple, time consuming appointments, SDF may be a more feasible alternative.

Effect of Silver Diamine Fluoride on Caries Arrest and Prevention

Dental caries is the most common global childhood disease. To control caries, the Centers for Disease Control and Prevention recommends school-based caries prevention, and the World Health Organization lists glass ionomer cement and silver diamine fluoride as essential medicines for oral disease. To determine the noninferiority of silver diamine fluoride with fluoride varnish vs traditional glass ionomer sealants with fluoride varnish after 2 years when provided to children via a school-based health care program. The CariedAway study is an ongoing single-blind, cluster randomized, noninferiority trial conducted between February 1, 2019, and June 1, 2023, among 2998 children in 47 New York City primary schools. Children aged 5 to 13 years of any race and ethnicity were recruited from block-randomized schools. Inclusion criteria for schools were a student population of at least 50% Hispanic or Latino or Latina ethnicity and/or Black race and at least 80% of students receiving free or reduced-cost lunch. Statistical analysis is reported through March 2022. Children received a single application of silver diamine fluoride with fluoride varnish or an active comparator of glass ionomer sealants and atraumatic restorations with fluoride varnish. Primary outcomes were caries arrest and incidence after a 2-year follow-up, assessed using mixed-effects multilevel models and clustered 2-sample proportion tests. The noninferiority margin was 10%. Intention-to-treat analysis was performed using multiple imputation. A total of 2998 children (1566 girls [52.2%]; mean [SD] age at baseline, 6.6 [1.2] years; 1397 Hispanic or Latino or Latina children [46.6%]; 874 [29.2%] with untreated dental caries) were recruited and treated from September 16, 2019, to March 12, 2020. Follow-up observations were completed for 1398 children from June 7, 2021, to March 2, 2022. The mean (SE) proportion of children with arrested caries was 0.56 (0.04) after experimental treatment and 0.46 (0.04) after control treatment (difference, -0.11; 95% CI, -0.22 to 0.01). The mean (SE) proportion of patients without new caries was 0.81 (0.02) after experimental treatment and 0.82 (0.02) after control treatment (difference, 0.01; 95% CI, -0.04 to 0.06). Analysis of imputed data for the full sample did not deviate from per-protocol analyses. There were no adverse events. In this randomized clinical trial, silver diamine fluoride with fluoride varnish was noninferior to sealants and atraumatic restorations with fluoride varnish for caries arrest and prevention. Results may support the use of silver diamine fluoride as an arresting and preventive agent in school-based oral health programs. ClinicalTrials.gov Identifier: NCT03442309.

Estimation of fluoride ion concentration in urine after application of silver diamine fluoride in patients with severe early childhood caries.

Despite the University of California San Francisco, the American Academy of Pediatric Dentistry (AAPD), and the Food and Drug Administration having approved the use of silver diamine fluoride (SDF) in arresting dentinal caries, literature available on its systemic absorption is limited. This study aimed to assess any systemic absorption of fluoride ion following the topical application of SDF in young children. Children aged between 3 and 6 years who were diagnosed with severe early childhood caries and required rehabilitation were recruited for the study. Before the onset of treatment for the arrest and control of caries, a baseline urine sample as a control was collected from the patient. In accordance with the manufacturer's instructions and AAPD guidelines, SDF was topically applied on a minimum of five carious teeth, following which additional urine samples were collected after 2 h and after 24 h, respectively, of application of SDF. The urine samples were stored at -20°C, and the estimation of fluoride ion concentrations in urine was then ascertained using a fluoride ion selective electrode. The results revealed that the fluoride concentration in urine before application of SDF was 0.66 mg/L ± 0.25 mg/L, and following 2 h of application, it was 1.13 mg/L ± 0.23. However, 24 h postapplication, the urinary fluoride concentration was reduced to 0.63 mg/L ± 0.20, which is close to the baseline value of the control sample. There was no significant systemic absorption of fluoride following the application of SDF, and it could be adopted as an effective and safe agent in the armamentarium for managing caries in young children.

Knowledge, awareness and attitude among dentists of North India regarding use of Silver Diamine Fluoride (SDF) in preventing dental caries.

AIM- To evaluate the knowledge, awareness and attitude of the dentist from North India towards Silver Diamine Fluoride (SDF) use in preventing dental caries. MATERIALS AND METHODS- An online survey was conducted among dentists of North India using online questionnaire to assess the knowledge, experience, and attitude of dentists regarding the use of SDF. 107 dentists participated in the online survey. Data obtained were analysed statistically. RESULTS-Most participants revealed they were somewhat taught about SDF. 29 % of the participants agreed that SDF can be used as an alternative to the conventional method of caries removal. Nearly about 32.7 % of the participants do not know regarding the application protocol interval for SDF. CONCLUSION- Knowledge about SDF among dental practitioners in North India was low to moderate. Increasing SDF knowledge among dentists may serve as an alternative for treating young patients who cannot co-operate with the traditional dental treatment. Keywords: Dental Caries, Questionnaires, Silver Diamine Fluoride, Survey.

Antibacterial effect and impact on caries activity of nanosilver fluoride and silver diamine fluoride in dentin caries of primary teeth: a randomized controlled clinical trial

BackgroundThe use of silver diamine fluoride (SDF) in caries treatment in children has increased despite the disadvantage of causing tooth discoloration. Nanosilver fluoride (NSF) is a possible alternative. This study aimed to assess the antibacterial effect of NSF and SDF and their impact on the activity of dentin caries in primary teeth.MethodsSynthesis and characterization of the physical and biological properties of NSF were conducted. Fifty children aged 4–6 years with dentin caries (active caries corresponding to ICDAS code 5) in deciduous teeth were randomly assigned to treatment by NSF or SDF. Baseline assessment of Streptococcus mutans (S. mutans) and lactobacilli counts as CFU/mL in caries lesions was done, followed by the application of the agents. After one month, microbiological samples were recollected, and lesion activity was reassessed. Groups were compared using Mann–Whitney and Chi-Square tests, while intragroup comparisons were done using Wilcoxon and McNemar tests. Multilevel logistic regression analysis was used to assess the effect of different variables on the outcomes.ResultsThere were 130 teeth in 50 children; mean ± SD age = 4.75 ± 0.76 years, 63% were posterior teeth. At the one-month follow-up appointment, both groups showed a significant decrease from baseline bacterial counts. There was a significant difference in the reduction of S. mutans between NSF and SDF (21.3% and 10.5%, respectively, p = 0.002), while not in lactobacilli (13.9% and 6.0%, respectively, p = 0.094). In both groups, there was a significant reduction in the number of active caries from baseline (p < 0.0001) with no significant difference between groups (percentage inactive = 64.4% and 63.4%, p = 0.903). Multilevel regression revealed non-significant differences in S. mutans and lactobacilli counts (AOR 1.281, p = 0.737 and 1.888, p = 0.341, respectively), and in the number of inactive lesions (AOR 1.355, p = 0.731) between groups.ConclusionThe short-term antibacterial efficacy of NSF was similar to that of SDF. In both groups there was a significant reduction of S. mutans and lactobacilli counts in active dentin caries, and two-thirds of the lesions became inactive with no differences between the two interventions. Further research is needed to investigate the long-term efficacy of NSF and its suitability for clinical use in caries management.Trial registration: This trial was prospectively registered on the clinicaltrials.gov registry with ID: NCT05221749 on 03/02/2022.

Silver Diamine Fluoride in Pediatric Dentistry

The use of Silver Diamine Fluoride (SDF) in pediatric dentistry has lately been gaining recognition and acceptance among dentists and parents. SDF has shown effectiveness in arresting dental caries in primary teeth in children. This review article states a brief history of the use of SDF in dentistry, advantages, disadvantages, indications, contra indications and clinical application of SDF.