Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children

J Dent. 2012 Nov;40(11):962-7. doi: 10.1016/j.jdent.2012.08.002. Epub 2012 Aug 11.


Objective: To compare the effectiveness of annual topical application of silver diamine fluoride (SDF) solution, semi-annual topical application of SDF solution, and annual application of a flowable high fluoride-releasing glass ionomer in arresting active dentine caries in primary teeth.

Methods: A total of 212 children, aged 3-4 years, were randomly allocated to one of three groups for treatment of carious dentine cavities in their primary teeth: Gp1-annual application of SDF, Gp2-semi-annual application of SDF, and Gp3-annual application of glass ionomer. Follow-up examinations were carried out every six months to assess whether the treated caries lesions had become arrested.

Results: After 24 months, 181 (85%) children remained in the study. The caries arrest rates were 79%, 91% and 82% for Gp1, Gp2 and Gp3, respectively (p=0.007). In the logistic regression model using GEE to adjust for clustering effect, higher caries arrest rates were found in lesions treated in Gp2 (OR=2.98, p=0.007), those in anterior teeth (OR=5.55, p<0.001), and those in buccal/lingual smooth surfaces (OR=15.6, p=0.004).

Conclusion: Annual application of either SDF solution or high fluoride-releasing glass ionomer can arrest active dentine caries. Increasing the frequency of application to every 6 months can increase the caries arrest rate of SDF application.

Clinical significance: Arrest of active dentine caries in primary teeth by topical application of SDF solution can be enhanced by increasing the frequency of application from annually to every 6 months, whereas annual paint-on of a flowable glass ionomer can also arrest active dentine caries and may provide a more aesthetic outcome.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acrylic Resins / administration & dosage*
  • Cariostatic Agents / administration & dosage*
  • Child, Preschool
  • Dental Caries / drug therapy*
  • Dentin / pathology*
  • Female
  • Fluorides / administration & dosage*
  • Fluorides, Topical
  • Glass Ionomer Cements / therapeutic use*
  • Humans
  • Logistic Models
  • Male
  • Quaternary Ammonium Compounds / administration & dosage*
  • Silicon Dioxide / administration & dosage*
  • Silver Compounds
  • Time Factors
  • Tooth, Deciduous


  • Acrylic Resins
  • Cariostatic Agents
  • Fluorides, Topical
  • Glass Ionomer Cements
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • glass ionomer
  • Silicon Dioxide
  • silver diamine fluoride
  • Fluorides