A randomized clinical trial to arrest dentin caries in young children using silver diamine fluoride

J Dent. 2020 Aug:99:103375. doi: 10.1016/j.jdent.2020.103375. Epub 2020 May 16.


Objectives: The study aimed to compare the effectiveness of 38% silver diamine fluoride (SDF) solution, and 5% sodium fluoride (NaF) varnish applied semiannually in arresting dentin caries in young children with high caries risk.

Methods: Children aged 1-3 years who had at least one active dentin carious lesion were randomly allocated into 2 groups as follows: Group 1 = 38% SDF (Topamine), and Group 2 = 5% NaF varnish (Duraphat). Both agents were applied every 6 months onto the carious surface. Lesion activity was assessed by the visual-tactile examination. Baseline and follow-up examinations were conducted by the same examiner. The children's demographic background, oral health-related habits, and oral hygiene practices, as well as parental satisfaction with children's dental appearance were collected at baseline and the 12-month follow-up.

Results: At baseline, 153 and 149 children were recruited in Group 1 and Group 2, respectively. The mean dmfs scores in Groups 1 and 2 were 8.89 and 9.79, respectively. After 12 months, 87.1% remained in the study. The caries arrest rate of Group 1 (35.7%) was significantly higher than that of Group 2 (20.9%) (p < 0.001). The results of the multilevel logistic regression analysis confirmed that the treatment in Group 1 was more effective in arresting dentin carious lesions than that of Group 2 (OR = 2.04; 95% CI, 1.41-2.96). The presence of plaque on caries lesions, tooth type, tooth surface type, frequency of milk feeding, snack taking, and family income influenced on caries activity. Regardless of the intervention groups, there were no differences in parental satisfaction with on the child's dental appearance before and after receiving the intervention.

Conclusion: Based on the 12-month results, 38% SDF is more effective than 5% NaF varnish in arresting dentin carious lesions in young children. SDF has no negative impact on parental satisfaction with the child's dental appearance.

Clinical significance: To control dentin carious lesions in young children with high caries risk, 38% SDF is more effective than 5% NaF varnish.

Keywords: Children; Dental caries; Early childhood caries; Fluoride varnish; Silver diamine fluoride.

Publication types

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

MeSH terms

  • Cariostatic Agents* / therapeutic use
  • Child
  • Child, Preschool
  • Dental Caries* / drug therapy
  • Dental Caries* / prevention & control
  • Dentin
  • Fluorides, Topical / therapeutic use
  • Humans
  • Infant
  • Quaternary Ammonium Compounds / therapeutic use
  • Silver Compounds / therapeutic use


  • Cariostatic Agents
  • Fluorides, Topical
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • silver diamine fluoride