Background and purpose: Early childhood caries (ECC) is a highly prevalent condition that can progress rapidly, particularly in young children with limited ability to cooperate during dental treatment. Non-invasive fluoride-based therapies, such as silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish, are used to manage early carious lesions. This study aimed to compare the effects of 38% SDF and 5% NaF varnish on salivary pH, caries arrest in primary teeth, and parental acceptance.
Materials and methods: In this randomized, single-blind clinical trial, 60 children aged 6–10 years with active non-cavitated or superficially cavitated carious lesions (ICDAS codes 1-3) were randomly assigned to receive either 38% SDF or 5% NaF varnish. Unstimulated salivary pH was measured at baseline and one week after treatment. Caries arrest was clinically evaluated after three months. Parental acceptance of SDF was assessed using a Likert-scale questionnaire. Statistical analyses included paired and independent t-tests and chi-square tests.
Results: Salivary pH increased significantly in both groups one week after treatment (P< 0.001), with a significantly greater increase in the SDF group. Caries arrest was observed in 96.7% of lesions in the SDF group and 90.0% in the NaF group, with no statistically significant difference between groups (P= 0.301). All parents rated SDF application as painless and easy to administer, and reported acceptable taste and discoloration.
Conclusion: Both SDF and NaF varnish were effective in arresting caries in primary teeth. SDF produced a greater increase in salivary pH at one week than NaF varnish. Given its high parental acceptance and non-invasive nature, SDF may be a useful option for managing early childhood caries, particularly in young children who have difficulty cooperating with conventional dental treatment.
(Clinical Trials Registry Number: IRCT20241019063428N1)