Arrest of interproximal caries lesion in primary molars with 38% silver diamine fluoride solution and 5% sodium fluoride varnish: A randomized clinical trial.

BACKGROUND

Dental caries is a global public health concern, with interproximal caries presenting a particular challenge due to their limited accessibility. Fluoride has long been employed in the prevention and management of early-stage carious lesions.

AIM: To evaluate and compare the effectiveness of 38% silver diamine fluoride (SDF) and 5% sodium fluoride varnish (NaF) in arresting interproximal caries in primary molars.

SETTINGS AND

DESIGN

A split-mouth randomized clinical trial was conducted following the CONSORT guidelines.

METHODS

Children aged 5-9 years with at least two noncavitated interproximal carious lesions (ICCMS stages RA1-RB4) were included. Teeth were randomly assigned to receive either 38% SDF (Group 1) or 5% NaF varnish (Group 2), applied biannually. Caries arrest was assessed radiographically as primary outcome at 6, 9, and 12 months.

STATISTICAL ANALYSIS: Descriptive statistics summarized the data. Normality was confirmed through the Shapiro-Wilk test, permitting parametric analysis. Paired and unpaired t-tests assessed intra- and inter-group differences, respectively, and Chi-square tests analyzed the categorical variables. A two-tailed α =0.05 and power of 80% were applied.

RESULTS

At the 12-month follow-up, the caries arrest rate was 76.31% in Group 1 and 47.3% in Group 2, showing a statistically significant difference (P < 0.05). The arrest rates for 38% SDF at RA1, RA2, RA3, and RB4 were 90.9%, 88%, 80%, and 37.5%, respectively, compared to 80%, 60%, 22.2%, and 0% for 5% NaF varnish.

CONCLUSION

SDF demonstrated greater effectiveness than NaF varnish in arresting interproximal caries in primary molars, particularly in lesions involving dentin.