Parental Acceptance of Silver Diammine Fluoride for Managing Early Childhood Caries: A Mixed Method Study.

Purpose: To explore parents' perceptions, acceptance and concerns regarding the use of silver diammine fluordie (SDF) to manage early childhood caries (ECC).

Methods

The authors conducted interviews with 39 parents whose children had participated in a randomized clinical trial using SDF to manage ECC. A mixed-methods design was employed: thematic analysis for open-ended responses and descriptive analysis for closed-ended questions.

Results

Parental acceptance of SDF was strongly linked to trust in the dentist (100%), its painless application (97.4%), absence of anesthesia, needles or drilling (92.3%), and its ability to reduce pain (97.4%). Most parents appreciated the fast treatment (89.7%) and limited alternatives during the pandemic (89.7%). Nearly all participants (94.9%) reported they would choose SDF again, with higher acceptance for posterior teeth (87.2% vs. 69.2% for anterior teeth). Additionally, 74.4% preferred SDF over restorations. Thematic analysis highlighted 4 key areas: (1) acceptance of SDF, (2) pain and comfort, (3) reactions to color change and (4) concerns and uncertainties.

Conclusions

Parents valued SDF as a safe, effective and non-invasive option for managing ECC, particularly given its ability to avoid drilling, needles and anesthesia. However, esthetic concerns about staining underscored the need for clear provider-parent communication and ongoing education about treatment limitations and the importance of follow-up applications for successful caries arrest.